Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND: Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. Selecting the best patient-reported outcome measure (PROM) among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to assess medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. METHODS: This review followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature). RESULTS: A total of 110 records encompassing 27 different PROMs were included in the review. The included records were published between 1986 and 2023, most of which reported studies conducted in the United States and were published in English. None of the PROMs were classified in the category "a", thus being recommended for use due to the quality of its measurement properties. The PROMs that should not be recommended for use (category "c") are the MTA, GMAS, DMAS-7, MALMAS, ARMS-D, and 5-item questionnaire. The remaining PROMs, e.g., MMAS-8, SMAQ, MEDS, MNPS, ARMS-12, MGT, MTA-OA, MTA-Insulin, LMAS-14, MARS-5, A-14, ARMS-10, IADMAS, MAQ, MMAS-5, ProMAS, ARMS-7, 3-item questionnaire, AS, 12-item questionnaire, and Mascard were considered as having the potential to be recommended for use (category "b"). CONCLUSION: None of the included PROMs met the criteria for being classified as trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, 21 PROMs have the potential to be recommended for use, but further studies are needed to ensure their quality based on the COSMIN guideline for systematic reviews of PROMs. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129109.

Content Validity of a Questionnaire Based on the Theory of Planned Behavior to Assess the Psychosocial Determinants of Insulin Adherence.

OBJECTIVES: To verify the content validity of questions of an insulin adherence questionnaire based on the Theory Planned Behavior in outpatients with type 2 diabetes mellitus. METHODS: The instrument was derived from a tool created to evaluate psychosocial determinants of adherence to oral antidiabetics medications in the Brazilian context, and was submitted for evaluation by a committee of experts and members of the target population. The item-level content validity index, the scale-level content validity index averaging calculation method, and the modified kappa coefficient were used to evaluate agreement among specialists. The comprehensibility of the instrument by members of the target population was qualitatively analyzed. RESULTS: The item-level content validity index was found to be lower than desired in 6 of the 20 items analyzed. Of these, one item was modified and 5 were excluded after the comprehensibility evaluation by members of the target population; one item from the perceived control scale was excluded. Content validation resulted in an instrument with 14 items, distributed in the domains intention (4 items), attitude (3 items), perceived norm (4 items), and perceived control (4 items) scales. CONCLUSIONS: The findings support good evidence of the content validity of the instrument for use among people with type 2 diabetes mellitus receiving insulin therapy.

Psychometric properties of instrument assessing nursing care provided to individuals with hiv/aids / Propiedades psicométricas de instrumento que evalúa la asistencia de la enfermería prestada a personas con hiv/sida / Propriedades psicométricas de instrumento que avalia assistência de enfermagem prestada às pessoas com hiv/aids

ABSTRACT Objective: to assess the psychometric properties of the Brazilian version of Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV). Method: this methodological study consisted of verifying and assessing convergent and structural validity and estimating the reliability of the instrument's translated and culturally adapted version. It was conducted in an HIV/AIDS referral center between August and November 2016 and included 141 participants. Confirmatory factor analysis was performed to assess structural construct validity, while Cronbach's alpha and composite reliability were performed to assess the internal consistency of each domain and estimate the instrument's reliability. Convergent construct validity was verified using Spearman's coefficient correlation. Results: QUOTE-HIV is structured on two components, Importance and Performance; hence, two models were generated at the end of the factor analysis, one for each component. Both models were statistically validated and presented satisfactory reliability parameters. Regarding convergent validity, positive and significant correlations were found between the scores obtained by the QUOTE-HIV domains and the Newcastle Satisfaction with Nursing Scales (NSNS), except for the performance domain in the importance component. Conclusion: QUOTE-HIV Brazilian version presented evidence of reliability, adequate internal consistency, and validity according to the convergent and structural construct validity methods adopted.

RESUMEN Objetivo: evaluar las propiedades de medida de la versión brasileña del Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV). Método: estudio metodológico que consistió en la verificación y evaluación de la validez de constructo convergente y estructural y en la estimativa de la confiabilidad del instrumento traducido y adaptado culturalmente. Fue realizado en un centro de referencia para HIV/SIDA en el período de agosto a noviembre de 2016 y contó con la participación de 141 sujetos. Para evaluar la validez de constructo estructural, se aplicó análisis factorial confirmatorio. Para estimar la confiabilidad, fue evaluada la consistencia interna de cada dominio del instrumento por medio del Alpha de Cronbach y de la confiabilidad compuesta. La validez de constructo convergente fue verificada por medio del coeficiente de correlación de Spearman. Resultados: como el instrumento QUOTE-HIV está estructurado en dos partes, importancia y desempeño, fueron generados dos modelos al final del análisis factorial, un para cada parte, ambos validados estadísticamente. En las dos partes fueron observados valores de confiabilidad satisfactorios. En relación a la validez convergente, fueron observadas correlaciones positivas significativas entre los puntajes de los dominios del QUOTE-HIV y el puntaje total del Newcastle Satisfaction with Nursing Scales (NSNS), excepto para el dominio desempeño del profesional en el componente importancia. Conclusión: la versión brasileña del QUOTE-HIV presentó evidencias de confiabilidad, con adecuada consistencia interna y validez, de acuerdo con los métodos de validez de constructo convergente y estructural empleados.

