Predictors of hope among women with breast cancer during chemotherapy.

OBJECTIVE: Identifying the predictors of hope in patients with breast cancer during chemotherapy treatment. METHOD: A prospective longitudinal study. The sample was composed of 122 women who responded to the instruments of hope, anxiety and depression, coping, fatigue, religiosity and self-esteem in the first and last cycle of chemotherapy. These variables were used in adjusting the logistic regression model that characterized multivariate statistics, allowing identification of predictor variables. RESULT: The increase of hope at the end of chemotherapy treatment was statistically significant (p = 0.012). The delay in undergoing treatment from the onset of breast cancer symptoms, Karnofsky Performance Status, depression, self-esteem and pain were characterized as factors being associated to hope by univariate analysis. Among the variables analyzed, pain was the only predicting factor of hope. CONCLUSION: Pain was the predicting factor in this sample. Hope increased during treatment and revealed the following associated factors: Karnofsky Performance Status, delay in starting the treatment, depression, self-esteem and pain. This study brought forth a multidisciplinary contribution, allowing for understanding the factors that can influence hope and presenting support to nursing care. The data evidenced conditions of improvement or worsening of hope, which requires interdisciplinary attention in Oncology. OBJETIVO: Identificar os fatores preditores da esperança nas pacientes com câncer de mama em tratamento quimioterápico. MÉTODO: Estudo prospectivo longitudinal. A amostra foi de 122 mulheres que responderam aos instrumentos de esperança, ansiedade e depressão, coping, fadiga, religiosidade e autoestima no primeiro e no último ciclo de quimioterapia. Essas variáveis foram utilizadas no ajuste do modelo de regressão logística que caracterizou a estatística multivariada permitindo a identificação das variáveis preditoras. RESULTADO: O aumento da esperança ao final do tratamento quimioterápico foi estatisticamente significante (p = 0,012). A demora na realização do tratamento desde o início dos sintomas do câncer de mama, o Karnofsky Performance Status, a depressão, a autoestima e a dor foram caracterizadas como fatores associados à esperança pela análise univariada. Dentre as variáveis analisadas, a dor apresentou-se como o único fator preditor da esperança. CONCLUSÃO: A dor foi o fator preditor nesta amostra. A esperança aumentou durante o tratamento e revelou os fatores associados: Karnofsky Performance Status, demora no início do tratamento, depressão, autoestima e dor. Este estudo trouxe uma contribuição multidisciplinar, permitiu compreender os fatores que podem influenciar a esperança e apresentou subsídios à assistência de enfermagem. Os dados evidenciaram condições de melhora ou agravamento da esperança, o que requer atenção interdisciplinar em Oncologia.

[Factors associated to the quality of life of adolescents with type 1 diabetes mellitus]. / Fatores associados à qualidade de vida de jovens com diabetes mellitus do tipo 1.

The objective of this study was to perform a literature review of the factors that may influence the Health Related Quality of Life (HRQL) of adolescents with type 1 diabetes mellitus using the PICO strategy. PubMed/MEDLINE, ISI Web of Knowledge and EMBASE were the databases used. A larger survey of articles was possible by combining standardized and non-standardized descriptors. Though HRQL is a specific construct used to evaluate aspects related to the repercussions of health, illness, and treatment, it appears that sociodemographic, psychosocial, and family-related aspects have a significant effect on HRQL.

[Locus of control in health and self-esteem in type-2 diabetic patients]. / Lócus de controle em saúde e autoestima em portadores de diabetes mellitus tipo 2.

The objective of this study was to relate the scores obtained with the application of the scales of locus of control of health and self esteem with socio-demographic and clinical variables, risk factors and chronic complications in 65 patients with type-2 diabetes mellitus. This is a descriptive cross-sectional study. Statistical analysis was performed using Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's Correlations tests. Regarding the locus of control, in average, patients presented higher scores in the internal dimension, and women showed more externality-at random for health. Statistically significant relationships were found between internality with time of diagnosis and physical activity; between externality-other powerful entities with glycated hemoglobin and physical activity; and between externality-at random with practice of physical activity. Most individuals has high self-esteem, but no variable was statistically related.

[The relationship between polipharmacy, chronic complications and depression in individuals with type 2 diabetes mellitus]. / A relação entre polifarmácia, complicações crônicas e depressão em portadores de Diabetes Mellitus Tipo 2.

