ABSTRACT
Abstract: Introduction: Currently, the study of the factors that improve interpersonal relationships in patient care and medical education has been considered relevant and necessary. Understanding what precedes empathy and medical interns' and young doctors' attitudes is a relevant topic for health professionals' education and for their academic and professional performance. Although patients and medical students have indicated that spirituality is an important issue, it is not frequently addressed in medical schools. Objective: This study aims to verify the association between (i) well-being related to spirituality, religiosity and the medical interns' and residents' personal beliefs and (ii) empathy and attitudes in the doctor-patient relationship. Methods: This was a quantitative, cross-sectional, observational study. A total of 64 undergraduate students in the last years of medical school and 50 residents answered the following self-administered instruments: WHOQOL-SRPB, Jefferson Scale of Empathy, and Patient-Practitioner Orientation Scale. Descriptive statistics, Pearson's correlation and stepwise linear regressions were used to analyze data. Results: Significant correlations (p<0.05) varying from weak (r=0.10) to moderate (r=0.39) were found. The WHOQOL-SRPB final score affected the global score of empathy (R2 = 0.12; p <0.00; VIF=1.00). The component meaning and purpose in life affected the global score of the patient-centered attitude (R2= 0.14; p <0.00; VIF=1.00). Conclusions: Spirituality, religiosity and personal beliefs are associated with patient-centered attitudes and medical interns' and residents' empathy. In general, well-being related to spirituality preceded empathy, and the component meaning and purpose in life preceded patient-centered attitudes. These results imply the need to consider well-being related to spirituality in interns' and residents' education for a better doctor-patient relationship.
Resumo: Introdução: Na atualidade, considera-se relevante e oportuno estudar os fatores que contribuem para a melhoria das relações interpessoais no contexto da assistência ao paciente e da educação médica. Compreender os preditores em relação à empatia e à atitude do interno de Medicina e do jovem médico é tema em destaque na formação dos profissionais de saúde, no desempenho acadêmico e profissional. A espiritualidade tem sido apontada como tema importante tanto pelos pacientes como pelos estudantes de Medicina, porém ainda pouco abordada nas escolas médicas. Objetivo: O estudo propõe verificar a associação entre o bem-estar relacionado à espiritualidade, à religiosidade e às crenças pessoais do interno e residente de Medicina e a empatia e a atitude na relação médico-paciente. Métodos: Trata-se de um estudo observacional, transversal, de abordagem quantitativa. O questionário WHOQOL-espiritualidade, religiosidade e crenças pessoais, a Escala Jefferson de Empatia e a Escala de Orientação Médico-Paciente foram autoaplicados por 64 estudantes dos últimos anos do curso e 50 residentes de Medicina. Realizaram-se estatística descritiva, correlação de Pearson e regressão linear stepwise para análise dos dados. Resultados: Foram encontradas correlações significativas (p < 0,05), variando de fracas (r = 0,10) a moderadas (r = 0,39). O escore final do WHOQOL-SRPB apresentou efeito sobre o escore global de empatia (R2 = 0,12; p < 0,00; β = 0,35; VIF = 1,00). Sentido da vida apresentou efeito sobre o escore global da atitude centrada no paciente (R2 = 0,14; p < 0,00; β = 0,38; VIF = 1,00). Conclusão: A espiritualidade, a religiosidade e as crenças pessoais foram associadas à atitude centrada no paciente e à empatia dos internos e residentes de Medicina. Em geral, o bem-estar relacionado à espiritualidade foi preditor da empatia, e o sentido da vida, preditor da atitude centrada no paciente. Esses resultados implicam a necessidade de se considerar o bem-estar relacionado à espiritualidade na formação dos internos e residentes para uma melhor qualidade da relação médico-paciente.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Religion , Students, Medical/psychology , Spirituality , Medical Staff, Hospital/psychology , Physician-Patient Relations , Linear Models , Cross-Sectional Studies , Surveys and Questionnaires , EmpathyABSTRACT
ABSTRACT OBJECTIVE: To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. METHODS: This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n = 170) and with overweight/obesity (n = 127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. RESULTS: Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p < 0.01; d = 0.49), self-esteem (p < 0.01; d = 0.38), parental impact-emotional (p < 0.05; d= 0.29), family cohesion (p < 0.05; d = 0.26), physical summary score (p < 0.05;d = 0.29), and psychosocial summary score (p < 0.05; d = 0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (ß = 0.23; p < 0.05); self-esteem, nutritional status (ß = -0.18;p ≤ 0.01); emotional impact on parents, impact on parents' time (ß = 0.31; p < 0.05); and in family cohesion, global behavior (ß = 0.30;p < 0.05). CONCLUSIONS: A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.
