RESUMEN
OBJECTIVE: Using the large Rome Foundation Global Epidemiology Survey dataset, the aim of this study was to evaluate the construct and convergent validity and internal consistency of the PHQ-4 across both gastrointestinal and non-gastrointestinal condition cohorts. Another aim was to provide descriptive information about the PHQ-4 including means, confidence intervals and percentage of caseness using a large representative sample. METHODS: A cross-sectional survey was conducted in 26 countries. Confirmatory factor and internal consistency analyses were conducted across subsamples of patients with gastrointestinal conditions (i.e., disorders of gut-brain interaction [DGBI; any DGBI, individual DGBI, and DGBI region], gastroesophageal reflux disease (GERD), coeliac disease, diverticulitis, inflammatory bowel disease (IBD), cancer anywhere in the gastrointestinal tract, peptic ulcer) and those without a gastrointestinal condition. Convergent validity was also assessed via a series of Pearson's correlation coefficients with PROMIS (physical and mental quality of life), and PHQ-12 (somatisation). RESULTS: Based on 54,127 participants (50.9% male; mean age 44.34 years) confirmatory factor analysis indicated acceptable to excellent model fits for the PHQ-4 across all subsamples and individual DGBI and DGBI region (Comparative Fit Index >0.950, Tucker-Lewis Index >0.950, Root Mean Squared Error of Approximation <0.05, and Standardised Root Mean Square Residual <0.05). The PHQ-4 was found to demonstrate convergent validity (Pearson's correlation coefficients >±0.4), and good internal consistency (Cronbach's α > 0.75). CONCLUSIONS: This study provides evidence that the PHQ-4 is a valid and reliable tool for assessing mental health symptomology in both gastrointestinal and non-gastrointestinal cohorts.
Asunto(s)
Enfermedades Gastrointestinales , Humanos , Masculino , Estudios Transversales , Femenino , Adulto , Enfermedades Gastrointestinales/psicología , Persona de Mediana Edad , Reproducibilidad de los Resultados , Cuestionario de Salud del Paciente/normas , Psicometría , Calidad de Vida , Análisis Factorial , AncianoRESUMEN
OBJECTIVE: The Patient Health Questionnaire-9 (PHQ-9) is a widely used self-report measure of depression whose psychometric properties were found to be merely acceptable. Insufficient attention has been devoted to its clinimetric validity, while its clinical utility is still debated, particularly for assessing depression severity. This is the first study to test the PHQ-9 construct validity and clinical utility based on clinimetric principles. METHODS: An online survey of 3,398 participants was conducted. Item response theory models (Rasch and Mokken analyses) were used to assess the PHQ-9 validity and determine its clinical utility. RESULTS: Fit to the Rasch model was achieved after adjusting the sample size. Items 2, 4, 6, and 9 over-discriminated, while items 1, 5, and 7 under-discriminated. Local dependency between items 2 and 6 was indicated. The PHQ-9 was not unidimensional. A Loevinger's coefficient of 0.49 was found, indicating an acceptable level of scalability. CONCLUSION: The PHQ-9 is an instrument with potential clinical utility as an overall index of depression, mainly for screening purposes. Substantial revision, particularly in the wording of over- and under-discriminating items, is needed.
Asunto(s)
Depresión , Cuestionario de Salud del Paciente , Psicometría , Humanos , Femenino , Masculino , Adulto , Reproducibilidad de los Resultados , Persona de Mediana Edad , Cuestionario de Salud del Paciente/normas , Depresión/diagnóstico , Depresión/psicología , Autoinforme/normas , Adulto Joven , Adolescente , Anciano , Encuestas y Cuestionarios/normasRESUMEN
Background: Patient Health Questionnaire (PHQ-9) has nine questions and is used in diabetic or hypertensive patients to detect depressive symptoms. The PHQ-2 uses the first two questions of the PHQ-9 to rapidly detect those patients that should answer the whole questionnaire. Aim: To validate the PHQ-2 to detect depressive symptoms in diabetic or hypertensive patients consulting at Primary Health Care (PHC). Material and Methods: Secondary analysis of data obtained during the baseline assessment of a clinical trial. Diabetic and hypertensive patients aged 18 years or more, attending a public health care clinic of Metropolitan Santiago, were invited to participate. Those accepting, answered the Patient Health Questionnaire (PHQ-9), consisting in nine questions about depressive symptoms. Demographics and health data were also collected. The PHQ-2 capacity to discriminate PHQ-9 scores equal or higher than 10 and 15 and the correlation between both versions, were assessed. Results: Ninety-four participants aged 64 ± years (73% women) answered the questionnaire. A cut-off score of 3 or more points in the PHQ-2 achieved the best tradeoff between sensitivity and specificity for discriminating PHQ-9 scores equal or higher than 10 (area under the receiver operating characteristic curve (ROC) = 0.92, 95% confidence interval [95% CI] = 0.87 to 0.97) and 15 points (area under the ROC curve = 0.95, 95% CI = 0.92 to 0.99). Both versions had a high positive correlation (r = 0.87). Conclusions: The PHQ-2 allows a stepped, simple and accurate screening for depressive symptoms. Diabetic or hypertensive patients with 3 or more points should be immediately assessed with the remaining questions of the PHQ-9.