The objectives of this study were: to characterize the polipharmacy in subjects with type 2 diabetes mellitus (DM2) and to verify the correlation between polipharmacy and number of medications for DM2 complications with depression indicators (Beck Depression inventory (BDI) and urinary cortisol (CORT) levels). A sample composed of 40 patients with DM2 from the Diabetes League of HCFM-USP was analyzed for depression indicators (CORT and BDI) in addition to evaluation for polipharmacy and number of DM2 complications. The results showed oral hypoglycemic agents, insulins, antihypertensives, diuretics, lipid-lowering drugs and thrombolytics are the most frequent medications used. In this sample, 75% used from 5 to 8 medicines daily and 12.5% used more than eight medicines/day; all of them used to take each medication at least 3 times daily. Between 1 and 3 DM2 complications were observed in 60% of the individuals and 22.5% showed more than 3 DM2 complications. No significant correlations were observed between depression indicators (BDI and CORT), number of medications and DM2 complications. However, positive correlation was observed between CORT and daily frequency of medication (Spearman, r = 0.319, p = 0.019).

Home blood glucose monitoring in type 1 diabetes mellitus.

OBJECTIVE: To determine which of two simplified blood glucose monitoring schemes promotes better metabolic control in type 1 diabetic patients during 12 months of participation in educational groups. METHODS: A crossover clinical trial involving 21 patients divided into two groups was conducted. They were submitted to a two monitoring schemes: 2 alternate daily preprandial measurements and 2 alternate daily pre-and postprandial measurements. The effectiveness of the schemes was evaluated based on HbA1c. Variations in mean HbA1c were analyzed by Friedman test. RESULTS: The groups were homogenous in terms of sociodemographic and clinical variables (p>0.05). Mean HbA1c levels ranged from 8.48 (+/-1.00) to 7.37 (+/-0.99) over time in Group A and from 9.89 (+/-0.86) to 8.34 (+/-1.06) in Group B. The analysis of the HbA1c showed a significant reduction in the first and last 6 months and over the 12 months of the study in two groups (p<0.05). The preprandial scheme demonstrated the largest number and highest percentage of significant drops in HbA1c. CONCLUSIONS: The two monitoring improved the metabolic control and the preprandial scheme was more effective.

Cultural adaptation and validation of the "Diabetes Quality of Life for Youths" measure of Ingersoll and Marrero into Brazilian culture.

The aim of this study was to adapt the "Diabetes Quality of Life for Youths (DQOLY)" measure into Brazilian culture and to analyze its psychometric properties. The cross-cultural adaptation included the phases of translation, backtranslation, committee review, and pretesting. The adapted instrument was applied to 124 type 1 diabetes mellitus' adolescents. The reliability results showed adequate Cronbach's alpha coefficients (0.8695 for Satisfaction domain, 0.8658 for Impact, 0.8387 for Worries and 0.9333 for total), with the exclusion of 3 inconsistent items. The test-retests showed no significant difference between two instrument's applications in different periods (p>0.05). The validity was demonstrated by the strategies: content, convergent, factorial and discriminant. All subscales showed positive correlations between itselves (p<0.001) and with the adolescents' self-perception of their health status (p<0.001). The present study suggests that this version of the DQOLY is a reliable and valid measure for its use in Brazil.

[Herth Hope Index--instrument adapted and validated to Portuguese]. / Escala de Esperança de Herth--instrumento adaptado e validado para a língua portuguesa.

This study was aimed at making available the Herth Hope Index adapted and validated into Portuguese in a study carried out with chronic disease patients. The scale is based on the original American instrument, and made possible the existence of an instrument to measure hope, something that did not exist previously in Brazil. For the cultural adaptation and validation were followed the methods that the literature recommends. The sample was comprised of 131 patients divided into 3 groups, of which 47 were oncology patients, 40 2-type diabetes patients, and 44 caretakers of these patients. The instrument consists of 12 statements with Likert-type answers with scores from 1 to 4 each; the higher the score, the higher the hope. The adapted Herth Hope Index has demonstrated suitable psychometric properties and for that reason is available for use.

[Intravenous insulin: controversy on the adsorption process of infusion kits]. / Insulina intravenosa: controvérsias sobre o processo de adsorção nos dispositivos de infusáo.

