ABSTRACT
Background: Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) are associated with low quality of life (QoL) and high disease-related symptoms. The patient self-report instruments can assess the burden of physical and psychological symptoms. The Dialysis Symptom Index (DSI) is a specific instrument to evaluate the multidimensional reported symptoms by patients undergoing HD. Aims: To translate, validate and assess the psychometric properties of the Portuguese version of the DSI. Methods: A cross-cultural adaptation process from English to Portuguese and a validation study (n = 156) were conducted. Reliability, validity and responsiveness were assessed. Results: The patients' most reported symptoms were, nausea (n = 86, 55%), muscle cramps (n = 92, 59%), feeling tired or lack of energy (n = 92, 59%), bone or joint pain (n = 88, 56%) and trouble staying asleep (n = 95, 60%). Cronbach's alpha of the DSI was 0.87, and intraclass correlation coefficient was 0.868 (95%CI 0.836-0.896). The smallest detectable change was 28.32. Conclusion: The Portuguese DSI demonstrates excellent psychometric properties for assessing HD patients' reported symptoms. It highlights symptom severity and impact, providing valuable insights for healthcare practitioners. Nurses can use the DSI to tailor interventions and enhance patient-centred care.
ABSTRACT
PURPOSE: To develop a mobile application (app) for oral cancer screening. METHODS: The app was developed using Android system version 4.4.2, with JAVA language. Information concerning sociodemographic data and risk factors for oral cancer development, e.g., tobacco and alcohol use, sun exposure and other contributing factors, such as unprotected oral sex, oral pain and denture use, were included. We surveyed a population at high risk for oral cancer development and then evaluated the sensitivity/specificity/accuracy and predictive values of clinical oral diagnosis between two blinded trained examiners, who used movies and data from the app, and in loco oral examination as gold-standard. RESULTS: A total of 55 individuals at high risk for oral cancer development were surveyed. Of these, 31% presented homogeneous/heterogeneous white lesions with potential of malignancy. The clinical diagnoses performed by the two examiners using videos were found to have sensitivity of 82%-100% (average 91%), specificity of 81%-100% (average 90.5%), and accuracy of 87.27%-95.54% (average 90.90%), as compared with the gold-standard. The Kappa agreement value between the gold-standard and the examiner with the best agreement was 0.597. CONCLUSION: Mobile apps including videos and data collection interfaces could be an interesting alternative in oral cancer research development.
Subject(s)
Early Detection of Cancer , Mobile Applications , Mouth Neoplasms/diagnosis , Adult , Aged , Female , Humans , Male , Medical Informatics , Middle Aged , Surveys and QuestionnairesABSTRACT
O Plano de Parto permite o registro das expectativas e preferências da gestante em relação ao parto. Este estudo tem como objetivo formalizar um modelo de referência para o Plano de Parto informatizado e identificar um conjunto de arquétipos para representar seus conceitos. MÉTODO: Trata-se de um estudo observacional, exploratório e descritivo. Foram identificados e analisados diversos modelos de Plano de Parto. Posteriormente foi realizada a modelagem do documento em dois níveis: um modelo de referência estruturado e a construção do template nas especificações openEHRa partir de arquétipos disponíveis em uma base de conhecimento clínico. RESULTADOS: Os conceitos clínicos do documento foram estruturados a partir de ajustes em arquétipos pré-existentes. A composição foi estruturada em sete seções abordando-se as expectativas das gestantes. CONCLUSÃO: Espera-se que esta proposta seja um ponto de partida, após sua validação na prática clínica, para viabilizar o acesso ao Plano de Parto em canais informatizados do pré-natal ao parto.
The Birth Plan enables the registry of pregnant women expectations and preferences for childbirth. This studyaims to formalize a standardized model for a computerized Delivery Plan and identify a set of archetypes to representits concepts. METHOD: This is an exploratory and descriptive observational study. We identified and analyzed several Birth Plan models and subsequently performed the document modeling at two LEVELS: a structured template and then a reference template based on openEHR specifications available in a clinical database. RESULTS: We structured the clinical concepts of the document based on pre-existing archetypes adjustments. The composition structure considered sevensections covering up the expectations of pregnant women. CONCLUSION: We expect that this standardized model serveas a starting point, after its validation in clinical practice, to enable access to the Birth Plan through computerized channels from pre-natal to childbirth.