RESUMO Objetivo: avaliar as propriedades de medida da versão brasileira do Quality of Care Through the Patient's Eyes - HIV (QUOTE-HIV). Método: estudo metodológico que consistiu na verificação e avaliação da validade de construto convergente e estrutural e na estimativa da confiabilidade de instrumento traduzido e adaptado culturalmente. Foi realizado em um centro de referência para HIV/AIDS no período de agosto a novembro de 2016 e contou com a participação de 141 sujeitos. Para avaliar a validade de construto estrutural, aplicou-se análise fatorial confirmatória. Para estimar a confiabilidade, foi avaliada a consistência interna de cada domínio do instrumento por meio do Alpha de Cronbach e da confiabilidade composta. A validade de construto convergente foi verificada por meio do coeficiente de correlação de Spearman. Resultados: como o instrumento QUOTE-HIV está estruturado em duas partes, importância e desempenho, foram gerados dois modelos ao final da análise fatorial, um para cada parte, ambos validados estatisticamente. Em ambas as partes foram observados valores de confiabilidade satisfatórios. Em relação à validade convergente, foram observadas correlações positivas significativas entre os escores dos domínios do QUOTE-HIV e o escore total do Newcastle Satisfaction with Nursing Scales (NSNS), exceto para o domínio desempenho do profissional no componente importância. Conclusão: a versão brasileira do QUOTE-HIV apresentou evidências de confiabilidade, com adequada consistência interna e validade, de acordo com os métodos de validade de construto convergente e estrutural empregados.

Linguistic validation of the Diabetic foot ulcer scale short form (DFS-SF): a methodological approach

Objective: to presenting the linguistic validation of the Diabetic Foot Ulcer Scale Short-Form (DFS-SF) among pa-tients with ulcer diabetic foot (DFU) to Brazilian Portuguese and evaluate its content, practicability and acceptability. Methods and casuistry: a cross-sectional, methodological research, was conducted among 30 outpatients in follow--up for DF, assessed regarding QoL, sociodemographic and clinical data. International recommendations provided by the Mapi Research Trust on adaptation procedures were followed: the stages of Forward translation, Backward trans-lation and the Cognitive interview were carried out. The Content Validity Index was calculated and a pre-test were gathered to produce a pre-final version. Practicability and acceptability were also assessed. Results: the semantic, idiomatic, cultural and conceptual equivalences between the linguistic validated and the original version were obtai-ned. The DFS-SF was practical, well accepted and easy to understand. Conclusion: the linguistic validation process of the Brazilian version of the DFS-SF has been completed in accordance with internationally recommended standards. The instrument was easy to apply, to understand and presented short time for administration. (AU)

Objetivo: apresentar a validação linguística do DFS-SF entre pacientes com DFU para o português do Brasil e avaliar seu conteúdo, praticabilidade e aceitabilidade. Metodologia e casuística: foi realizada uma pesquisa metodológica de corte transversal entre 30 pacientes ambulatoriais em acompanhamento para DFU. Seguiram-se recomendações internacionais fornecidas pelo Mapi Research Trust sobre procedimentos de adaptação: tradução direta, tradução reversa e entrevista cognitiva. O Índice de Validade de Conteúdo foi calculado e um pré-teste foi coletado para produzir uma versão pré-final. A praticidade e aceitabilidade também foram avaliadas. Resultados:foram obtidas as equivalências semântica, idiomática, cultural e conceitual entre a versão linguística validada e a versão original. O DFS-SF foi prático, bem aceito e fácil de entender. Conclusão: O DFS-SF da versão brasileira foi concluído de acordo com os padrões internacionalmente recomendados, foi fácil de aplicar, entender e apresentou pouco tempo para administração. (AU)

Musculoskeletal symptoms, psychosocial factors and work ability in Brazilian labor justice workers.