Insulin adsorption is a non-specific surface phenomenon that interferes with the patient's insulin demand. This literature review aimed at identifying the causes of insulin adsorption in intravenous solutions and the strategies used to reduce adsorption. Articles from Medical Literature and Retrieval System On Line (MEDLINE), Latin American and Caribbean Health Science Literature (LILACS), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Co-ordination and Improvement of Graduate People (CAPES) databases were used. Polypropylene flasks and in-line equipment without filter presented less adsorption, adsorption was maximum when the first looml of the solution were infused. Strategies used to minimize insulin adsorption pre-exposure of 50 to 100 solution flasks for 30-60 minutes, use of flasks with smaller internal surface, and short in-lines.

[Reuse of discarded syringes in residences of children and teenagers with diabetes mellitus]. / Reutilizacão de seringas descartáveis no domicílio de crianças e adolescentes com diabetes mellitus.

Inadequate or insufficient supply of medication and material to apply insulin leads families to resort to a variety of strategies, such as the practice of reusing dischargeable syringes in order to reduce the expenses with the illness. This is a study aimed at evaluating the practice of insulin application, analyzing the practice of syringe reuse and describing the most frequent changes of application sites. It is a comparative, transversal survey carried out with 199 diabetic children and adolescents. It was developed at the diabetes' Outpatient Unit of the Hospital das Clínicas' Child Institute, of the University of São Paulo's School of Medicine. The studied population was divided in two groups: in Group A were those who reused the syringes, and in Group B those who did not. A common strategy was rewrapping the needle without previously cleaning it and keeping it inside or outside the refrigerator in a closed container. The most common complaint was pain. The hospital and the nurse were responsible for the orientation for that practice.

[Quality of Life Instrument for Youths with Diabetes]. / Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD).

The aim of this study is to make the Quality of Life Instrument for Youths with Type 1 Diabetes available, considering that there are no specific instruments to evaluate the Health Related Quality of Life of Youths with type 1 Diabetes in Brazil. This instrument is derived from the American instrument "Diabetes Quality of Life for Youths". The methods recommended in literature were used for the adaptation to the Brazilian culture and validation. The instrument includes 50 items distributed in the domains: Satisfaction (17 items) Impact (22 items) and Concerns (11 items). Its use demonstrated that its psychometric properties were adequate for its use in our environment.

[Hypoglycemia in type 1 diabetic patients]. / Hipoglicemia em pacientes com diabetes mellitus do tipo 1.

The study analyzed the occurrence of hypoglycemia and metabolic control of two monitoring schemes in type-1 diabetic patients during 12 months they participated in education groups. Clinical crossed trials were conducted with 21 patients divided into two groups included the monitoring scheme proposed. Glycemic individuals' profiles directed monthly adjustments of insulin doses. The analyses were performed using Fisher, t-Student and Friedman's tests. There were no significant differences in hypoglycemia between the groups in any given month or scheme (p > 0.05). The comparisons within groups between insulin mean dose and HbA1c, and hypoglycemic episodes also did not show significant difference (p > 0.05). Metabolic control improved during the study in both groups, independently from the monitoring scheme (p < 0.05).

[Management of diabetic ketoacidosis in diabetic patients: clinical practice nursing recommendations]. / O manejo da cetoacidose em paclentes com Diabetes melltus : subsidlos para a prática clínica de enfermagem.

Diabetic ketoacidosis is a severe and acute condition in Type 1 Diabetes mellitus that is prompted by relative or absolute insulin deficiency. It is frequently related to stressful situations, in which stress hormones are elevated. It is considered a clinical emergency that requires immediate and effective intervention. This article, based on the physiopathology and the clinical manifestations, aims at providing clinical practice nursing recommendations for the management of diabetic ketoacidosis

[The difference in acute myocardial infarction pain between diabetic and non diabetic patients]. / A diferenciação da dor do infarto agudo do miocárdio entre pacientes diabéticos e não-diabéticos.

The goal of this study was to compare the acute myocardial infarction (AMI) pain between diabetic and non diabetic patients. A sample of 80 AMI patients was divided in two groups, with and without diabetes mellitus (DM), being 29% diabetic and 71% non diabetic patients. The patients with DM said they had no pain (p<0.05) and gave lower scores for pain when compared with patients without DM. There was a significant difference between average scores for pain among diabetic and non diabetic patients (p<0.001). In conclusion, the diabetic patients presented no pain or diminished pain when compared with patients without diabetes.