Subject(s)
Humans , Female , Prenatal Care , Medical Informatics , Humanizing Delivery , Electronic Health Records , Retrospective Studies , Congresses as TopicABSTRACT
PURPOSE: To analyze comparatively the conditions of birth in Portugal and Brazil from 1975 to 2007. METHODS: Indicators of maternal and child health: rates of maternal death and neonatal mortality, cesarean rate and public spending on health were retrospectively collected from electronic databases of health information from the Unified Health System (DATASUS) and the National Institute of Statistics of Portugal (INE), among others. Their values were descriptively analyzed in terms of trends and the temporal sanitary scenarios were presented and discussed, comparing, when possible, the information from the two countries. RESULTS: Births in Portugal were characterized by lower maternal mortality (12.2 x 76.2/100.000) and neonatal mortality (2.2 x 14.6/1000), compared to Brazil, considering the average of the years from 2004 to 2007. The history of the conquest of maternal and child indicators of excellence in Portugal involved a phase that paralleled the significant socio-economic improvements and the increasing contribution of public health, followed by another from the 1990 s, involving better equipped health care units. In Brazil, rates of maternal and neonatal mortality are declining, but satisfactory values have not yet been achieved. The historical difference in the amount of social spending on health, both in current and historical values, was a crucial difference between countries. Despite the disparities in maternal and neonatal outcomes, cesarean section rates were equally ascendant (34.5% in Portugal and 45.5% in Brazil), considering the average for the period from 2004 to 2007. CONCLUSION: The indicators of maternal and neonatal death in Portugal and Brazil have aligned themselves to social, economic and contributions of public investments in health. The increasing rates of caesarean section do not explain the discrepancies in maternal and neonatal outcome between countries.
Subject(s)
Health Status Indicators , Infant Welfare , Maternal Welfare , Brazil , Humans , Infant, Newborn , Portugal , Retrospective StudiesABSTRACT
OBJETIVO: Analisar comparativamente as condições de nascimento em Portugal e no Brasil, no período entre 1975 a 2007. MÉTODOS: Os indicadores de saúde materno-infantis, razão de morte materna, mortalidade neonatal, taxa de cesarianas e gastos públicos em saúde, foram retrospectivamente coletados nas bases eletrônicas de informação do Sistema Único de Saúde (DATASUS), Instituto Nacional de Estatística de Portugal (INE), entre outras. Seus valores foram analisados descritivamente quanto a sua tendência e os cenários sanitários nos quais transcorreram foram apresentados e discutidos, comparando-se, sempre que possível, as informações dos dois países. RESULTADOS: Os nascimentos em Portugal caracterizaram-se por baixa mortalidade materna (12,2x76,2/100.000) e mortalidade neonatal (2,2x14,6/1000), comparativamente ao Brasil, na média dos anos 2004 a 2007. O histórico da conquista de indicadores materno-infantis de excelência em Portugal envolveu uma fase que transcorreu paralela às expressivas melhorias socioeconômicas e ao aporte crescente de recursos públicos em saúde, seguida de outra a partir da década de 1990, simultânea ao melhor aparelhamento das unidades de assistência à saúde. No Brasil, os índices de mortalidade materna e neonatal estão em queda, mas valores satisfatórios ainda não foram conquistados. A diferença histórica no montante do gasto público em saúde foi uma discrepância importante entre os países. A despeito das disparidades nos resultados maternos e neonatais, as taxas de cesariana mostraram-se igualmente ascendentes (34,5 por cento em Portugalx45,5 por cento no Brasil), na média do período 2004 a 2007. CONCLUSÃO: Os indicadores da morte materna e neonatal em Portugal e no Brasil alinharam-se às diferenças sociais, econômicas e aos aportes de investimentos públicos em saúde. As crescentes taxas de cesariana não explicam as discrepâncias no resultado materno e neonatal entre os países.
PURPOSE: To analyze comparatively the conditions of birth in Portugal and Brazil from 1975 to 2007. METHODS: Indicators of maternal and child health: rates of maternal death and neonatal mortality, cesarean rate and public spending on health were retrospectively collected from electronic databases of health information from the Unified Health System (DATASUS) and the National Institute of Statistics of Portugal (INE), among others. Their values were descriptively analyzed in terms of trends and the temporal sanitary scenarios were presented and discussed, comparing, when possible, the information from the two countries. RESULTS: Births in Portugal were characterized by lower maternal mortality (12.2x76.2/100.000) and neonatal mortality (2.2x14.6/1000), compared to Brazil, considering the average of the years from 2004 to 2007. The history of the conquest of maternal and child indicators of excellence in Portugal involved a phase that paralleled the significant socio-economic improvements and the increasing contribution of public health, followed by another from the 1990s, involving better equipped health care units. In Brazil, rates of maternal and neonatal mortality are declining, but satisfactory values have not yet been achieved. The historical difference in the amount of social spending on health, both in current and historical values, was a crucial difference between countries. Despite the disparities in maternal and neonatal outcomes, cesarean section rates were equally ascendant (34.5 percent in Portugal and 45.5 percent in Brazil), considering the average for the period from 2004 to 2007. CONCLUSION: The indicators of maternal and neonatal death in Portugal and Brazil have aligned themselves to social, economic and contributions of public investments in health. The increasing rates of caesarean section do not explain the discrepancies in maternal and neonatal outcome between countries.