BACKGROUND: The implementation of the electronic judicial process (PJe) in recent years is associated with an increase in workload and stricter control through productivity targets in the Brazilian labor judiciary. OBJECTIVES: To evaluate the relations between musculoskeletal symptoms, psychosocial factors and work ability in civil servants of a labor justice body in the context of the PJe. METHODS: A cross-sectional exploratory study with a quantitative approach involving 449 workers. Sociodemographic, occupational and related data were collected through questionnaires validated in the Brazilian context. Data analysis was conducted by descriptive and inferential statistics: Mann-Whitney test, Spearman's correlation coefficient and multiple linear regression. RESULTS: There was a correlation between musculoskeletal symptoms and psychosocial factors (p < 0.05), as well as between both musculoskeletal symptoms and psychosocial factors with reduced work ability (p < 0.05). The multiple linear regression model pointed to the female gender and the dimensions "demands", "control" and "peer support" as related to the musculoskeletal symptoms. CONCLUSION: We highlight the importance of a broader approach, involving psychosocial factors in preventive actions related to musculoskeletal disorders considering the important relationship with work ability.

Psychometric properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: systematic review protocol.

BACKGROUND: The pharmacological treatment of cardiovascular diseases and type 2 diabetes mellitus reduces the risk of cardiovascular events.; however, most patients do not adhere to the treatment. There are several self-reported measures for assessing medication adherence. Identifying the instruments with the best psychometric evidence is essential for selecting an accurate measure. The aim of this study is to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to access medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. METHODS: This protocol is reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The following databases will be searched: Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO and ProQuest. DISCUSSION: This review will provide a detailed assessment of the measurement properties of self-reported medication adherence instruments in patients with cardiovascular diseases and/or type 2 diabetes mellitus to support clinical practice and research. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129109.

Musculoskeletal symptoms and work ability in a context of electronic judicial process.

INTRODUCTION: The recent transformations undergone by Brazilian labor court, especially with the introduction of electronic process of law (processo judicial eletrônico [PJe]), had a significant influence on how people work. OBJECTIVES: This study aimed to evaluate the occurrence of musculoskeletal symptoms and work ability in public sector employees working in a specialized labor court body. METHODS: A cross-sectional study was conducted with 449 workers, who provided demographic and occupational information and completed the Nordic Musculoskeletal Questionnaire (NMQ) and the Work Ability Index (WAI). RESULTS: Symptoms occurred more frequently in wrists/hands (62.4%), shoulders (62.1%), and neck (60.4%) in the past 12 months, and in the neck (29.8%), shoulders (29.4%), and wrists/hands (29.2%) in the past 7 days. The mean WAI score was 38.7 (6.4), and 31.4% of participants had poor or moderate work ability. WAI scores were poorer when participants had previous problems, and the number of body segments involved in complaints was greater among those with inadequate work ability. CONCLUSIONS: Higher frequency of musculoskeletal symptoms in wrists/hands, shoulders, and neck may be related to using PJe for work and is associated with poorer work ability scores, highlighting the importance of preventive interventions for work-related musculoskeletal disorders.

Effects of an intervention program with health education and hatha yoga on the health of professionals with musculoskeletal symptoms.

INTRODUCTION: Musculoskeletal and mental disorders are relevant in the workers' disease process, and ergonomic interventions that include guidance and physical exercise consist of strategies of health promotion. Integrative and complementary practices are presented as a possibility of promoting comprehensive care and yoga consists of a therapeutic alternative. OBJECTIVE: To evaluate the effects of an intervention including educational measures and hatha yoga in musculoskeletal pain, disability, and stress in professionals of a university hospital. METHODS: We selected 125 professionals with musculoskeletal symptoms of intensity ≥ 1 who did not practice yoga and randomly assigned them to intervention (n = 63) and control (n = 62) groups, requesting answers to the following questionnaires: initial characterization, the Nordic Musculoskeletal Questionnaire and a numeric scale, the Pain Disability Questionnaire, and the Perceived Stress Scale. The intervention group went through a 12-week program with educational measures and hatha yoga. At the end of the study period, both groups answered to the questionnaires once again. We compared data before and after the intervention and between groups. RESULTS: Both groups presented improvements after 12 weeks, but the difference between mean results obtained in the first and second data collections revealed that the levels of pain, disability, and stress decreased more strongly in the intervention group than in the control group. Considering that the intervention group began the program in worse clinical conditions, the program led to a reduction in the difference between groups, but this was not enough for the intervention group to reach better results than the control. CONCLUSIONS: The intervention promoted improvements in the intensity of pain, disability, and stress among the participants of the intervention group. Similar programs could be explored in the promotion of occupational health.

Psychometric properties evaluation of the Psychological Empowerment Instrument in a Brazilian context.