RESUMO OBJETIVO: Avaliar a percepção dos pais ou cuidadores a respeito da qualidade de vida relacionada à saúde (QVRS) de crianças/adolescentes com sobrepeso/obesidade e os possíveis fatores associados a essa percepção. MÉTODOS: Estudo transversal com a participação de 297 cuidadores de crianças e adolescentes eutróficos (n = 170) e com sobrepeso/obesidade (n = 127), provenientes de escolas públicas e privadas do município do estudo. Escores de QVRS obtidos por meio do Child Health Questionnaire - Parent Form 50 (CHQ-PF50) foram comparados de acordo com o estado nutricional e sexo das crianças/adolescentes. Análises de regressão múltipla foram usadas para determinar o valor preditivo das variáveis estudadas para a variação dos escores de QVRS. RESULTADOS: Pais de crianças/adolescentes com sobrepeso/obesidade atribuíram menores escores de QVRS para seus filhos nos domínios: função física (p < 0,01; d = 0,49), autoestima (p < 0,01; d = 0,38), impacto emocional dos pais (p < 0,05; d = 0,29), coesão familiar (p < 0,05; d = 0,26), sumário do escore físico (p < 0,05; d = 0,29) e sumário do escore psicossocial (p < 0,05; d = 0,25). Nos modelos de regressão múltipla, as variáveis com maior contribuição para a variação dos escores de QVRS foram: no domínio função física, impacto no tempo dos pais (ß = 0,23; p < 0,05); autoestima, estado nutricional (ß = -0,18; p ≤ 0,01); impacto emocional nos pais, impacto no tempo dos pais (ß = 0,31; p < 0,05); coesão familiar, comportamento global (ß = 0,30; p < 0,05). CONCLUSÕES: Há impacto negativo na QVRS de crianças/adolescentes com sobrepeso/obesidade em aspectos físicos e psicossociais. O estado nutricional foi a variável de maior contribuição para a avaliação da autoestima das crianças e adolescentes do presente estudo.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Obesity/psychology , Perception , Parents/psychology , Pediatric Obesity/psychology , Quality of Life/psychology , Cross-Sectional Studies , Caregivers/psychology , Nutritional Status , Parent-Child Relations , Self Concept , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception. METHODS: This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n=170) and with overweight/obesity (n=127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores. RESULTS: Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p<0.01; d=0.49), self-esteem (p<0.01; d=0.38), parental impact-emotional (p<0.05; d=0.29), family cohesion (p<0.05; d=0.26), physical summary score (p<0.05; d=0.29), and psychosocial summary score (p<0.05; d=0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (ß=0.23; p<0.05); self-esteem, nutritional status (ß=-0.18; p≤0.01); emotional impact on parents, impact on parents' time (ß=0.31; p<0.05); and in family cohesion, global behavior (ß=0.30; p<0.05). CONCLUSIONS: A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.
Subject(s)
Obesity/psychology , Parents/psychology , Pediatric Obesity/psychology , Perception , Quality of Life/psychology , Adolescent , Adult , Caregivers/psychology , Child , Cross-Sectional Studies , Female , Humans , Male , Nutritional Status , Parent-Child Relations , Self Concept , Surveys and QuestionnairesABSTRACT
Multiple sclerosis (MS) is a chronic, neurological, immune-mediated disease that can worsen in the postpartum period. There is no consensus on the use of immunoglobulin for prevention of disease relapses after delivery. We have shown that the controversial beneficial effect of immunoglobulin given immediately after birth could not be observed in patients with MS.
