ABSTRACT
Purpose: Impaired respiratory muscle strength has been associated with some geriatric syndromes. However, no studies have previously evaluated the relationship between respiratory muscle strength and dynapenic abdominal obesity. This study aimed to analyze whether there is an association between respiratory muscle strength and abdominal obesity, dynapenia and dynapenic abdominal obesity (DAO) in community-dwelling older adults. Patients and Methods: Cross-sectional study conducted with community-dwelling older adults (n=382 / 70.03 ± 7.3 years) from Macapá, Amapá, Brazil. Respiratory muscle strength was assessed by measuring maximal inspiratory and expiratory pressures (MIP and MEP, respectively), using an analog manovacuometry. DAO was defined as the combination of dynapenia (grip strength < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). We performed descriptive and inferential statistical analyses using the student's t-test for independent and related samples and linear regression model. Results: Older adults with abdominal obesity, dynapenia, and DAO presented lower mean values (obtained and obtained versus predicted; except abdominal obesity versus MIP) for maximal respiratory pressures compared to individuals without these conditions. However, the adjusted analysis only indicated an association between MIP and the following conditions: dynapenia (MIP - ß =-0.171; p<0.001), abdominal obesity (MIP - ß=0.102; p=0.042), and DAO (MIP - ß=-0.101; p=0.028). Conclusion: Older adults with abdominal obesity, dynapenia, and DAO showed impaired maximal respiratory pressures. The results of the adjusted analysis indicate that inspiratory muscle strength may require greater attention by health professionals aiming at preventing respiratory complications and improving respiratory health care in older people with these conditions.
Subject(s)
Independent Living , Obesity, Abdominal , Male , Female , Humans , Aged , Obesity, Abdominal/epidemiology , Cross-Sectional Studies , Obesity/epidemiology , Muscle Strength , Respiratory MusclesABSTRACT
The sitting position is one of the most common positions in the workplace and one that can contribute to overloading the musculoskeletal system. Ergonomics can play a significant role in ensuring an appropriate relationship between people and their work and in achieving better conditions for workers' health. The objective of this study was to consult the available evidence on the results of different ergonomic interventions for the musculoskeletal systems of workers who perform their jobs in a sitting position. This was an integrative review, searching the LILACS, MEDLINE, PubMed, SciELO, and CINAHL electronic databases for articles published from 2010 to 2019. The following keywords were used: Trabalhadores OR Workers OR Trabajadores AND Dor OR Pain OR Dolor AND Postura Sentada OR Sitting Position OR Sedestación AND Ergonomia OR Ergonomics OR Ergonomía. A total of 183 articles were identified, 14 of which were selected for the review. For qualitative analysis, the articles were organized by author, year, sample/population, objective, analytical instrument, intervention and type of intervention: combinations of physical exercise programs and postural and ergonomic guidance; different types of guidance and facilitating instruments; or configuration of furniture and use of supporting devices. A quantitative analysis of study quality was conducted using the Physiotherapy Evidence Database, based on the Delphi list. The interventions contributed to improve physical conditions and the tasks being carried out, making them more appropriate for the workers.
A postura sentada é uma das mais adotadas nos ambientes de trabalho e pode contribuir na sobrecarga do sistema musculoesquelético. A ergonomia pode apresentar um papel significativo para manter a relação adequada do homem com o trabalho e para abordar melhores condições à saúde dos trabalhadores. O objetivo deste estudo foi verificar as evidências disponíveis sobre os resultados de diferentes intervenções ergonômicas no sistema musculoesquelético de trabalhadores que exercem atividades na postura sentada. Tratou-se de uma revisão integrativa, utilizando as bases de dados eletrônicas LILACS, MEDLINE, PubMed, SciELO e CINAHL, com busca de artigos publicados no período de 2010 a 2019. Utilizaram-se os seguintes descritores: Trabalhadores OR Workers OR Trabajadores AND Dor OR Pain OR Dolor AND Postura Sentada OR Sitting Position OR Sedestación AND Ergonomia OR Ergonomics OR Ergonomía. Foram encontrados 183 artigos, sendo 14 selecionados. A análise qualitativa organizou os artigos de acordo com autor, ano, amostra/população, objetivo, instrumento de análise, intervenção e tipo de intervenção: associação de programas de exercícios físicos e orientações posturais e ergonômicas; diferentes formas de orientação e instrumentos facilitadores; e configuração do mobiliário e utilização de dispositivos auxiliares. A análise quantitativa da qualidade dos estudos considerou a escala Physiotherapy Evidence Database, baseado na lista Delphi. As intervenções contribuíram para melhorar as condições físicas e as tarefas executadas, tornando-as mais apropriadas para os trabalhadores.