AIM: To evaluate the psychometric properties of the Psychological Empowerment Instrument among Brazilian nurses. BACKGROUND: The Psychological Empowerment Instrument-Brazil is a structured questionnaire that aims to measure the psychological empowerment in the work environment. METHOD: A methodological study involving 219 nurses. Confirmatory factor analysis was conducted to evaluate the factor structure validity of the Psychological Empowerment Instrument-Brazil. Model fit indices and saliences of factor loadings were assessed. The convergent validity was estimated using the average variance extracted and composite reliability. The correlational analysis was verified using the Spearman Correlation between the Psychological Empowerment Instrument-Brazil and other specific tools. Discriminant validity, internal consistency, test-retest and floor/ceiling effects were also assessed. RESULTS: Factor structure indices of the second-order hierarchical model were [λ = 0.47-0.84; χ2 /df = 1.84, GFI = 0.93, CFI = 0.96, TLI = 0.94, RMSEA = 0.06 (90% CI = 0.04-0.08)]. Model refinement was not required. All subscales presented suitable average variance extracted, composite reliability and Cronbach's alpha, except the Impact subscale (0.39; composite reliability = 0.65, α = 0.63). All correlations between Psychological Empowerment Instrument-Brazil and the other questionnaires were significant. CONCLUSION: Psychometric properties of the Psychological Empowerment Instrument-Brazil were suitable when applied to Brazilian nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Psychological Empowerment Instrument-Brazil supports the evaluation of the empowerment level, as well as the applicability of the psychological empowerment in the work environment of Brazilian nurses.

Retorno ao trabalho de pacientes com Síndrome Coronariana Aguda / Acute Coronary Syndrome patients' return to work

Resumo Introdução: as doenças cardiovasculares representam grande impacto de morbimortalidade para a sociedade brasileira. Objetivo: verificar o tempo para retorno ao trabalho de pacientes com Síndrome Coronária Aguda (SCA); identificar e correlacionar variáveis sociodemográficas, clínicas, psicossociais e ocupacionais que podem influenciar nesse período e no desempenho no trabalho. Métodos: estudo transversal correlacional desenvolvido em 2015-2016 com 65 pacientes com SCA que retornaram ao trabalho. Instrumentos utilizados: Questionário de Caracterização; Questionário de Avaliação do Desempenho no Trabalho; Veterans Specific Activity Questionnaire; MacNew Heart Disease Health-related Quality of Life; Escala Hospitalar de Ansiedade e Depressão; e Impacto da Doença no Cotidiano do Valvopata. Foram aplicados: o teste de Mann-Whitney; pós-teste de Dunn; e coeficiente de correlação de Spearman. Resultados: o tempo médio para retorno ao trabalho foi de 7,3 meses. Os participantes que exerciam trabalho manual apresentaram tempo maior para retorno ao trabalho. O desempenho no trabalho foi fortemente correlacionado com a qualidade de vida e inversamente com ansiedade e depressão. Conclusão: os dados apontam a necessidade de desenvolvimento de estratégias a fim de promover o retorno ao trabalho de pacientes com SCA.

Abstract Introduction: cardiovascular diseases represent a major morbidity and mortality impact on the Brazilian society. Objective: to verify the Acute Coronary Syndrome (ACS) patients' time to return to work; and to identify and correlate sociodemographic, clinical, psychosocial, and occupational variables that may influence that time and their work performance. Methods: cross-sectional correlational study conducted in 2015-2016 with 65 ACS patients who returned to work. The instruments used were: Sociodemographic Questionnaire; Work Performance Evaluation Questionnaire; Veterans Specific Activity Questionnaire; MacNew Heart Disease Health-related Quality of Life; Hospital Anxiety and Depression Scale; and Impact of Valvular Disease in Everyday Life. Mann-Whitney test, Dunn's posttest, and Spearman's correlation coefficient were applied. Results: participants took 7.3 months on average to return to work; the ones who performed manual labor took longer to do so. Professional performance was found to be strongly correlated with quality of life and, inversely, with anxiety and depression. Conclusion: data indicate the need to develop strategies to promote ACS patients' return to work.

Ioga na saúde do trabalhador: revisão integrativa de estudos de intervenção / Yoga and occupational health: integrative review of intervention studies

Introdução: Efeitos do ioga no bem-estar físico e mental têm sido estudados em diversas áreas. Objetivos: Investigar e analisar o que a literatura científica dos dez anos subsequentes à publicação da Política Nacional de Práticas Integrativas e Complementares apresenta sobre resultados de intervenções utilizando ioga no ambiente de trabalho com trabalhadores. Método: Foram encontrados 10 artigos que se enquadraram nos critérios de inclusão, publicados de 2006 a 2015, disponíveis nas bases Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medical Literature Analyses and Retrieval System Online (MedLine), Web of Science, Scopus, Cochrane e Scientific Electronic Library Online (SciELO). Os artigos foram analisados quanto a ano de publicação, autoria, título, objetivos, resultados, conclusões e as intervenções caracterizadas quanto ao tipo de ioga, práticas envolvidas, frequência, duração da prática e da intervenção, instrumentos de medida e intervenções adicionais. Resultados: Os achados sugerem que o ioga está relacionado a efeitos físicos e psicológicos em trabalhadores de diferentes áreas, mas não foram encontrados benefícios sobre determinadas condições e a prática não proporciona o mesmo efeito positivo para todos. Verificou-se que a adesão dos trabalhadores aos programas propostos influencia os resultados das investigações. Muitos dos estudos não descreveram com clareza os programas. Conclusão: As características descritas evidenciam programas diferentes, permitindo uma síntese dos resultados, mas não uma comparação entre eles

