The best internal structure of the Diabetes Quality of Life Measure (DQOL) in Brazilian patients.

BACKGROUND: Diabetes Mellitus (DM) is considered a chronic disease with numerous secondary complications that negatively affect the quality of life of patients. However, the specific, known and validated instruments for Brazilian Portuguese are too extensive, which often makes their use infeasible. OBJECTIVE: To validate the internal structure of the Brazilian version of the Diabetes Quality of Life (DQOL) measure. METHODOLOGY: Patients with DM type 1 or 2, between the ages of 18 and 76, were evaluated between April 2022 and May 2022. The survey was conducted online using the Google Forms platform. The original DQOL contains 46 multiple-choice questions organized into four domains. For structural validity, confirmatory factor analysis (CFA) was performed using RStudio software (Boston, MA, USA) with the packages lavaan and semPlot. RESULTS: A total of 354 subjects were evaluated. The 3-domain, 24-item version of the DQOL was the most adequate, with acceptable values for all fit indices (chi-square/GL < 3, TLI and CFI > 0.90, and RMSEA and SRMR < 0.08). CONCLUSION: The structure with three domains and 24 items is the most appropriate based on factor analysis. The Brazilian version of the DQOL with a structure of 3 domains and 24 items has adequate measurement properties that support its use in the clinical and scientific context in patients with DM.

Unplanned Pregnancy and Depressive Symptoms during the COVID-19 Pandemic.

This is a cross-sectional study conducted with pregnant women who underwent prenatal care at basic health units in São Luís City, Maranhão State, Brazil. The authors used a semistructured questionnaire to assess the socioeconomic, demographic, and clinical characteristics of pregnant women as well as the Edinburgh Scale to investigate depressive symptoms. In order to assess the association between the explanatory variable and the outcome variable, Poisson logistic regression was performed with statistical significance at p < 0.05. A total of 205 women were interviewed, most aged between 18 and 29 years (66.83%). Of this total, 74.63% had not planned their pregnancy and 26.67% had depressive symptoms. The variables unplanned pregnancy (PR = 1.41; CI = 0.99−2.00; p = 0.05) and not undergoing psychological counseling (PR = 1.42; CI = 0.51−0.83; p ≤ 0.01) correlated with depressive symptoms during pregnancy. It is thus possible to link the variables unplanned pregnancy (p > 0.05) and not undergoing psychological counseling (p = 0.001) to depression. Therefore, it is important to monitor the mental health of pregnant women, especially in situations of vulnerability.

Vigilância epidemiológica e prognóstico de sobrevida de pacientes com câncer de colo de útero / Epidemiologic vigilance and prognosis of patients with cervical cancer

A mortalidade por câncer vem crescendo significativamente nas últimas décadas. No Brasil, a estimativa do Instituto Nacional do Câncer - INCA/Ministério da Saúde registra a ocorrência de 472 mil novos casos de câncer e 134 mil mortes por ano. Apresenta-se como segunda causa de óbito na população brasileira e assume, portanto, uma importância epidemiológica cada vez maior. Uma vez instalado o câncer de colo de útero, contudo, muito ainda pode ser feito pelas pacientes, na fase que se conhece como prevenção secundária ou de diagnóstico precoce para impedir sua progressão. A vigilância epidemiológica do câncer, portanto, insere-se em todos os níveis de atenção do modelo: promoção da saúde, monitoramento dos fatores de risco, rastreamento populacional ou oportunístico dos cânceres passíveis de detecção precoce, análise do perfil de qualidade da atenção à saúde, estudos de mortalidade, de sobrevida, entre outros.

The mortality of cancer has significantly increased in the last decades. In Brazil, the estimate of the National Cancer Institute of the Health Ministry (INCA) records the occurrence of 472 thousands of new cases of cancer and 134 thousands of death per year, presenting as the second cause of death amoung Brazilian people and it carries an increasing epidemiological importance. Once the cervical cancer is installed, much can still be done by the patients, in the phase called secondary prevention or early diagnosis to hinder its progression. Thus, the epidemiological vigilance of cancer is inserted in all attention levels of the model: health promotion, monitoring of risk factors, population screening or opportunistic of cancers liable of early detection, assessment of the health attention, quality profile, mortality and survival studies, among others.