Translation, Validity and Internal Consistency of the Quality of Dying and Death Questionnaire for Brazilian families of patients that died from cancer: a cross-sectional and methodological study

ABSTRACT BACKGROUND: The Quality of Dying and Death Questionnaire (QoDD) may prove to be an important evaluation tool in the Brazilian context, and, therefore, can contribute to a more precise evaluation of the dying and death process, improving and guiding the end-of-life patient care. OBJECTIVE: To translate and cross-culturally adapt the QoDD into Brazilian Portuguese and measure its validity (convergent and known-groups) and internal consistency DESIGN AND SETTING: A cross-sectional, methodological study was conducted at the Hospital de Câncer de Barretos, Brazil METHODS: A total of 78 family caregivers participated in this study. Semantic, cultural, and conceptual equivalences were evaluated using the content validity index. The construct validity was assessed through convergent validation and known groups analysis [presence of family members at the place of death; feel at peace with dying; and place of death (hospital versus home; hospital versus Palliative Care)]. Internal consistency was evaluated using Cronbach's alpha. RESULTS: The questionnaire was translated into Brazilian Portuguese and presented evidence of a clear understanding of its content. Cronbach's alpha values were ≥ 0.70, except for the domains of treatment preference (α = 0.686) and general concerns (α = 0.599). The convergent validity confirmed a part of the previously hypothesized correlations between the Palliative Care Outcome Scale-Brazil (POS-Br) total scores and the QoDD domain scores. The QoDD-Br domains could distinguish the patients who died in palliative care and general wards. CONCLUSION: The QoDD-Br is a culturally adapted valid instrument, and may be used to assess the quality of death of cancer patients.

Translation, Validity and Internal Consistency of the Quality of Dying and Death Questionnaire for Brazilian families of patients that died from cancer: a cross-sectional and methodological study.

BACKGROUND: The Quality of Dying and Death Questionnaire (QoDD) may prove to be an important evaluation tool in the Brazilian context, and, therefore, can contribute to a more precise evaluation of the dying and death process, improving and guiding the end-of-life patient care. OBJECTIVE: To translate and cross-culturally adapt the QoDD into Brazilian Portuguese and measure its validity (convergent and known-groups) and internal consistency. DESIGN AND SETTING: A cross-sectional, methodological study was conducted at the Hospital de Câncer de Barretos, Brazil. METHODS: A total of 78 family caregivers participated in this study. Semantic, cultural, and conceptual equivalences were evaluated using the content validity index. The construct validity was assessed through convergent validation and known groups analysis [presence of family members at the place of death; feel at peace with dying; and place of death (hospital versus home; hospital versus Palliative Care)]. Internal consistency was evaluated using Cronbach's alpha. RESULTS: The questionnaire was translated into Brazilian Portuguese and presented evidence of a clear understanding of its content. Cronbach's alpha values were ≥ 0.70, except for the domains of treatment preference (α = 0.686) and general concerns (α = 0.599). The convergent validity confirmed a part of the previously hypothesized correlations between the Palliative Care Outcome Scale-Brazil (POS-Br) total scores and the QoDD domain scores. The QoDD-Br domains could distinguish the patients who died in palliative care and general wards. CONCLUSION: The QoDD-Br is a culturally adapted valid instrument, and may be used to assess the quality of death of cancer patients.

Autoestima de idosos comunitários e fatores associados: estudo de base populacional / Self-esteem of community-based elderly and associated factors: a population-based study / Autoestima de ancianos comunitarios y factores asociados: estudio de base populacional

Objetivou-se avaliar autoestima de idosos comunitários e verificar sua associação com variáveis sociodemográficas e de saúde. O inquérito epidemiológico ocorreu na zona urbana de Uberaba, estado de Minas Gerais, no qual participaram 980 idosos. Utilizaram-se Escalas de Autoestima de Rosenberg, Katz, Lawton e Depressão Geriátrica Abreviada e análise descritiva com testes de Mann Whitney, Kruskal Wallis, correlação de Spearman e regressão linear múltipla (p<0,05). A coleta de dados ocorreu entre agosto de 2012 e março de 2013. Predominou o sexo feminino, 70-80 anos, casados, renda de um salário mínimo, quatro a sete anos de estudo, que moravam com filhos. A mediana foi de cinco doenças. Os escores de autoestima apresentaram mediana de 10. Os preditores dos piores níveis de autoestima foram maior idade (p<0,01), menor escolaridade (p=0,021) e indicativo de depressão (p<0,001). Os idosos comunitários apresentaram elevada autoestima e o indicativo de depressão foi o preditor principal da baixa autoestima (AU).

The aim was to assess the self-esteem of community-based elderly and verify its association with socio-demographic and health variables. The epidemiological survey was held in the urban region of Uberaba, a city in the state of Minas Gerais, with 980 elderly people. The Rosenberg Self-Esteem, Katz, Lawton and Short Geriatric Depression Scales were used and, for descriptive analysis, the Mann-Whitney and Kruskal-Wallis tests, Spearman's correlation and multiple linear regression were used (p<0.05). The data were collected between August 2012 and March 2013. The female gender was predominant, 70-80 years, married, income one minimum wage, between four and seven years of education, who lived with their children. The median number of illnesses was five. The median self-esteem score was ten. The predictors of worse levels of self-esteem were higher age (p<0.01), lower education (р=0.021) and signs of depression (р<0.001). The community-based elderly presented high self-esteem and signs of depression were the main predictor of low self-esteem (AU).

Estudio cuyo objetivo fue evaluar la autoestima de ancianos comunitarios y verificar su asociación con variables sociodemográficas y de salud. La investigación epidemiológica ocurrió en la zona urbana de Uberaba, estado de Minas Gerais. Participaron 980 ancianos. Fueron utilizadas Escalas de Autoestima de Rosenberg, Katz, Lawtone Depresión Geriátrica Abreviada y análisis descriptivo con testes de Mann Whitney, Kruskal Wallis, correlación de Spearman y regresión linear múltipla (p<0,05). Los datos fueron obtenidos entre agosto de 2012 y marzo de 2013. Fueron predominantes el sexo femenino, 70-80 años, casados, renta de un salario mínimo, cuatro a siete años de estudio, que vivían con hijos. La mediana fue de cinco enfermedades. Los scores de autoestima presentaron mediana de 10. Los predictores de los peores niveles de autoestima fueron mayor edad (p<0,01), menor escolaridad (р=0,021) e indicativo de depresión (р<0,001). Los ancianos comunitarios presentaron elevada autoestima y el indicativo de depresión fue el predictor principal de la baja autoestima (AU).