Background: Effects of yoga on physical and mental health have been investigated in several fields. Objective: To investigate and analyze results of yoga interventions in the workplace reported along 10 years after the formulation of the National Policy of Integrative and Complementary Practices. Method: We located 10 studies published from 2006 to 2015 which met the inclusion criteria, included in databases Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medical Literature Analyses and Retrieval System Online (MEDLINE), Web of Science, Scopus, Cochrane and Scientific Electronic Library Online (SciELO). Analyzed variables were: publication year, authorship, title, aims, results, and conclusions. Interventions were characterized based on yoga style, practices implemented, frequency and duration of sessions, duration of intervention, measurement instruments, and additional interventions. Results: Our findings suggest that yoga has physical and psychological effects on workers from different professional categories. However, we did not find benefits for some conditions, and yoga practice does not have the same positive effects on all practitioners. Workers' adherence to programs influences the results of research. Many studies did not clearly describe the implemented programs. Conclusion: The characteristics of interventions show substantial differences among programs, which enable a synthesis, but not comparisons.

[Obstacles to return to work: Translation and cross-cultural adaptation of the questionnaire to the Brazilian context]. / Obstáculos para retorno ao trabalho: tradução e adaptação cultural do questionário para o contexto brasileiro.

The few existing questionnaires addressing return to work in Brazil are medical and/or psychological and do not examine work environment-related issues. The Obstacles to Return-to-Work Questionnaire (ORTWQ) is multidimensional, including biopsychosocial and environmental factors, and has proven useful in the return to work issue. The scope of this study is to describe the translation and cultural adaptation process of ORTWQ for use in the Brazilian context. It also discusses aspects related to work and the importance for health professionals to identify obstacles to return to work for occupational health vigilance. For the cultural adaptation process, there were five steps: translation, synthesis, back translation, evaluation by an expert committee and the pre-test process. Before the pre-test phase, the Content Validity Index was checked and was considered adequate when it was ≥ 0.8. The expression "increase working hours" was withdrawn from the questionnaire, since the partial returnto-work regime is rare in Brazil. The sample for the pre-test involved 40 individuals. The average time for completing ORTWQ was 14 minutes and the Brazilian version of ORTWQ proved to be adequate. Further studies should assess psychometric qualities of the questionnaire.

Os raros questionários existentes no Brasil que abordam retorno ao trabalho são físicos e/ou psicológicos e não abrangem questões relativas ao ambiente de trabalho. O Obstacles to Return-to-Work Questionnaire (ORTWQ) é multidimensional, inclui fatores biopsicossociais, ambientais e tem se mostrado útil como preditor de retorno ao trabalho. Este estudo tem como objetivo discutir a importância, para a Vigilância em Saúde do Trabalhador, de questionários que identificam os obstáculos para retorno ao trabalho, bem como traduzir e adaptar culturalmente o ORTWQ para uso no contexto brasileiro. Cinco etapas foram seguidas para a adaptação cultural: tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste. Antes do pré-teste, o Índice de Validade de Conteúdo foi verificado e considerado adequado quando ≥ 0,8. Foi retirado do questionário, o termo "aumentar as horas de trabalho", uma vez que o regime de retorno parcial ao trabalho é raro no Brasil. Participaram do pré-teste 40 sujeitos. A versão brasileira do ORTWQ mostrou-se adequada e o tempo médio para preenchimento foi de 14 minutos. Outros estudos devem avaliar as qualidades psicométricas desse questionário.

Obstáculos para retorno ao trabalho: tradução e adaptação cultural do questionário para o contexto brasileiro / Obstacles to return to work: Translation and cross-cultural adaptation of the questionnaire to the Brazilian context