Subject(s)
Immunoglobulins, Intravenous/therapeutic use , Mothers , Multiple Sclerosis, Relapsing-Remitting/prevention & control , Multiple Sclerosis/drug therapy , Postpartum Period/drug effects , Adult , Case-Control Studies , Female , Humans , Immunoglobulins, Intravenous/pharmacology , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications/immunology , Pregnancy Outcome , Puerperal Disorders/prevention & control , Recurrence , Retrospective Studies , Risk Assessment , Risk Factors , Treatment OutcomeABSTRACT
O objetivo deste trabalho foi descrever a qualidade de vida relacionada à saúde dos cuidadores de crianças e adolescentes com câncer e comparar seus escores com controles saudáveis, com os tipos de tumor e a fase de tratamento. Entre setembro de 2005 a janeiro de 2007, 73 cuidadores de crianças e adolescentes com câncer (idade média= 34,8; DP=8,5) e 125 cuidadores de crianças e adolescentes saudáveis (idade média= 37,2; DP=9,1) participaram de um estudo transversal e responderam a um questionário de qualidade de vida relacionada à saúde (SF-36). Os resultados demonstraram que os escores de todos domínios do SF-36 dos cuidadores de crianças e adolescentes com câncer foram menores que os dos controles. Não se observou diferença significativa dos escores segundo o tipo de tumor (leucemias, do sistema nervoso central e sólidos) e a fase de tratamento (quimioterapia/radioterapia versus fora de tratamento). Conclui-se que os cuidadores de crianças e adolescentes com câncer apresentam prejuízo multidimensional na qualidade de vida relacionada à saúde, independentemente do tipo de câncer e da fase do tratamento. Esses resultados indicam que o tratamento de crianças e adolescentes com câncer deve incluir estratégias específicas para o acompanhamento da saúde física, mental e social dos seus cuidadores.
To describe the health-related quality of life of caregivers of children and adolescents with cancer and to compare their scores with healthy children´s caregivers as a control group, the tumor types and treatment phase. Between September 2005 and January 2007, 73 caregivers of children and adolescents with cancer (average age = 34.8; SD = 8.5) and 125 caregivers of healthy children and adolescents (average age = 37.2; SD = 9.1) participated in a crosssectional study and completed a health-related quality of life questionnaire (SF-36). The results showed scores in all domains of the SF-36 of the caregivers of children and adolescents with cancer were lower than those of the control group. There was no significant difference in scores according to tumor type (leukemia, of the central nervous system and solid tumors) and phase of treatment (chemotherapy / radiotherapy versus off-treatment). It follows that caregivers of children and adolescents with cancer have a disadvantage in multidimensional health-related quality of life, regardless of cancer type and stage of treatment. These results indicate that treatment of children and adolescents with cancer should include specific strategies for monitoring the physical, mental and social health of their caregivers.
Subject(s)
Quality of Life , Child , Adolescent , Caregivers , NeoplasmsABSTRACT
BACKGROUND AND OBJECTIVE: Women with multiple sclerosis (MS) who intend to get pregnant are often advised to discontinue disease modifying therapy (DMT) prior to conception. This recommendation is not based on medical evidence and may interfere with disease control by immunomodulatory drugs. The present study was designed to help discuss the effect of DMT for MS on pregnancy and on disease course. PATIENTS AND METHODS: Retrospective data from 152 pregnancies of 132 women with MS were collected by the physician in charge of the case. All data were entered into a specific file for qualitative and quantitative statistical analysis. RESULTS: From the total group of patients, 89 pregnancies occurred without any exposure to MS drugs, while 61 pregnancies occurred with at least eight weeks of exposure to MS immunomodulatory drugs. The rate of obstetric and neonatal complications was similar in both groups, except for the newborn weight and height which was smaller for mothers receiving medications. Mothers' post-delivery relapse rate and EDSS scores in the follow-up period were significantly higher in the absence of treatment. CONCLUSION: It is possible that, with further such supportive data, international guidelines on MS treatment in young women who intend to get pregnant may need to be revised.
