Methods to assess ambivalence towards food and diet: a scoping review.

BACKGROUND: Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects. METHODS: In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet. RESULTS: We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire. CONCLUSION: This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

Valor preditivo do national early warning SCORE 2 para admissão à unidade de terapia intensiva em pessoas com infecção por SARS-COV 2 / Predictive value of the national early warning SCORE 2 for admission to the intensive care unit in people with SARS-COV 2 infection

INTRODUÇÃO: Pacientes com infecção por SARS-CoV 2 podem apresentar rápida deterioração clínica, evoluindo para Síndrome do Desconforto Respiratório Agudo, sepse ou choque, bem como necessidade de ventilação mecânica ou de cuidados intensivos. É premente avaliar sinais de alerta de deterioração clínica, com vistas a intervir precocemente, aumentando as chances de sobrevida de pacientes com COVID-19. Tendo em vista que a alteração dos sinais vitais são frequentes na evolução da COVID-19, optou-se por utilizar a escala National Early Warning Score (NEWS2). O NEWS2 identifica o risco de deterioração clínica precoce e prediz os cuidados requeridos e sua frequência; sendo um indicador competente para intervenções precoces. No entanto, pouco se sabe sobre sua aplicação para pacientes com COVID-19. Este estudo visou analisar, de forma pioneira no Brasil, a performance prognóstica e o poder discriminatório do NEWS2 em unidades de internação adulto de um hospital universitário paulista quanto às admissões em unidades de terapia intensiva (UTI). MÉTODOS: Tratou-se de estudo de coorte retrospectivo que avaliou informações de 300 participantes hospitalizados por COVID-19 no período de março de 2020 a março de 2022. Foi utilizado o NEWS2 com vistas a obter um escore de risco de deterioração clínica precoce; e o Índice de Comorbidades de Charlson (ICC), para ajustar o risco estimado pelo NEWS2 de acordo com a prevalência de condições clínicas prévias. RESULTADOS: O escore médio do NEWS2 foi de 4,1 unidades, o que sugere moderada complexidade da atenção. O NEWS2 apresentou bom poder discriminatório, com sensibilidade de 71,1%, especificidade de 56,3%, Valor preditivo positivo de 22,4%, Valor preditivo negativo de 91,7%, Razão de verossimilhança positiva de 1,6 e Razão de verossimilhança negativa de 0,5. A análise da área sob a curva ROC (AUROC, 66%; IC95% = 0,57-0,54; p=0,0009) evidenciou que o índice foi modestamente capaz de predizer a deterioração clínica de pacientes com COVID-19 e a probabilidade de admissão na UTI. CONCLUSÕES: Conclui-se que o NEWS2 apresentou bom poder discriminatório para avaliar a gravidade de pacientes com COVID-19 e moderada capacidade de predição da admissão de pacientes com COVID-19 na UTI.

Sociodemographic, clinical, and dietary characteristics of overweight adults: a secondary analysis of a population study / Caracterização sociodemográfica, clínica e da alimentação de adultos com excesso de peso: análise secundária de um estudo populacional

ABSTRACT Objective: To estimate the prevalence of overweight among Brazilian adults aged 20 to 59, according to sociodemographic characteristics, health-related behaviors, and food consumption. Methods: A cross-sectional study based on data from a population-based survey in a major metropolitan city in the state of São Paulo, Brazil, conducted between 2015-2016. Prevalences and prevalence ratios were estimated using Poisson regression; food consumption means were estimated using linear regression. Results: We analyzed data from 855 adults, 61% of whom were overweight. The prevalence of overweight was significantly higher among males, those aged 30 or older, with 8 to 11 years of education, and those who reported eating more than they should. The body mass index was significantly associated with hypertension, diabetes, high cholesterol, waist-to-height ratio, taking weight-loss medications, overeating, and the habit of checking labels. Overweight adults reported eating meat with visible fat and drinking soda more frequently than those not overweight. Overweight adults reported eating significantly more grams of food daily and had a higher intake of energy, total fat, saturated fats, trans fats, carbohydrates, protein, insoluble dietary fiber, sodium, and potassium. Their diets had a higher glycemic load when compared to participants who were not overweight. Conclusion: Adults with and without overweight differed in their sociodemographic, dietary, and clinical characteristics. Diet quality was similar between both groups, suggesting a need for improving dietary habits in this population regardless of body weight.