Resumo Os raros questionários existentes no Brasil que abordam retorno ao trabalho são físicos e/ou psicológicos e não abrangem questões relativas ao ambiente de trabalho. O Obstacles to Return-to-Work Questionnaire (ORTWQ) é multidimensional, inclui fatores biopsicossociais, ambientais e tem se mostrado útil como preditor de retorno ao trabalho. Este estudo tem como objetivo discutir a importância, para a Vigilância em Saúde do Trabalhador, de questionários que identificam os obstáculos para retorno ao trabalho, bem como traduzir e adaptar culturalmente o ORTWQ para uso no contexto brasileiro. Cinco etapas foram seguidas para a adaptação cultural: tradução, síntese, retrotradução, avaliação por comitê de especialistas e pré-teste. Antes do pré-teste, o Índice de Validade de Conteúdo foi verificado e considerado adequado quando ≥ 0,8. Foi retirado do questionário, o termo "aumentar as horas de trabalho", uma vez que o regime de retorno parcial ao trabalho é raro no Brasil. Participaram do pré-teste 40 sujeitos. A versão brasileira do ORTWQ mostrou-se adequada e o tempo médio para preenchimento foi de 14 minutos. Outros estudos devem avaliar as qualidades psicométricas desse questionário.

Abstract The few existing questionnaires addressing return to work in Brazil are medical and/or psychological and do not examine work environment-related issues. The Obstacles to Return-to-Work Questionnaire (ORTWQ) is multidimensional, including biopsychosocial and environmental factors, and has proven useful in the return to work issue. The scope of this study is to describe the translation and cultural adaptation process of ORTWQ for use in the Brazilian context. It also discusses aspects related to work and the importance for health professionals to identify obstacles to return to work for occupational health vigilance. For the cultural adaptation process, there were five steps: translation, synthesis, back translation, evaluation by an expert committee and the pre-test process. Before the pre-test phase, the Content Validity Index was checked and was considered adequate when it was ≥ 0.8. The expression "increase working hours" was withdrawn from the questionnaire, since the partial returnto-work regime is rare in Brazil. The sample for the pre-test involved 40 individuals. The average time for completing ORTWQ was 14 minutes and the Brazilian version of ORTWQ proved to be adequate. Further studies should assess psychometric qualities of the questionnaire.

Psychometric properties in instruments evaluation of reliability and validity. / Propriedades psicométricas na avaliação de instrumentos: avaliação da confiabilidade e da validade.

Measurement instruments play an important role in research, clinical practice and health assessment. Studies on the quality of these instruments provide evidence of how the measurement properties were assessed, helping the researcher choose the best tool to use. Reliability and validity are considered the main measurement properties of such instruments. Reliability is the ability to reproduce a result consistently in time and space. Validity refers to the property of an instrument to measure exactly what it proposes. In this article, the main criteria and statistical tests used in the assessment of reliability (stability, internal consistency and equivalence) and validity (content, criterion and construct) of instruments are presented, discussed and exemplified. The assessment of instruments measurement properties is useful to subsidize the selection of valid and reliable tools, in order to ensure the quality of the results of studies.

Instrumentos de medida desempenham um importante papel na pesquisa, na prática clínica e na avaliação de saúde. Estudos sobre a qualidade desses instrumentos fornecem evidências de como as propriedades de medida foram avaliadas, auxiliando o pesquisador na escolha da melhor ferramenta para utilização. A confiabilidade e a validade são consideradas as principais propriedades de medida de tais instrumentos. Confiabilidade é a capacidade em reproduzir um resultado de forma consistente, no tempo e no espaço. Validade refere-se à propriedade de um instrumento medir exatamente o que se propõe. Neste artigo são apresentados, discutidos e exemplificados os principais critérios e testes estatísticos empregados na avaliação da confiabilidade (estabilidade, consistência interna e equivalência) e validade (conteúdo, critério e construto) de instrumentos. A avaliação das propriedades de medida de instrumentos é útil para subsidiar a seleção de instrumentos válidos e confiáveis, de modo a assegurar a qualidade dos resultados dos estudos.

Validation of the Brazilian Version of the Job Satisfaction Survey Using Confirmatory Factor Analysis.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the validity of the Brazilian version of the Job Satisfaction Survey (JSS) using confirmatory factor analysis supported by structural equation modeling in a sample of Brazilian nursing workers. METHODS: Data from 360 nursing workers were analyzed. Confirmatory factor analysis used partial least squares structural equation modeling (PLS-SEM). RESULTS: The results showed that the Brazilian version of the JSS presented better adjustment to the model after the removal of four items from the scale. According to confirmatory factor analysis, convergent and discriminant validities were confirmed. CONCLUSIONS: The Brazilian version of JSS showed strong evidence of construct validity through convergent and discriminant measures.

Psychometric Properties of the Obstacles to Return-to-Work Questionnaire in a Brazilian context.