Subject(s)
Immunologic Factors/adverse effects , Immunologic Factors/therapeutic use , Multiple Sclerosis/complications , Multiple Sclerosis/drug therapy , Pregnancy Complications , Adult , Argentina , Brazil , Breast Feeding , Cesarean Section , Databases, Factual , Delivery, Obstetric , Disease Progression , Female , Glatiramer Acetate , Humans , Infant, Newborn , Infant, Newborn, Diseases/chemically induced , Infant, Newborn, Diseases/epidemiology , Interferons/adverse effects , Male , Mexico , Obstetric Labor Complications/epidemiology , Peptides/adverse effects , Pregnancy , Recurrence , Retrospective Studies , United KingdomABSTRACT
This study evaluated the health-related quality of life (HRQL) of caregivers of overweight and obese children and adolescents. Three-hundred and sixty caregives of children and adolescents (ages ranging from 9 to 12 years) diagnosed with overweight (n=96; average age 11.1 years), obesity (n=62; average age 10.9 years) and eutrophy (n=202; average age 10.7 years), regular students of public and private schools in Uberlândia (Minas Gerais), were invited to answer The 36 item Short Form Questionnaire (SF-36). The scores obtained were compared according to the body mass index (BMI) of the children and adolescents, and no significant differences were found between caregivers of overweight, obese and etrophic children and adolescents. Hence, there is no harm to the HRQL of caregivers of overweight and obese children and adolescents.
Subject(s)
Caregivers , Overweight , Quality of Life , Adolescent , Adult , Child , Cross-Sectional Studies , Humans , Middle Aged , Obesity/therapy , Overweight/therapyABSTRACT
Este estudo avaliou a qualidade de vida relacionada à saúde (QVRS) de cuidadores de crianças e adolescentes com sobrepeso e obesidade. Trezentos e sessenta cuidadores de crianças e adolescentes com idade entre 9 e 12 anos, com diagnóstico de sobrepeso (n=96; idade média=11,1 anos), obesidade (n=62; idade média de 10,9 anos) e eutrofia (n=202; idade média de 10,7 anos), matriculadas em escolas públicas e particulares da cidade de Uberlândia (MG), foram convidados a responder o questionário The 36 item Short Form Questionnaire (SF-36). Os escores obtidos pelo questionário foram comparados segundo o índice de massa corpórea (IMC) das crianças e adolescentes e não foram encontradas diferenças significativas entre os cuidadores de crianças e adolescentes com sobrepeso, obesidade e eutrofia.Logo, os cuidadores de crianças e adolescentes com sobrepeso ou obesidade não apresentam prejuízo na sua QVRS.
This study evaluated the health-related quality of life (HRQL) of caregivers of overweight and obese children and adolescents. Three-hundred and sixty caregives of children and adolescents (ages ranging from 9 to 12 years) diagnosed with overweight (n=96; average age 11.1 years), obesity (n=62; average age 10.9 years) and eutrophy (n=202; average age 10.7 years), regular students of public and private schools in Uberlândia (Minas Gerais), were invited to answer The 36 item Short Form Questionnaire (SF-36). The scores obtained were compared according to the body mass index (BMI) of the children and adolescents, and no significant differences were found between caregivers of overweight, obese and etrophic children and adolescents. Hence, there is no harm to the HRQL of caregivers of overweight and obese children and adolescents.
Este estudio evaluó la calidad de vida relacionada a la salud (QVRS) de cuidadores de niños y adolescentes con sobrepeso y obesidad. Trescientos sesenta cuidadores de niños y adolescentes con edad entre 9 y 12 años, con diagnóstico de sobrepeso (n=96; edad media=11,1 años), obesidad (n=62; edad media 10,9 años) y eutrofia (n=202; edad media 10,7 años), matriculados en escuelas públicas y particulares de la ciudad de Uberlandia (MG, Brasil), fueron invitados a responder el cuestionario The 36 items Short Form Questionnaire (SF-36). Los puntajes obtenidos por el cuestionario fueron comparados según el índice de masa corporal (IMC) de los niños y adolescentes y no se encontraron diferencias significativas entre los cuidadores de niños y adolescentes con sobrepeso, obesidad y eutrofia. Se infiere que los cuidadores de niños y adolescentes con sobrepeso y obesidad no presentas perjuicio en su QVRS.