RESUMO Objetivo: Estimar a prevalência de excesso de peso entre adultos brasileiros, de 20 a 59 anos, segundo características sociodemográficas, de comportamentos relacionados à saúde e quanto ao consumo alimentar. Métodos: Estudo transversal, de pesquisa de base populacional, em uma cidade metropolitana de São Paulo - Brasil, conduzida entre os anos de 2015 e 2016. Foram estimadas as prevalências e as razões de prevalência por meio da regressão de Poisson, e as médias de consumo alimentar pelo uso da regressão linear. Resultados: Foram analisados dados referentes à 855 adultos, 61% destes apresentavam sobrepeso. A prevalência de excesso de peso foi significativamente maior entre: homens, com 30 anos ou mais, pessoas que possuíam entre 8 e 11 anos de estudo e entre aqueles que acreditavam comer mais do que deveriam. O índice de massa corporal foi significativamente associado à hipertensão, diabetes, colesterol alto, razão cintura-estatura, uso de medicamentos, comer mais do que deveria e o hábito de checar rótulos. Adultos com excesso de peso ingeriam carnes com gordura e refrigerantes em maior frequência quando comparados à adultos com peso saudável. Adultos com excesso de peso consumiam, significativamente, mais gramas de alimentos por dia e apresentaram maior ingestão de calorias, gorduras totais, saturadas e trans, carboidratos, proteína, fibras insolúveis, sódio e potássio. A dieta deles continha uma maior carga glicêmica quando comparada àqueles com peso saudável. Conclusão: Adultos com e sem excesso de peso, diferiram quanto às características sociodemográficas, dietéticas e clínicas. A qualidade da dieta foi similar em ambos os grupos, o que sugere a necessidade de melhora dos hábitos alimentares da população, independentemente do peso corporal.

A Mobile Phone App Intervention to Promote Healthy Salt Intake Among Adults: Protocol for a Randomized Controlled Study.

BACKGROUND: There is sound evidence associating high salt intake and a greater risk of cardiovascular and noncardiovascular diseases. High salt intake has been observed in several populations worldwide. Therefore, promoting healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases, and consider the target population's context. OBJECTIVE: This protocol aims to describe a mobile phone app intervention to promote healthy salt intake among adults. METHODS: This is an experimental and longitudinal study protocol conducted in three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone app intervention based on the date of module 1. In module 3, the intervention will be evaluated using a randomized controlled study, with three steps of data collection in a 2-month follow-up in a sample of 86 adults (43 participants for each group: the control group and intervention group) recruited from the primary health care centers of a Brazilian town. The discretionary salt intake questionnaire will assess salt consumption, the app usability will be assessed using the System Usability Scale, and psychosocial variables (habit, intention, and self-efficacy) will also be measured. RESULTS: Recruitment began in October 2021, and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. CONCLUSIONS: Results from this study will help people to control salt intake when cooking at home, will stimulate self-care, will work as an alternative or supportive method in the relationship between health care professionals and patients, and will contribute to implementing the app intervention to promote healthy salt intake on a large scale. TRIAL REGISTRATION: The Brazilian Clinical Trials Registry RBR-4s8qyyq; https://ensaiosclinicos.gov.br/rg/RBR-4s8qyyq. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37853.

