Functional independence and spirometry in adult post-intensive care unit patients. / Independência funcional e espirometria em pacientes adultos pós-unidade de terapia intensiva.

OBJECTIVE: To relate functional independence to the degree of pulmonary impairment in adult patients 3 months after discharge from the intensive care unit. METHODS: This was a retrospective cohort study conducted in one adult intensive care unit and a multi-professional post-intensive care unit outpatient clinic of a single center. Patients admitted to the intensive care unit from January 2012 to December 2013 who underwent (3 months later) spirometry and answered the Functional Independence Measure Questionnaire were included. RESULTS: Patients were divided into groups according to the classification of functional independence and spirometry. The study included 197 patients who were divided into greater dependence (n = 4), lower dependence (n = 12) and independent (n = 181) groups. Comparing the three groups, regarding the classification of the Functional Independence Measure, patients with greater dependence had higher Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment values at intensive care unit admission with more advanced age, more days on mechanical ventilation, and longer stay in the intensive care unit and hospital. The majority of patients presented with pulmonary impairment, which was the obstructive pattern observed most frequently. When comparing functional independence with pulmonary function, it was observed that the lower the functional status, the worse the pulmonary function, with a significant difference being observed in peak expiratory flow (p = 0.030). CONCLUSION: The majority of patients who returned to the outpatient clinic 3 months after discharge had good functional status but did present with pulmonary impairment, which is related to the degree of functional dependence.

OBJETIVO: Relatar a independência funcional e o grau de comprometimento pulmonar em pacientes adultos 3 meses após a alta da unidade de terapia intensiva. MÉTODOS: Este foi um estudo de coorte retrospectiva conduzido em uma unidade de terapia intensiva multiprofissional para pacientes adultos em um único centro. Incluíram-se pacientes admitidos à unidade de terapia intensiva entre janeiro de 2012 e dezembro de 2013 que, 3 meses mais tarde, foram submetidos à espirometria e responderam ao questionário Medida de Independência Funcional. RESULTADOS: Os pacientes foram divididos em grupos segundo sua classificação de independência funcional e espirometria. O estudo incluiu 197 pacientes, que foram divididos entre os grupos maior dependência (n = 4), menor dependência (n = 12) e independente (n = 181). Na comparação dos três grupos com relação à classificação pela Medida de Independência Funcional, pacientes com maior dependência tinham escores Acute Physiology and Chronic Health Evaluation II e Sequential Organ Failure Assessment mais altos quando da admissão à unidade de terapia intensiva, idade mais avançada, mais dias sob ventilação mecânica e tempo mais longo de permanência na unidade de terapia intensiva e no hospital. A maioria dos pacientes apresentava comprometimento pulmonar, sendo o padrão obstrutivo o mais frequentemente observado. Na comparação da independência funcional com a função pulmonar, observou-se que, quanto pior a condição funcional, pior a função pulmonar, observando-se diferenças significantes em relação ao pico de fluxo expiratório (p = 0,030). CONCLUSÃO: Em sua maioria, os pacientes que retornaram ao ambulatório 3 meses após a alta tinham boa condição funcional, porém apresentavam comprometimento pulmonar relacionado com o grau de dependência funcional.

Adaptation and cross-cultural validation of the Brazilian version of the Warwick-Edinburgh mental well-being scale.

OBJECTIVE: the Warwick-Edinburgh mental well-being scale (WEMWBS) was designed to assess the level of mental well-being of a population or specific groups. The scale consists of 14 items covering functional psychological aspects, as well as well-being. The final score is calculated by adding up the response of each item, ranging from 1 to 5, obtaining a result from 14 to 70 points. METHODS: the procedure was developed in accordance with the protocol recommended by the World Health Organization covering translation, back translation, semantic equivalence, expert evaluation of the previous steps, pre-test and final version of the instrument. Following, the final version was applied to a sample of 122 individuals and the data were subjected to descriptive statistical analysis, factor analysis, internal consistency and correlation with other validated instruments. RESULTS: we performed the instrument's adaptation to the Portuguese spoken in Brazil, replacing terms to approximate the language to expressions of everyday life. The final version showed similar results to those from the original version, demonstrated by factor analysis, internal consistency (Cronbach's alpha: 0.89) and positive correlation with instruments validated to the Portuguese language. CONCLUSION: the Brazilian version of the WEMWBS proved to be easy to use and understand, showed high internal consistency and construct validity similar to the original instrument.

Adaptation and cross-cultural validation of the Brazilian version of the Warwick-Edinburgh mental well-being scale / Adaptação e validação transcultural da versão brasileira da escala de bem-estar mental de Warwick-Edinburgh.

Summary Objective: the Warwick-Edinburgh mental well-being scale (WEMWBS) was designed to assess the level of mental well-being of a population or specific groups. The scale consists of 14 items covering functional psychological aspects, as well as well-being. The final score is calculated by adding up the response of each item, ranging from 1 to 5, obtaining a result from 14 to 70 points. Methods: the procedure was developed in accordance with the protocol recommended by the World Health Organization covering translation, back translation, semantic equivalence, expert evaluation of the previous steps, pre-test and final version of the instrument. Following, the final version was applied to a sample of 122 individuals and the data were subjected to descriptive statistical analysis, factor analysis, internal consistency and correlation with other validated instruments. Results: we performed the instrument's adaptation to the Portuguese spoken in Brazil, replacing terms to approximate the language to expressions of everyday life. The final version showed similar results to those from the original version, demonstrated by factor analysis, internal consistency (Cronbach's alpha: 0.89) and positive correlation with instruments validated to the Portuguese language. Conclusion: the Brazilian version of the WEMWBS proved to be easy to use and understand, showed high internal consistency and construct validity similar to the original instrument. .

Resumo Objetivo: a escala de bem-estar mental de Warwick-Edinburgh (EBEMWE) foi desenhada para avaliar o nível de bem-estar mental de uma população em geral ou de grupos específicos. A escala é constituída por catorze itens, abrangendo aspectos funcionais psíquicos, assim como bem-estar. O escore final é calculado pela soma das respostas de cada item, cujo valor varia de 1 a 5, obtendo um resultado total de 14 a 70 pontos. Métodos: o processo foi desenvolvido de acordo com o protocolo da Organização Mundial da Saúde (OMS), abrangendo tradução, retrotradução, equivalência semântica, avaliação de especialistas das etapas anteriores, pré-teste do instrumento e versão final. Na sequência, a versão final foi aplicada em uma amostra de 122 indivíduos, e os dados obtidos foram submetidos a tratamento estatístico descritivo, análise fatorial, avaliação da consistência interna e correlação com outros instrumentos validados. Resultados: realizou-se adequação do instrumento para o português utilizado no Brasil, substituindo termos para aproximar a linguagem às expressões do dia a dia. A versão final apresentou resultados similares à versão original, demonstrados pela análise fatorial, pela consistência interna (alfa de Cronbach: 0,89) e pela correlação positiva com instrumentos validados para a língua portuguesa. Conclusão: a versão brasileira da EBEMWE mostrou-se de fácil aplicação e compreensão, apresentou alta consistência interna e similar validade de construto ao instrumento original. .