Purpose To evaluate the psychometric properties of the Obstacles to Return-to-Work Questionnaire (ORTWQ) among Brazilian workers on sick-leave due to musculoskeletal disorders. Methods Confirmatory factor analysis was conducted to evaluate the factor structure validity of the ORTWQ. Model fit indices and salience of factor loadings were assessed. The convergent validity was estimated using the Average Variance Extracted (AVE) and Composite Reliability (CR). The correlational analysis was verified using the Spearman Correlation between the ORTWQ and other specific tools. Discriminant Validity, internal consistency, stability (test-retest) and floor/ceiling effect were also assessed. Results A total of 301 participants completed the ORTWQ with a mean age of 45.0 (9.9) years. After refinement, the factor structure indexes of the oblique model were [χ2/df = 1.8; CFI = 0.9; TLI = 0.9; PGFI = 0.7; PCFI = 0.8; RMSEA = 0.05 (90% CI 0.05-0.06)]. Only Depression, Physical Workload and Perceived Prognosis subscales presented suitable AVE indices: 0.63, 0.51 and 0.52 respectively. The correlations between ORTWQ and the other questionnaires were appropriate for almost all subscales. Reliability evaluation showed adequate estimates for all subscales except for the Worry Due to Sick-Leave (CR = 0.45; α = 0.44; ICC = 0.69). A higher order hierarchical model is suggested, in order to estimate an overall score to ORTWQ in a Brazilian population. Conclusions The psychometric properties of the Brazilian version of the ORTWQ were evaluated and after refinement, the validity, reliability and floor/ceiling effects indexes were suitable when applied to a sample of Brazilian workers on sick-leave due to musculoskeletal disorders. However, the factor structure presented some issues regarding convergent and discriminant validity.

Tradução e adaptação transcultural do psychological empowerment instrument para o contexto brasileiro / Translation and cultural adaptation of the psychological empowerment instrument for the Brazilian context / Traducción y adaptación cultural del instrumento de epoderamiento psicológico al contexto brasileño

Empoderamento psicológico está relacionado a uma sensação de motivação referente ao ambiente de trabalho. É um processo pelo qual os trabalhadores ganham o controle, expressam e satisfazem suas necessidades e são capazes de identificar, analisar e propor soluções aos problemas relacionados ao trabalho. Estudos comprovam que quando utilizado nos ambientes de trabalho de enfermagem, proporcionam resultados positivos, como: o aumento da satisfação no trabalho, comprometimento organizacional e redução do Burnout. O Psychological Empowerment Instrument (PEI) é um instrumento que avalia uma medida multidimensional de empoderamento psicológico no contexto do trabalho. Trata-se de um questionário composto de 12 itens e subdivido em quatro domínios (significado, competência, autodeterminação e impacto) com uma escala de medida do tipo Likert. Objetivo: discutir a importância da aplicação do empoderamento psicológico no ambiente da enfermagem, bem como disponibilizar uma versão do PEI para a língua portuguesa do Brasil, traduzindo e adaptando culturalmente o instrumento. Métodos: estudo metodológico, de corte transversal. O processo de adaptação cultural desenvolveu-se por meio de etapas recomendadas internacionalmente – tradução, síntese, retrotradução, avaliação por comitê de especialistas e o pré-teste. Resultados: o índice de validade de conteúdo foi considerado adequado (0,95). Os itens foram analisados pelos membros do comitê de especialistas que sugeriram alterações com o objetivo de facilitar a compreensão pela população. Foi também realizado um pré-teste com 31 sujeitos. Conclusão: o PEI se mostrou adequado para a população brasileira. É necessário que outros estudos avaliem as propriedades psicométricas do instrumento.

Psychological empowerment is related to a sense of motivation in the work environment. It is a process through which workers have their control increased, can express and satisfy their needs and are able to identify, analyze and propose solutions to problems related to their work. Studies have shown that when used in nursing work environments it provides positive results, such as increased job satisfaction, organizational commitment, and reduced burnout. The Psychological Empowerment Instrument (PEI) is an instrument that evaluates a multidimensional measure ofempowerment in occupational context. This is a questionnaire consisting of 12 items, subdivided into 4 domains (meaning, competence, self determinationand impact) with a Likert-type measurement scale. Objective: to discuss the importance of applying the psychological empowerment in nursing environment, as well as to provide a Brazilian Portuguese version of PEI, translating and culturally adapting the instrument. Methods: methodological and cross-sectional study. The adaptation process was developed through internationally recommended steps – translation, synthesis, back-translation, evaluation by an expert committee and pre-test. Results: the content validity index was considered appropriate(0.95). The items were analyzed by members of the expert committee, and they suggested some changes in order to facilitate understanding bythe population. It was also performed a pre-test with 31 subjects. Conclusion: the PEI has shown to be adequate for the Brazilian population. It is necessary for further studies to evaluate the psychometric properties of the instrument.