Predictors of hope among women with breast cancer during chemotherapy / Factores predictivos de la esperanza entre mujeres con cáncer de mama durante el tratamiento quimioterápico / Fatores preditores da esperança entre mulheres com câncer de mama durante o tratamento quimioterápico

Abstract OBJECTIVE Identifying the predictors of hope in patients with breast cancer during chemotherapy treatment. METHOD A prospective longitudinal study. The sample was composed of 122 women who responded to the instruments of hope, anxiety and depression, coping, fatigue, religiosity and self-esteem in the first and last cycle of chemotherapy. These variables were used in adjusting the logistic regression model that characterized multivariate statistics, allowing identification of predictor variables. RESULT The increase of hope at the end of chemotherapy treatment was statistically significant (p = 0.012). The delay in undergoing treatment from the onset of breast cancer symptoms, Karnofsky Performance Status, depression, self-esteem and pain were characterized as factors being associated to hope by univariate analysis. Among the variables analyzed, pain was the only predicting factor of hope. CONCLUSION Pain was the predicting factor in this sample. Hope increased during treatment and revealed the following associated factors: Karnofsky Performance Status, delay in starting the treatment, depression, self-esteem and pain. This study brought forth a multidisciplinary contribution, allowing for understanding the factors that can influence hope and presenting support to nursing care. The data evidenced conditions of improvement or worsening of hope, which requires interdisciplinary attention in Oncology.

Resumen OBJETIVO identificar los factores predictivos de la esperanza en las pacientes con cáncer de mama en tratamiento quimioterápico. MÉTODO Estudio prospectivo longitudinal. La muestra fue de 122 mujeres que respondieron a los instrumentos de esperanza, ansiedad y depresión, coping (enfrentamiento), fatiga, religiosidad y autoestima el primero y el último ciclo de quimioterapia. Dichas variables fueron utilizadas en el ajuste del modelo de regresión logística que caracterizó la estadística multivariada permitiendo la identificación de las variables predictivas. RESULTADO El aumento de la esperanza al final del tratamiento quimioterápico fue estadísticamente significativo (p = 0,012). La demora en la realización del tratamiento desde el inicio de los síntomas del cáncer de mama o Karnofsky Performance Status, la depresión, la autoestima y el dolor se caracterizaron como factores asociados con la esperanza por el análisis univariado. Entre las variables analizadas, el dolor se presentó como el único factor predictor de la esperanza. CONCLUSIÓN El dolor fue el factor predictor en esta muestra. La esperanza aumentó durante el tratamiento y reveló los factores asociados: Karnofsky Performance Status, demora en el inicio del tratamiento, depresión, autoestima y dolor. Este estudio brindó un aporte multidisciplinario, permitió comprender los factores que pueden influenciar la esperanza y presentó subsidios para la asistencia de enfermería. Los datos evidenciaron condiciones de mejora o agravamiento de la esperanza, lo que requiere atención interdisciplinaria en Oncología.

Resumo OBJETIVO Identificar os fatores preditores da esperança nas pacientes com câncer de mama em tratamento quimioterápico. MÉTODO Estudo prospectivo longitudinal. A amostra foi de 122 mulheres que responderam aos instrumentos de esperança, ansiedade e depressão, coping, fadiga, religiosidade e autoestima no primeiro e no último ciclo de quimioterapia. Essas variáveis foram utilizadas no ajuste do modelo de regressão logística que caracterizou a estatística multivariada permitindo a identificação das variáveis preditoras. RESULTADO O aumento da esperança ao final do tratamento quimioterápico foi estatisticamente significante (p = 0,012). A demora na realização do tratamento desde o início dos sintomas do câncer de mama, o Karnofsky Performance Status, a depressão, a autoestima e a dor foram caracterizadas como fatores associados à esperança pela análise univariada. Dentre as variáveis analisadas, a dor apresentou-se como o único fator preditor da esperança. CONCLUSÃO A dor foi o fator preditor nesta amostra. A esperança aumentou durante o tratamento e revelou os fatores associados: Karnofsky Performance Status, demora no início do tratamento, depressão, autoestima e dor. Este estudo trouxe uma contribuição multidisciplinar, permitiu compreender os fatores que podem influenciar a esperança e apresentou subsídios à assistência de enfermagem. Os dados evidenciaram condições de melhora ou agravamento da esperança, o que requer atenção interdisciplinar em Oncologia.