Asunto(s)
Adolescente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Depresión/diagnóstico , Diabetes Mellitus , Cuestionario de Salud del Paciente , Psicometría , Tamizaje Masivo , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Diabetes Mellitus/psicología , Cuestionario de Salud del Paciente/normasRESUMEN
Atualmente, o Gothenburg Trismus Questionnaire (GTQ) é o único questionário de qualidade de vida específico sobre trismo. A afecção, definida como restrição à abertura da boca, gera prejuízo a atividades habituais como comer, engolir, falar e fazer a higiene oral, trazendo grande desconforto aos pacientes. A tradução de questionários de qualidade de vida desempenha um importante papel no conhecimento da saúde das populações nos diferentes países. O objetivo do presente estudo é apresentar a validação do GTQ para a língua portuguesa, a fim de permitir sua aplicação efetiva nas populações de idioma português. O GTQ foi validado com sucesso para a língua portuguesa conforme os seguintes passos: Tradução, Retradução (back translation), Adaptação cultural e Revalidação.
Currently, the Gothenburg Trismus Questionnaire (GTQ) is the only quality-of-life questionnaire specific for the assessment of trismus. The disease, characterized by limited mouth opening, impairs usual activities such as eating, swallowing, talking, and performing oral hygiene, causing great discomfort to patients. Translation of quality-of-life questionnaires plays an important role in promoting health awareness in the populations of different countries. This study aimed to validate the Portuguese version of the GTQ to allow its effective application in Portuguesespeaking populations. The Portuguese version of the GTQ was successfully validated through the following steps: translation, back translation, cultural adaptation, and revalidation.
Asunto(s)
Humanos , Calidad de Vida , Traducción , Trismo/cirugía , Trismo/complicaciones , Trismo/radioterapia , Estudio de Evaluación , Cuestionario de Salud del Paciente/normas , Cuestionario de Salud del Paciente/estadística & datos numéricosRESUMEN
Objetivo: deste trabalho foi determinar a prevalência e nível de ansiedade ao atendimento odontológico de gestantes de João Pessoa, Brasil, além de analisar a sua relação com fatores socioeconômicos. Métodos: o presente estudo é caracterizado por ser transversal do tipo observacional, a amostra foi composta por 360 gestantes atendidas nas Unidades de Saúde da Família na Cidade de João Pessoa/Brasil. Foram aplicados a dental anxiety scale e um questionário estruturado, por meio do qual foram investigados fatores socioeconômicos. Na análise estatística, foi empregado o teste de c². O nível de significância adotado foi de 5 porcento. Resultados: a prevalência de ansiedade entre as gestantes foi de 96,4 porcento. A maioria (41,1 porcento) apresentou alto nível de ansiedade (p < 0,001). A média de idade das gestantes foi 23,4 ± 5,9 anos. Em relação ao estado civil, a maioria das gestantes era casada (35 porcento). A renda familiar revelada apresentou média de 610,07 reais, sendo 92 porcento abaixo de dois salários mínimos. Oitenta e nove gestantes (24,7 porcento) estavam no primeiro trimestre, frente à maioria (47,8 porcento), no segundo trimestre (p > 0,05). Conclusões: a maioria das gestantes apresentou ansiedade, de nível alto. Os fatores socioeconômicos investigados não revelaram associação com a presença de ansiedade. Evidencia-se a necessidade de atenção odontológica durante a gestação com medidas direcionadas a redução da ansiedade ao atendimento odontológico(AU)
Objetivos: determinar la prevalencia y el nivel de ansiedad a la atención dental para embarazadas de João Pessoa, Brasil, y analizar su relación con factores socioeconómicos. Métodos: la muestra consistió en 360 mujeres embarazadas inscritas en las Unidades de Salud de la Familia en la ciudad de João Pessoa, Brasil. Se aplicó la escala de ansiedad dental y un cuestionario estructurado, a través del cual los factores socioeconómicos fueron investigados. En el análisis estadístico se utilizó la prueba c2. El nivel de significación fue de 5 por ciento. Resultados: la prevalencia de ansiedad entre las mujeres embarazadas fue del 96,4 por ciento. La mayoría (41,1 por ciento) mostró altos niveles de ansiedad (p < 0,001). La edad media de las madres fue de 23,4 ± 5,9 años. En cuanto al estado civil, la mayoría de las madres estaban casadas (35 por ciento). En cuanto al ingreso de la familia había un promedio de 610,07, el 92 por ciento por debajo de dos salarios mínimos. Un total de 89 pacientes (24,7 por ciento) correspondió al primer trimestre, en comparación con la mayoría (47,8 por ciento) en el segundo trimestre (p > 0,05). Conclusión: la mayoría de las mujeres tenían ansiedad de alto nivel. Los factores socioeconómicos investigados no mostraron asociación con la presencia de ansiedad. Este estudio pone de relieve la necesidad de cuidado dental durante el embarazo y las medidas destinadas a reducir la ansiedad en el cuidado dental(AU)
Objectives: determine the prevalence and level of dental anxiety among pregnant women from Joao Pessoa, Brazil, and analyze its relationship to socioeconomic factors. Methods: the sample consisted of 360 pregnant women registered with Family Health Units in the city of Joao Pessoa, Brazil. The study was based on the Dental Anxiety Scale and a structured questionnaire through which socioeconomic factors were surveyed. The chi-square test was used for statistical analysis, with a significance of 5 percent. Results: the prevalence of anxiety among pregnant women was 96.4 percent. Most (41,1 percent) showed high anxiety levels (p < 0,001). The mean age of mothers was 23,4 ± 5,9 years. As to marital status, most mothers were married (35 percent). Average family income was 610,07, with 92,percent below two minimum salaries. A total 89 patients (24,7 percent) were in their first quarter, whereas most (47,8 percent) were in their second quarter (p > 0,05). Conclusion: most women had high level anxiety. The socioeconomic factors studied did not show any association with the presence of anxiety. The study revealed the importance of dental care during pregnancy and the measures aimed at reducing dental anxiety(AU)