ABSTRACT
The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 - 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International-Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship.
ABSTRACT
BACKGROUND: The Work Role Functioning Questionnaire 2.0 (WRFQ 2.0) is an instrument that measures the difficulties perceived by workers in meeting work demands, given their physical or emotional health, but it has not yet been adapted for Brazil. Thus, this study aimed to translate, cross-culturally adapt and assess the psychometric properties of the WRFQ 2.0 into Brazilian Portuguese. METHODS: This is an observational study. Initially, translation and cross-cultural adaptation into Brazilian Portuguese was carried out. After that, this version was submitted to an evaluation of its internal structure. The internal consistency and test-retest reliability were assessed. To determine the construct validity, Spearman's correlation coefficient (rho) was used to determine the magnitude of correlation between the WRFQ 2.0 and the Work Ability Index (WAI), Numerical Pain Rating Scale (NPRS) and Self -Estimated Functional Inability because of Pain (SEFIP-work). RESULTS: The internal structure with five domains and 27 items presented adequate fit indices for the Brazilian version of the WRFQ 2.0. Adequate correlations of the five domains of the WRFQ 2.0 with the NPRS, WAI and SEFIP-work were found (rho ranged between 0.145 and 0.338). The test-retest reliability of the WRFQ 2.0 ranged from substantial to excellent (intraclass correlation coefficient ≥ 0.785) and internal consistency was adequate (Cronbach's alpha ≥ 0.852). CONCLUSION: The Brazilian Portuguese version of the WRFQ 2.0 presents valid internal structure with five domains and 27 items, adequate construct based on correlations with other instruments, and acceptable test-retest reliability and internal consistency.
Subject(s)
Cross-Cultural Comparison , Language , Brazil , Humans , Psychometrics , Quality of Life , Reproducibility of Results , Surveys and Questionnaires , TranslationsABSTRACT
Objetivou-se descrever o empreendimento da abordagem familiar, por meio de um trabalho interprofissional, em um centro de saúde escola na Atenção Básica à Saúde/Estratégia Saúde da Família. Trata-se de um estudo de caso descritivo sobre a abordagem familiar, utilizando-se como referencial teórico-metodológico o Modelo Calgary de Avaliação Familiar. Foram realizadas visitas domiciliares para engajamento, avaliação e intervenção, tendo em vista a abordagem da estrutura, desenvolvimento e funcionalidade da família. Foram empregados os instrumentos: Genograma e Ecomapa, Estágio de Ciclo de Vida Familiar e Apgar. Identificados como problemas crenças disfuncionais relacionadas ao cuidado da saúde; comunicação disfuncional entre os membros; ausência de referência de autoridade para os adolescentes; conflito importante entre os progenitores. O plano de intervenções foi composto por validação das demandas pelos membros da família; orientações técnicas sobre prevenção, promoção e recuperação da saúde e sobre comunicação assertiva, como a reflexão sobre os papéis exercidos no intuito de trabalhar a responsabilização dos progenitores. Acredita-se que a abordagem familiar executada por equipe multiprofissional se constitui como estratégia alternativa capaz de auxiliar na reversão do modelo hegemônico de saúde, fortalecendo a integralidade do cuidado na Atenção Básica preconizada pelo Sistema Único de Saúde.
