Validation of the Portuguese version of functional assessment of cancer therapy-fatigue (FACT-F) in Brazilian cancer patients.

GOALS OF WORK: The purpose of this study was to validate the Portuguese version of the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) in order to establish its assessment properties, including validity and reliability in a sample of Brazilian cancer patients. MATERIALS AND METHODS: Two hundred seventy patients with different types of cancer were included for this study; the mean age was 50.5 years. The reliability was assessed by internal consistency and reproducibility. Construct validity was assessed through convergent validity and discriminant validity. Convergent validity was examined by comparing the FACT-F to the SF-36. Discriminant validity of the FACT-F evaluated the ability of the scale to differentiate defined groups, discriminating patients according to Eastern Cooperative Oncology Group Performance Status and different stages of disease. MAIN RESULTS: FACT-F had high internal consistency (Cronbach alpha coefficient was 0.78 for physical well-being, 0.68 for social/family well-being, 0.75 for emotional well-being, 0.74 for functional well-being, 0.91 for fatigue, and 0.92 for total FACT-F). The range of test-retest intraclass correlation was from 0.72 to 0.91 (p < 0.0001). The Pearson product correlation revealed good correlations between the total FACT-F and subscales of the SF-36 in most dimensions, ranging from r = 0.51 to r = 0.76, except for SF-36 physical (r = 0.31). The positive correlations between the SF-36 vitality scale and FACT-F total (r = 0.76) and the fatigue subscale (r = 0.77) support the convergent validity. CONCLUSIONS: The Portuguese version of FACT-F is a reliable and valid instrument to assess quality of life and fatigue, representing a valid tool to screen cancer-related fatigue in Brazilian cancer patients.

Phantom limb phenomena in cancer amputees.

PURPOSE: The objective of this study was to determine the prevalence of phantom pain and correlated conditions such as phantom sensations and stump pain in a population of cancer patients who had undergone limb amputation. METHOD: A cross-sectional study was carried out in adult patients submitted to limb amputation, who were being followed up at the Physiotherapy Department between April 3 and November 30, 2006. The presence of phantom pain and associated conditions was quantified using a verbal numerical scale. The data obtained were analyzed for means, medians, and proportions with their respective confidence intervals, as appropriate. RESULTS: Seventy-five patients participated in this study, 50 men (66.7%) and 25 women (33.3%). Mean age was 54.4 years (SD +/- 18.5); range 19 to 88 years. The prevalence of phantom pain was 46.7% (95%CI: 35.1 to 58.6), phantom sensation 90.7% (95%CI: 81.7 to 96.2), and surgical stump pain 32.0% (95%CI: 21.7 to 43.8). CONCLUSION: Phantom pain and phantom sensations are highly prevalent among cancer patients. Further studies should be carried out to determine the main factors associated with their onset.

Reproducibility of functional assessment of Cancer therapy-fatigue (FACT-F) questionnaire for cancer patients

Objective: The objective of this study was evaluating the reproducibility in Portuguese of Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire for cancer patients by applying it according to the test-retest method. Material and Methods: Subjects were 85 cancer patients with an average age of 51.0 years, being 56 (65.9%) women and 29 (34.1%) men. FACT-F questionnaire consists of 40 items, divided in five domains, and is applied for evaluating quality of life and fatigue in patients with cancer. We used as a measuring tool intraclass correlation coefficient values obtained from two measures of test-retest and scatter plot proposed by Bland-Altman. Results: In 36.5% of cases the questionnaire was self-administered, and in 63.5% of the cases read by an interviewer and filled after verbal answer. Intraclass correlation coefficient values found for the domains were: physical well-being 0.72; social/family well-being 0.91; emotional well-being 0.90; functional well-being 0.86; fatigue subscale 0.88, and for the FACT-F 0.91. The Bland-Altman plot showed to be adequate, since most points were within the limits of reliability. Conclusions: FACT-F questionnaire in Portuguese has good test-retest reproducibility in patients with different types of cancer, performance status and stages.

