Psychometric Properties of the Healthy Lifestyle Behaviors Scale in Portuguese Pregnant Women.

BACKGROUND: Pregnancy provides a privileged and opportune moment to implement interventions promoting healthy lifestyle behaviors and significantly improving perinatal outcomes. The Healthy Lifestyle Behaviors Scale (HLBES) can be used to assess health promoting behaviors, such as diet, physical activity, and mental health. PURPOSE: This study aimed to examine the psychometric properties of the HLBES in Portuguese pregnant women. METHODS: A methodological study was conducted on a convenience sample of 192 pregnant women receiving prenatal care. After cross-cultural adaptation, an exploratory factor analysis and internal consistency assessment were carried out to evaluate the psychometric properties of the scale. Data collected included the Healthy Lifestyle Beliefs Scale to assess the HLBES' criterion validity. RESULTS: Exploratory factor analysis with Varimax rotation yielded 2 subscales that explained 45.23% of the total variance. The scale revealed an overall internal consistency of 0.78 and a good criterion validity with the Healthy Lifestyle Beliefs Scale (r = 0.65, P < .01). CONCLUSION: Our results suggest that the HLBES is an instrument for reporting healthy lifestyle behaviors in Portuguese pregnant women; however, further studies are recommended. This scale can be used to not only describe healthy lifestyle behaviors in pregnant women but also to determine the effects of health promoting interventions.

Validation and Psychometric Assessment of the Practice Environment Scale of the Nursing Work Index in the Portuguese Hospital Context.

BACKGROUND: The nursing work environment has an impact on patient safety outcomes and its measurement should be a regular practice. PURPOSE: To assess the reliability and construct validity of the Practice Environment Scale of the Nursing Work Index in the Portuguese context. METHODS: An exploratory factor analysis followed by a confirmatory factor analysis to assess model adjustment quality was performed with a sample of 3,686 nurses. RESULTS: The final solution for the exploratory factor analysis comprised 26 items and five factors (56.6% of the total variance). The confirmatory factor analysis, after refinement, showed a stable factor structure. CONCLUSIONS: The final model showed good construct validity and high reliability, which supports the decision to exclude the items that are not essential to the construct being measured.

Positive impact of the Portuguese smoking law on respiratory health of restaurant workers.

The impact of smoke-free law on the respiratory and sensory symptoms among restaurant workers was evaluated. Fifty-two workers in 10 Portuguese restaurants were interviewed before and 2 years after implementation of the smoke-free law. A significant reduction in self-reported workplace environmental tobacco smoke (ETS) exposure was observed after the enforcement of the law, as well as a marked reduction in adverse respiratory and sensory symptoms such as dry, itching, irritated, or watery eyes, nasal problems, and sore or dry throat or cough, between pre- and post-ban. This study demonstrates that the smoking ban was effective in diminishing the exposure symptoms among workers and consequently in improving their respiratory health. These observations may have implications for policymakers and legislators in other countries currently considering the nature and extent of their smoke-free workplace legislation.

The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure.

BACKGROUND: The systolic pulmonary artery pressure (PAPs) can be accurately estimated, non-invasively, using continuous-wave Doppler (CWD) ultrasound measurement of the peak velocity of a tricuspid regurgitant (TR) jet. However, it is often difficult to obtain adequate tricuspid regurgitation signals for measurement of PAPs, what could lead to its underestimation. Therefore, utilization of air-blood-saline contrast has been implemented for the improvement of Doppler signal in several clinical contexts. It is now recommended in the evaluation of patients with pulmonary hypertension. Physical activity is severely restricted in patients with PAH, being exertional dypnea the most typical symptom. Exercise stress echo-Doppler imaging allows assessment of the response to exercise. It is an excellent screening test for patients with suspected PAH. Our purpose was to evaluate the value and accuracy of agitated saline with blood contrast echocardiography, in the improvement of the Doppler signal, to quantify PAPs during treadmill exercise-echocardiography. PURPOSE: To evaluate the value of contrast echocardiography, using agitated saline with blood, in the improvement of the Doppler signal used to quantify the pulmonary artery systolic pressure during exercise. METHODS: From a total of 41 patients (pts), we studied 38 pts (93%), 35 women, aged 54 +/- 12 years-old. 27 with the diagnosis of systemic sclerosis, 10 with history of pulmonary embolism and one patient with a suspected idiopathic PAH, who were referred to the Unity of Heart Failure and Pulmonary Hypertension for screening of PAH. According to the Unity protocol, a transthoracic echocardiogram was made, in left decubitus (LD), with evaluation of right ventricle-right atria gradient (RV/RAg). A peripheral venous access was obtained, with a 3-way stopcock and the patients were placed in orthostatism (O), with a new evaluation of RV/RAg. Exercise echocardiography (EE) was begun, with evaluation of RV/RAg at peak exercise (P) and afterwards agitated saline (8 cc with 1 cc of air and 1 cc of blood) was injected, followed by a new evaluation of RV/RAg (PC) and then the interruption of the EE. Pulmonary Hypertension was diagnosed when RV/RAg at the end of the exercise was superior to 40 mmHg. RESULTS: The quality of Doppler signal was deteriorated in 5 pts, maintained in 6 pts and improved in 26 pts, with the use of contrast. In one patient, an interventricular septal defect was diagnosed. In 6 pts, a Doppler signal was only obtained with the use of contrast. In 15 pts, a RV/RAg superior to 40 mmHg was only obtained with the use of contrast. Of these, 9 have already been submitted to right heart cathetherism, that confirmed the diagnosis of pulmonary hypertension in 5 of them (56%). RV/RAg (P) was 44 +/- 11 mmHg and RV/RAg (PC) was 54 +/- 11 mmHg, p < 0,001. CONCLUSION: 1. The method is applicable in a large number of patients. 2. RV/RA gradients obtained at peak exercise are higher with the use of contrast, and the clinical meaning of this difference should be evaluated in a larger number of pts submitted to right heart cathetherism. The high number of false positives should lead to a higher diagnostic threshold. 3. This method seems to have relevant clinical value in the diagnosis of pulmonary arterial hypertension.