The purpose of this study was to describe the entrepreneurship approach through an interprofessional work in a school health center in the Basic Health Care / Family Health Strategy. This is a descriptive case study about the family approach, using as a theoretical-methodological reference the Calgary Family Assessment Model. Home visits were made for engagement, evaluation and intervention, in order to approach the structure, development and functionality of the family. The instruments were: Genogram and Ecomapa, Family Life Cycle Stage and Apgar. Identified as dysfunctional beliefs related to health care problems; dysfunctional communication between members; lack of reference authority for adolescents; conflict between parents. The intervention plan was composed of validation of the demands by the family members; guidelines on prevention, promotion and recovery of health and on assertive communication. As the reflection on the roles played in order to work on the accountability of the parents. It is believed that the family approach carried out by a multiprofessional team constitutes an alternative strategy capable of assisting in the reversal of the hegemonic model of health, strengthening the integrality of care in the Basic Attention advocated by the Unified Health System.
Subject(s)
Unified Health SystemABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES Fibromyalgia is characterized by diffuse pain, which may compromise the self-rated quality of life (SRQoL). Little is known about the influence of psychosocial and environmental factors on SRQoL in women with fibromyalgia. The objective was to investigate factors related to SRQol among women with fibromyalgia, according to International Classification of Functioning domain. METHODS A cross-sectional population-based study was performed with 1,557 women. Those who self-reported fibromyalgia answered the Fibromyalgia Impact Index. SRQoL was evaluated by questions ranging from 1 (unsatisfied) to 3 (very satisfied). Exposures included personal and environmental factors distributed in four blocks according to hypothesized influence on outcome. Multiple linear regression was performed, considering 95% of confidence interval, using IBM SPSS version 24. RESULTS Income sufficiency was related to higher SRQoL in model 1. Physical environment was related to SRQoL in model 2, 3 and 4. Functional capacity measurement was related to SRQoL in model 4. In the final model, only depressive symptoms (ß:-0.374; CI: -0.037/ -0.004) and number of painful body areas (ß: 0.204; CI: -0.102/-0.001) remained significantly related to SRQoL, explaining 27% of the variance. CONCLUSION SRQoL was related to depressive symptoms and number of painful body areas even after controlled by socioeconomic, environment and health status. However, other aspects may mediate or moderate that outcome, deserving attention in a biopsychosocial approach. The results highlighted the relevance of biopsychosocial aspects on quality of life of women with fibromyalgia, addressing factors that could be approached in clinical practice to promote health and well-being.
RESUMO JUSTIFICATIVA E OBJETIVOS Fibromialgia é caracterizada por dor difusa, que pode comprometer a qualidade de vida autorrelatada (QVAR). Sabe-se pouco sobre a influência de fatores psicossociais e ambientais na QVAR em mulheres com fibromialgia. O objetivo deste estudo foi investigar fatores relacionados à QVAR entre mulheres com fibromialgia, segundo o domínio da Classificação Internacional de Funcionalidade. MÉTODOS Estudo transversal de base populacional realizado com 1.557 mulheres. Aquelas que se autorrelataram com fibromialgia responderam ao Índice de Impacto da Fibromialgia (n=115). A QVAR foi avaliada por questões que variavam de 1 (insatisfeita) a 3 (muito satisfeita). As exposições incluíram fatores pessoais e ambientais distribuídos em quatro blocos de acordo com a influência hipotética no desfecho. Foi realizada regressão linear múltipla, considerando 95% do intervalo de confiança, utilizando-se a versão 24 do IBM SPSS. RESULTADOS Suficiência de renda foi relacionada à maior QVAR no modelo 1. Ambiente físico estava relacionado à QVAR nos modelos 2, 3 e 4. Medição da capacidade funcional esteve relacionada à QVAR no modelo 4. Apenas sintomas depressivos (ß:-0,374; IC: -0,037/ -0,004) e número de áreas corporais dolorosas (ß: 0,204; IC: -0,102/-0,001) mantiveram-se significativamente relacionado à QVAR, explicando 27% da variância. CONCLUSÃO QVAR esteve relacionada a sintomas depressivos e número de áreas corporais dolorosas mesmo depois de controlada por condição socioeconômica, ambiental e saúde. Outros aspectos podem mediar esse desfecho, merecendo atenção na abordagem biopsicossocial. Os resultados destacaram relevância dos aspectos biopsicossociais na qualidade de vida das mulheres com fibromialgia, recorrendo a fatores que poderiam ser abordados na prática clínica para promover saúde e bem-estar.