El empoderamiento psicológico se relaciona con la motivación para ejercer las tareas en el ambiente laboral. Es un proceso mediante el cuallos trabajadores adquieren control, expresan y satisfacen sus necesidades y son capaces de identificar y proponer soluciones a los problemaslaborales. Los estudios demuestran que cuando se utiliza en el ambiente de enfermería, aporta resultados positivos, como mayor satisfacciónen el trabajo, compromiso con la organización y disminución del desgaste. El Instrumento de Empoderamiento Psicológico (PEI) evalúa unamedida multidimensional de empoderamiento en el contexto laboral. Se trata de un cuestionario que consta de 12 ítems subdivido en 4 dominios(significado, competencia, autodeterminación e impacto) con una escala de medición tipo Likert. Objetivo: discutir la importancia de la aplicacióndel empoderamiento psicológico en enfermería, así como proporcionar la versión del PEI al idioma portugués de Brasil, traducir y adaptar culturalmente dicho instrumento. Métodos: Estudio metodológico transversal. El proceso de adaptación cultural siguió las etapas recomendadas internacionalmente – traducción, síntesis, retrotraducción, evaluación por el comité de expertos y prueba previa. Resultados: El índice de validezde contenido fue considerado apropiado (0,95). Los ítems fueron analizados por los miembros del comité de expertos quienes sugirieron algunas alteraciones para facilitar su comprensión. También se realizó una prueba piloto con 31 sujetos. Conclusión: El PEI es adecuado para la población brasileña. Se precisan otros estudios para evaluar las propiedades psicométricas del instrumento.

Quality of life of people with chronic ulcers.

INTRODUCTION: Patients with chronic ulcers have physical, social, and psychological changes that directly affect their quality of life. OBJECTIVES: To evaluate the quality of life and analyze the association between personal and health characteristics in patient quality of life for those with chronic ulcers. METHOD: A cross-sectional study, nonprobabilistic. The questionnaire to evaluate personal and health characteristics and the Ferrans and Power Quality of Life Index-Wound Version were used for the data collection. The sample consisted of 200 patients with chronic ulcers of several etiologies (venous ulcers, pressure ulcers, diabetic ulcers, and mixed) recruited at the basic health units in two cities in the South of Minas Gerais, Brazil. RESULTS: Overall, the study found that their quality of life was rated as good. There was a positive correlation between the different ages (P = 0.0165), number of children (P = 0.0083), and practice of religion (P = 0.0394) with quality of life.

Factor analysis of an instrument to measure the impact of disease on daily life. / Análise de fatores do instrumento de medida do impacto da doença no cotidiano.

OBJECTIVE: to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients. METHOD: the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach's alpha coefficient. RESULTS: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance. CONCLUSION: future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.

Análise de fatores do instrumento de medida do impacto da doença no cotidiano / Análisis de factores del instrumento de medición de impacto de la enfermedad en el cotidiano / Factor analysis of an instrument to measure the impact of disease on daily life

RESUMO Objetivo: verificar a estrutura de fatores do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata (IDCV) quando aplicado em coronariopatas. Método: fizeram parte deste estudo 153 coronariopatas em seguimento ambulatorial. A estrutura de fatores do IDCV foi inicialmente avaliada por meio da análise confirmatória de fatores e, subsequentemente, por meio da análise exploratória de fatores. Utilizou-se o método de estimação dos componentes principais de análise com rotação Varimax e eigenvalues acima de um para extração de fatores e carga fatorial superior a 0,40 para seleção dos itens. A consistência interna foi estimada por meio do coeficiente alfa de Cronbach. Resultados: a análise confirmatória não confirmou a estrutura original de fatores do IDCV. A análise exploratória de fatores evidenciou três dimensões que, em conjunto, explicaram 78% da variância da medida. Conclusão: estudos futuros com ampliação da casuística são necessários para confirmação da nova estrutura de fatores do IDCV.

RESUMEN Objetivo: verificar la estructura de factores del Instrumento para Medición del Impacto de la Enfermedad en el Cotidiano del Valvulópata (IDVC) aplicado a enfermos coronarios. Método: formaron parte de este estudio 153 enfermos coronarios en seguimiento ambulatorio. Estructura de factores del IDVC evaluada inicialmente mediante análisis confirmatorio de factores, y luego por análisis exploratorio de factores. Se aplicó método de estimación de componentes principales de análisis con rotación Varimax y eigenvalues por sobre 1 para extracción de factores, y carga factorial superior a 0,40 para selección de ítems. Consistencia interna estimada mediante coeficiente alfa de Cronbach. Resultados: el análisis confirmatorio no confirmó la estructura original de factores del IDCV. El análisis exploratorio de factores evidenció tres dimensiones que, en conjunto, explicaron el 78% de la diferencia de la medida. Conclusión: estudios futuros con casuística ampliada serán necesarios para confirmación de la nueva estructura de factores del IDCV.

ABSTRACT Objective: to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients. Method: the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach's alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance. Conclusion: future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.