Avaliação da esperança em pacientes com doença crônica e em familiares ou cuidadores / Assessment of hope in patients with chronic illness and their family or caregivers / Evaluación de la esperanza en pacientes con enfermedad crónica y en familiares o cuidadores

OBJETIVOS: Avaliar o escore de esperança entre os três diferentes grupos e suas variáveis sociodemográficas e clínicas e correlacionar esperança com essas variáveis. MÉTODOS: Estudo descritivo com amostra constituída por 131 indivíduos - 47 pacientes oncológicos, 40 pacientes diabéticos e 44 acompanhantes/ familiares/cuidadores - que responderam às Escalas de Esperança de Herth e de Autoestima de Rosenberg, o Inventário de Depressão de Beck, e um instrumento com dados pessoais. RESULTADOS: Não houve diferença nos escores de esperança entre os grupos. A esperança correlacionou-se positivamente com autoestima e negativamente com a depressão. Para pacientes oncológicos, o escore de esperança não se relacionou a nenhuma variável clínica. Para os pacientes diabéticos, as diferentes formas de tratamento e outras comorbidades não influenciaram na esperança. CONCLUSÃO: Os pacientes com doença crônica e seus familiares apresentaram escores altos de esperança. A mensuração da esperança pode melhorar o cuidado de enfermagem.

OBJECTIVES: To evaluate the level of hope among the three different groups and correlate their levels with demographic and clinical variables. METHODS: Descriptive study with a sample of 131 individuals (including 47 cancer patients, 40 diabetic patients and 44 caregivers/ family / caregivers) responding to Hertha's Scale of Hope, Rosenberg's Self-esteem Scale, the Beck Depression Inventory, and an instrument including personal data. RESULTS: There was no difference in hope scores between groups. Hope was positively correlated with self-esteem and negatively correlated with depression. For cancer patients, the hope score was not related to any clinical variable. For diabetic patients, different forms of treatment and other comorbidities were not found to influence hope. CONCLUSION: Patients with chronic disease and their families had high hope scores. The measurement of hope can improve nursing care.

OBJETIVOS: Evaluar el escore de esperanza entre los tres diferentes grupos y sus variables sociodemográficas y clínicas y correlacionar la esperanza con esas variables. MÉTODOS: Estudio descriptivo con una muestra constituida por 131 individuos - 47 pacientes oncológicos, 40 pacientes diabéticos y 44 acompañantes/ familiares/cuidadores - que respondieron a las Escalas de Esperanza de Herth y de Autoestima de Rosenberg, el Inventario de Depresión de Beck, y un instrumento con datos personales. RESULTADOS: No hubo diferencia en los escores de esperanza entre los grupos. La esperanza se correlacionó positivamente con la autoestima y negativamente con la depresión. Para pacientes oncológicos, el escore de esperanza no se relacionó a ninguna variable clínica. Para los pacientes diabéticos, las diferentes formas de tratamiento y otras co-morbidades no influyeron en la esperanza. CONCLUSIÓN: Los pacientes con enfermedad crónica y sus familiares presentaron escores altos de esperanza. La mensuración de la esperanza puede mejorar el cuidado de enfermería.

Fatores associados à qualidade de vida de jovens com diabetes mellitus do tipo 1 / Factors associated to the quality of life of adolescents with type 1 diabetes mellitus / Factores asociados a la calidad de vida de jóvenes con diabetes mellitus tipo 1

O objetivo deste estudo foi realizar a revisão bibliográfica acerca dos fatores que podem influenciar a Qualidade de Vida Relacionada à Saúde (QV) dos adolescentes com diabetes mellitus tipo 1, por meio da estratégia de PICO. As bases de dados utilizadas foram PubMed/MEDLINE, ISI Web of Knowledge e EMBASE. O maior levantamento dos artigos foi possível com a combinação de descritores padronizados e não padronizados. Apesar da QV ser um construto específico de avaliação dos aspectos relacionados às repercussões da saúde, doença e tratamento, os fatores sócio-demográficos, psicossociais e relacionados à família parecem influenciar de forma significativa na QV.