Fadiga em pacientes com câncer de mama em tratamento adjuvante / Fatigue in patients with breast cancer in adjuvant treatment

Em pacientes com câncer em tratamento adjuvante a fadiga é altamente prevalente e é um sintoma debilitante e crônico. O objetivo deste estudo foi analisar, na literatura científica, a prevalência e curso da fadiga em pacientes com câncer de mama em tratamento adjuvante. A revisão da literatura foi realizada a partir da base de dados online Pubmed, para o período entre janeiro de 1996 e setembro de 2004, utilizando os seguintes descritores: fatigue e breast cancer. O total de artigos obtidos por meio dessa busca foi de 108. Foram identificados 14 artigos que atendiam aos critérios de inclusão para este estudo. A fadiga ocorreu entre 1% e 94% dos pacientes com câncer, e foi medida por meio de instrumentos específicos em nove estudos. A fadiga aumentou durante a radioterapia, permaneceu com um platô e retornou ao nível pré-tratamento meses após o seu término. Durante a quimioterapia observou-se que houve aumento da sua prevalência e severidade e que ela é maior durante os primeiros dias após a quimioterapia em relação ao período entre os ciclos. Muitos dos estudos revelaram que a fadiga está significativamente associada a vários fatores físicos, biológicos e comportamentais sendo que quando relacionada ao câncer ela é multidimensional. Devem ser realizadas mais pesquisas controladas, principalmente em mulheres brasileiras com câncer de mama. Estas pesquisas devem avaliar grupos mais homogêneos e com instrumentos válidos e confiáveis para melhor conhecimento da fadiga nesta população e propiciar melhora da qualidade de vida das pacientes.

Fatigue is a highly prevalent and a debilitating and chronic symptom in patients with cancer in adjuvant treatment. The objective of this study was to analyze in scientific literature the prevalence and course of fatigue in patients with breast cancer in adjuvant treatment. The literature review was carried through from the on-line Pubmeddatabase between January 1996 and September 2004, using the following key words: "fatigue and breast cancer".The total numbers of article found in this search was 108. Among those, 14 articles had been identified that metthe inclusion criteria for this study were identified. The fatigue occurred between 1% and 94% in patients with cancer, and was measured by specific instruments in nine studies. The fatigue increased during radiotherapy, remained as a plateau and returned to the pre-treatment level some months after radiotherapy was finished. Duringthe chemotherapy it was observed the increase of its prevalence and severity, and the fatigue is higher during thefirst days after the chemotherapy, when compared to the period between the cycles. Many studies had disclosed that the fatigue is significantly associated with some physical, biological and behavioral facts and, when it is relatedto cancer it is multidimensional. More controlled research must be carried in the future, mainly in Brazilian women with breast cancer. Research with more homogeneous groups and with valid instruments for better knowledgeof the fatigue in this population is important in order to improve the quality of life of these patients.

Avaliação de equipamentos de ultra-som para fisioterapia segundo a norma NBC 1689 da associação brasileira de normas técnicas

Este trabalho apresenta a avaliação de 33 equipamentos de ultra-som para fisioterapia utilizando uma metodologia baseada na Norma NBR-IEC 1689. Os equipamentos analisados são de fabricação nacional e estrangeira, com tempo de uso variado, de diversas marcas e modelos, utilizados em serviços públicos e privados na cidade de Rio de Janeiro. Os parâmetros avaliados foram: área de radiação efetiva do cabeçote aplicador, intensidade acústica efetiva, freqüência ultra-sônica de trabalho, relação de não uniformidade do feixe, intensidade máxima do feixe, tipo de feixe, forma de onda de modulação para o modelo pulsátil, fator de operação e exatidão do temporizador. Nenhum dos equipamentos atendeu completamente a norma.

This work presents an evaluation of 33 ultrasound equipments used in physiotherapy, based on the norm IEC 1689. The tested equipments have a broad range or characteristics; from public and private services located in the city of Rio de Janeiro. The evaluated parameters were: effective radiating area, acoustic effective intensity, acoustic frequency, beam non-uniformity ratio, beam maximum intensity, beam type, acoustic pulsed waveform, duty factor and timer. None of the tested equipments satisfied, completely, the norm.