Subject(s)
Adolescent , Adult , Child , Humans , Middle Aged , Caregivers , Overweight , Quality of Life , Cross-Sectional Studies , Obesity/therapy , Overweight/therapyABSTRACT
Translate, culturally adapt, and validate the "Parkinson's Disease Quality of Life" (PDQL) BR, into Brazilian Portuguese. Fifty-two patients answered the PDQL-BR. Twenty-one patients answered the PDQL-BR again 14 days later. The UPDRS and HY scale was applied. Validation was evaluated using psychometric properties, checking the quality of the data, reliability, and validity. Quality of the data was evaluated based on occurrence of ceiling and floor effects. Reliability was evaluated based on: internal consistency of an item, homogeneity, and reproducibility. Validation was checked through the evaluation of convergent and discriminatory validation. There was no ceiling and floor effect. When evaluating reliability, items 20, 30, and 37 showed correlation of 0.34, 0.26, and 0.37, respectively, to your scale; the other items was higher than 0.4. The alpha Cronbach coefficient was higher than 0.7 for most domains. There was good reproducibility. There were no meaningful changes in the PDQL-BR translation and cross-cultural adaptation.
ABSTRACT
UNLABELLED: Allergic rhinitis (AR) remains a significant pediatric health problem because of the burden of uncontrolled symptoms on daily activities and on general well being. AIM: to assess the impact of AR on health-related quality of life (HRQL) of children and adolescents using a generic instrument, the Child Health Questionnaire (CHQ - PF50). METHODS: Between January and November 2004, parents or caregivers of 23 children and adolescents with AR without comorbidities and with positive prick tests for at least one air allergen were invited to participate of a cross-sectional study and asked to answer the self-administered CHQ-PF50. The scores were compared to those of healthy children and adolescents. RESULTS: Patient scores were lower (p<0.05) than healthy subsets in both the physical and psychosocial summaries and in most of the CHQ-PF50 scales (p<0,05), except for the 'change in health' scale. The size effect was higher in the physical score compared to the psychosocial summary score. CONCLUSIONS: allergic rhinitis has a global negative impact on the HRQL of children and adolescents, with major repercussions in physical function; AR also negatively affects family relations.
Subject(s)
Quality of Life/psychology , Rhinitis, Allergic, Perennial/psychology , Adolescent , Child , Child, Preschool , Chronic Disease , Epidemiologic Methods , Female , Humans , MaleABSTRACT
Allergic rhinitis (AR) remains a significant pediatric health problem because of the burden of uncontrolled symptoms on daily activities and on general well being. AIM: to assess the impact of AR on health-related quality of life (HRQL) of children and adolescents using a generic instrument, the Child Health Questionnaire (CHQ - PF50). METHODS: Between January and November 2004, parents or caregivers of 23 children and adolescents with AR without comorbidities and with positive prick tests for at least one air allergen were invited to participate of a cross-sectional study and asked to answer the self-administered CHQ-PF50. The scores were compared to those of healthy children and adolescents. RESULTS: Patient scores were lower (p<0.05) than healthy subsets in both the physical and psychosocial summaries and in most of the CHQ-PF50 scales (p<0,05), except for the "change in health" scale. The size effect was higher in the physical score compared to the psychosocial summary score. CONCLUSIONS: allergic rhinitis has a global negative impact on the HRQL of children and adolescents, with major repercussions in physical function; AR also negatively affects family relations.
A rinite alérgica (RA) representa importante problema de saúde pública, compromete as atividades diárias e pode repercutir no bem estar dos pacientes. OBJETIVO: Avaliar o impacto da RA na qualidade de vida relacionada à saúde (QVRS) de crianças e adolescentes por meio do questionário genérico Child Health Questionnaire (CHQ-PF50). CASUÍSTICA E MÉTODOS: Entre janeiro e novembro de 2004 pais ou responsáveis de 23 crianças e adolescentes com RA sem comorbidades e teste cutâneo de hipersensibilidade imediata positivo para pelo menos um aeroalérgeno foram convidados a participar de um estudo transversal e solicitados a responder o CHQ-PF50. Os escores obtidos foram comparados com os de crianças e adolescentes saudáveis. RESULTADOS: Os escores obtidos pelos pacientes foram menores (p<0,05) que os do grupo controle nos sumários físico e psicossocial e na maioria das escalas, com exceção na escala "alteração na saúde". O tamanho do efeito foi maior no escore sumário físico que no psicossocial. CONCLUSÕES: A RA causa impacto negativo global na QVRS de crianças e adolescentes com maior repercussão na função física, e afeta negativamente a dinâmica familiar.