The objective of this study was to perform a literature review of the factors that may influence the Health Related Quality of Life (HRQL) of adolescents with type 1 diabetes mellitus using the PICO strategy. PubMed/MEDLINE, ISI Web of Knowledge and EMBASE were the databases used. A larger survey of articles was possible by combining standardized and non-standardized descriptors. Though HRQL is a specific construct used to evaluate aspects related to the repercussions of health, illness, and treatment, it appears that sociodemographic, psychosocial, and family-related aspects have a significant effect on HRQL.

El objetivo de este estudio fue realizar la revisión bibliográfica acerca de los factores que puedan influenciar la Calidad de Vida Relacionada a la Salud (QV) de adolescentes con diabetes mellitus tipo 1, mediante la estrategia de PICO. Se utilizaron las bases de datos PubMed/MEDLINE, ISI Web of Knowledge y EMBASE. La mayor captación de artículos se posibilitó combinando descriptores estandarizados y no estandarizados. A pesar de que la QV es un constructo específico de evaluación de aspectos relacionados a las repercusiones de salud, enfermedad y tratamiento, los factores socio-demográficos, psicosociales y relacionados a la familia parecen influir en ella de forma significativa.

Lócus de controle em saúde e autoestima em portadores de diabetes mellitus tipo 2 / Locus of control in health and self-esteem in type-2 diabetic patients / Locus de control en salud y autoestima en pacientes de diabetes mellitus tipo 2

O presente estudo teve como objetivo relacionar os escores obtidos pela aplicação das escalas de lócus de controle da saúde e autoestima com variáveis sócio-demográficas, clínicas, fatores de risco e complicações crônicas em 65 portadores de diabetes mellitus do tipo 2. Trata-se de um estudo descritivo transversal onde foram utilizados, para a análise estatística, os testes de Qui-quadrado de Pearson, Mann-Whitney, Kruskal-Wallis e de Correlação de Spearman. Em relação ao lócus de controle, os pacientes apresentaram, em média, maiores escores na dimensão interna, sendo que as mulheres demonstraram maior externalidade-ao acaso para a saúde. Relações estatisticamente significativas foram encontradas entre internalidade com tempo de diagnóstico e atividade física; entre externalidade-outros poderosos com hemoglobina glicada e atividade física e entre externalidade-ao acaso com a prática de atividade física. A autoestima foi alta na maioria dos indivíduos, porém não se relacionou estatisticamente a nenhuma variável.

The objective of this study was to relate the scores obtained with the application of the scales of locus of control of health and self esteem with socio-demographic and clinical variables, risk factors and chronic complications in 65 patients with type-2 diabetes mellitus. This is a descriptive cross-sectional study. Statistical analysis was performed using Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's Correlations tests. Regarding the locus of control, in average, patients presented higher scores in the internal dimension, and women showed more externality-at random for health. Statistically significant relationships were found between internality with time of diagnosis and physical activity; between externality-other powerful entities with glycated hemoglobin and physical activity; and between externality-at random with practice of physical activity. Most individuals has high self-esteem, but no variable was statistically related.

El estudio objetivó relacionar los puntajes obtenidos por aplicación de escalas de locus de control de salud y autoestima con variables sociodemográficas, clínicas, factores de riesgo y complicaciones crónicas en 65 pacientes de diabetes mellitus tipo 2. Estudio descriptivo transversal, fueron utilizados para el análisis estadístico las pruebas de Qui-cuadrado de Pearson, Mann-Whitney, Kruskal-Wallis y de Correlación de Spearman. En relación al locus de control, los pacientes presentaron en promedio mayores puntajes en la dimensión interna, siendo las mujeres quienes demostraron mayor externalidad al acaso para la salud. Relaciones estadísticamente significativas fueron encontradas entre internalidad con tiempo de diagnóstico y actividad física, entre externalidad-otros poderosos con hemoglobina glicosilada y actividad física y entre externalidad al acaso con práctica de actividad física. La autoestima fue alta en la mayoría de los individuos, sin embargo no se relacionó estadísticamente a ninguna variable.

Cultural adaptation and validation of the herth hope index for portuguese language: study in patients with chronic illness / Adaptação cultural e validação do herth hope index para a língua portuguesa: estudo em pacientes com doença crônica / La adaptación cultural y validación de la herth hope index para portugués: estudio en pacientes con enfermedad crónica

This study aims the cultural adaptation and validation of the Herth Hope Index, an instrument to measure hope. In this methodological study participated 131 individuals: cancer patients, type 2 diabetes patients and their relatives or care providers. The results confirmed reliability of the scale with Cronbach alpha of 0.834. The test-retest verified the reproducibility of the scale. The construct validity was established by convergent validity between the Escala de Esperança de Herth (Brazilian version) and the Rosenberg Self-Esteem Scale, and the divergent validity between the Escala de Esperança de Herth and the Beck Depression Inventory. The factorial analysis confirmed three factors though composition different from the original scale. The psychometric properties of the Escala de Esperança de Herth were confirmed and indicate it has potential to be used to measure hope in the Brazilian population.

Este estudo tem por objetivo a adaptação cultural e validação do Herth Hope Index, um instrumento para mensurar a esperança. Neste estudo metodológico participaram 131 indivíduos: pacientes oncológicos, pacientes com diabetes do tipo 2 e seus familiares ou cuidadores. Os resultados confirmaram a confiabilidade da escala com Alpha de Cronbach de 0,834. O teste-reteste confirmou a reprodutibilidade da escala. A validade de construto foi estabelecida pela validade convergente entre a Escala de Esperança de Herth (versão Brasileira) e a escala de auto-estima de Rosenberg, e a validade divergente entre a Escala de Esperança de Herth e o Inventário de Depressão de Beck. A análise fatorial confirmou três fatores, apesar da composição diferente da escala original. As propriedades psicométricas da Escala de Esperança de Herth foram confirmadas e, portanto, ela pode ser usada para mensurar esperança na população brasileira.

Este estudio tiene como objetivo la adaptación cultural y validación de la escala Herth Hope Index, una herramienta para la medición de la esperanza. Incluyó 131 individuos: pacientes con cáncer, con diabetes del tipo 2 y sus familiares o cuidadores. Los resultados confirmaron la fiabilidad de la escala con Alfa de Cronbach 0,834. El test-retest confirmó la reproducibilidad de la escala. La validez de constructo fue creado por la validez de convergencia entre la escala de la Esperanza Herth (versión brasileña) y la escala de autoestima de Rosenberg, y la validez divergentes entre la escala de la Esperanza Herth y el Inventario de Depresión de Beck. El análisis factorial confirmó tres factores, a pesar de la distinta composición de la escala original. Las propiedades psicométricas de la escala de la Esperanza Herth se han confirmado y, por tanto, se puede utilizar para medir la esperanza en la población brasileña.

A relação entre polifarmácia, complicações crônicas e depressão em portadores de Diabetes Mellitus Tipo 2 / Relación entre polifarmacia, complicaciones crónicas y depresión en portadores de Diabetes Mellitus Tipo 2 / The relationship between polipharmacy, chronic complications and depression in individuals with Type 2 Diabetes Mellitus

Os objetivos deste estudo foram: caracterizar a polifarmácia entre portadores de Diabetes Mellitus tipo2(DM2); e correlacionar polifarmácia e número de complicações do DM2 com indicadores de depressão (Inventário de Depressão de Beck[IDB] e cortisol urinário[CORT]). A amostra foi composta por 40 pacientes da Liga de Diabetes do HCFM-USP, avaliados quanto aos indicadores de depressão (CORT e IDB) e quanto à prática de polifarmácia e número de complicações do DM2. Os resultados mostraram que os medicamentos utilizados foram: antidiabéticos orais, insulinas, anti-hipertensivos, diuréticos, anti-lipêmicos e trombolíticos. No grupo estudado, 75 por cento fizeram uso diário de 5 a 8 medicamentos, e 12,5 por cento de 8 medicamentos/dia ou mais; todos fizeram no mínimo 3 tomadas diárias, 60 por cento tinham entre 1 e 3 complicações do DM2, e 22,5 por cento tinham 3 ou mais. A correlação entre os indicadores de depressão(IDB e CORT), o número de medicamentos e o número de complicações do DM2 não foi estatisticamente significante. No entanto, houve correlação positiva entre CORT e número de tomadas diárias de medicamentos (Spearman,r=0.319, p=0.019).

The objectives of this study were: to characterize the polipharmacy in subjects with Type 2 Diabetes Mellitus (DM2) and to verify the correlation between polipharmacy and number of medications for DM2 complications with depression indicators (Beck Depression Inventory (BDI) and urinary cortisol (CORT) levels). A sample composed of 40 patients with DM2 from the Diabetes League of HCFM-USP was analyzed for depression indicators (CORT and BDI) in addition to evaluation for polipharmacy and number of DM2 complications. The results showed oral hypoglycemic agents, insulins, antihypertensives, diuretics, lipid-lowering drugs and thrombolytics are the most frequent medications used. In this sample, 75 percent used from 5 to 8 medicines daily and 12.5 percent used more than eight medicines/day; all of them used to take each medication at least 3 times daily. Between 1 and 3 DM2 complications were observed in 60 percent of the individuals and 22.5 percent showed more than 3 DM2 complications. No significant correlations were observed between depression indicators (BDI and CORT), number of medications and DM2 complications. However, positive correlation was observed between CORT and daily frequency of medication (Spearman, r=0.319, p=0.019).

Fueron objetivos de este estudio: caracterizar a la polifarmacia entre portadores de Diabetes Mellitus tipo 2 (DM2) y correlacionar la polifarmacia y el número de complicaciones de la DM2 con indicadores de depresión (Inventario de Depresión de Beck [IDB] y cortisol urinario [CORT]). La muestra fue integrada por 40 pacientes de la Liga de Diabetes del HCFM-USP evaluados respecto de los indicadores de depresión (CORT e IDB) y también en cuanto a la práctica de polifarmacia y número de complicaciones de la DM2. Los resultados mostraron que los medicamentos utilizados fueron: antidiabéticos orales, insulinas, antihipertensivos, diuréticos, antilipemiantes y trombolíticos. Dentro del grupo estudiado, 75 por ciento de los pacientes utilizaban diariamente entre 5 y 8 medicamentos, un 12,5 por ciento de la muestra hacía uso de 8 medicamentos/día o más; todos hicieron como mínimo tres tomas diarias, el 60 por ciento presentaba entre 1 y 3 complicaciones de la DM2 y el 22,5 por ciento presentaba 3 o más. La correlación entre los indicadores de depresión (IDB y CORT) y el número de medicamentos y de complicaciones de la DM2 no fue estadísticamente significativa. Sin embargo, hubo correlación positiva entre CORT y la cantidad de tomas diarias de medicamentos (Spearman, r=0.319, p=0.019).

Depressão, cortisol urinário e perfil sócio-demográfico de portadores de diabetes mellitus tipo 2 / Depresion, el cortisol urinario y perfil sociodemografico em portadores de diabetes mellitus tipo 2 / Depression, urinary cortisol and social demographics characteristics in subjects with type 2 diabetes mellitus

O objetivo deste estudo foi investigar a relação entre indicadores de depressão e perfil sócio-demográfico de portadores de Diabetes Mellitus tipo 2 (DM2).A avaliação sócio-demográfica foi conduzida em amostra composta por 40 pacientes na Liga de Diabetes (HC-FMUSP).Os indicadores de depressão foram investigados a partir do Inventário de Depressão de Beck (IBD) em associação com cortisol urinário (CORT).Os resultados mostraram que indivíduos portadores de DM2 com alta escolaridade, baixo poder aquisitivo individual e familiar e com história de rompimento de relação conjugal estável estão mais propensos a sintomas de depressão.

The objective this study was investigate the relationship between depression indicators and social-demographics characteristics in subjects with Type 2 Diabetes Mellitus (DM2). The socio-demographic evaluation was conducted in a sample composed of 40 patients with DM2 from Diabetes League (HCFM-USP).Depression indicators were evaluated through the Beck Depression Inventory (BDI) in addition to urinary cortisol (CORT).The results showed that individuals with high education level,poor individual and familiar economic status in addition to history of broken stable relationship are more likely to depressive symptoms.

Lo objective deste estudo fue investigar la relación entre la depresión y los indicadores de perfil socio-demográfico de los pacientes con diabetes mellitus tipo 2 (DM2). Evaluación socio-demográficos se llevó a cabo en una muestra de 40 pacientes en la Liga de la Diabetes (HC-FMUSP). Indicadores de la depresión se han investigado en el Beck Depression Inventory (BDI),en asociación con el cortisol urinario (CORT).Resultados muestraron que los pacientes con DM2 con alto nivel de educación,las personas de bajos ingresos y familias con historia de interrupción de los matrimonios estables son más propensos a tener síntomas de la depresión.