Autocuidado e risco cardiometabólico em pessoas com hipertensão arterial em seguimento na atenção primária / Self-care and cardiometabolic risk in people with high arterial pressure following primary care

O objetivo deste estudo foi avaliar o autocuidado e o risco cardiometabólico em pessoas com hipertensão arterial (HA) em seguimento clínico regular na atenção primária à saúde. Estudo analítico e transversal conduzido entre 86 pessoas com HA no interior do Estado de São Paulo, por meio da aplicação das versões brasileiras da Escala de Autocuidado de Hipertensão e do Escore de Risco Cardiometabólico de Framingham. Os participantes demonstraram níveis satisfatórios de confiança (71,3(14,7)), níveis insatisfatórios para manutenção (59,2(14,5)) e manejo (55,1(20,3)) do autocuidado na Escala de Autocuidado e 34,6% de chance de desenvolver infarto agudo do miocárdio nos próximos dez anos. Os indivíduos com menor idade apresentaram níveis de confiança satisfatórios em relação ao manejo do autocuidado, e observou-se maior risco cardiometabólico entre pessoas com diabetes e angina. Os indivíduos possuem confiança, mas demonstram inadequados manejo e manutenção do comportamento de autocuidado, e quanto menor a idade, melhor o manejo do autocuidado.

This study aimed evaluate self-care and cardiometabolic risk in people with arterial hypertension undergoing regular clinical follow-up in primary health care. Exploratory study conducted among people with hypertension in the interior of the State of São Paulo, through the application of the Brazilian versions of the Hypertension Self-Care Scale and the Framingham Cardiometabolic Risk Score. Participants demonstrated satisfactory levels of confidence (71.3 (14.7)) and unsatisfactory levels for Self-Care maintenance (59.2 (14.5)) and management (55.1 (20.3)), domains of the Scale Self-care; and a 34.6% chance of developing acute myocardial infarction in the next 10 years. The youngest individuals had satisfactory levels of confidence in relation to the management of self-care; and higher cardiometabolic risk was observed among people with diabetes and angina. No significant associations were found between the other variables. Individuals have confidence, but demonstrate inadequate Self-Care management and maintenance and the younger the better self-care management.

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.

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.

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.

Effect of implementation intention on walking in people with diabetes: an experimental approach.

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

What methods have been used to estimate salt intake? A systematic review.

The relationship between salt intake and cardiovascular diseases is a contemporary scientific controversy, which has been attributed to the limits of the measures of salt intake used in the studies. Thus, this article sought to systematically review the literature on the methods used to estimate salt intake in different study designs. Of the 124 articles, 60.5% used only biochemical measures, 26.6% only self-report measures and 12.9% reported the combined use of both methods. The 24-hour urinary sodium excretion was the predominant biochemical method (79.1%) and the Food Frequency Questionnaire was the predominant self-report measure (36.4%). Interventional studies used mostly 24-hour urinary sodium excretion; while longitudinal studies used self-report measures. The question guiding the study and its design, as well as constraints related to costs, sample size and feasibility seems to influence the choice of the type of measurement.

Effect of implementation intention on walking in people with diabetes: an experimental approach

ABSTRACT OBJECTIVE To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Manutenção da permeabilidade dos dispositivos de acesso venoso central em pacientes com câncer / Maintenance of central venous access devices permeability in cancer patients / Mantenimiento de la permeabilidad de los dispositivos de acceso venoso central en pacientes con câncer

Objetivo: atualizar o conhecimento sobre a manutenção da permeabilidade dos Dispositivos de Acesso Vascular Central (DAVC) em paciente com câncer. Conteúdo: os pacientes que fazem uso de quimioterápicos muitas vezes necessitam de DAVC seguros e de longa permanência; a obstrução ocorre em 36% dos pacientes com DAVC inseridos no período de 2 anos, que pode ser classificada como mecânica, por precipitação de medicamento/minerais e pela formação de coágulos. A equipe de enfermagem é responsável por realizar os cuidados para manter a permeabilidade desses dispositivos através do Flushing e Locking. O uso de heparina demonstrou baixa evidência quando comparado ao Soro Fisiológico (SF), em relação a diminuição da obstrução. Conclusão: o uso de SF na manutenção dos DAVC mostra-se seguro, eficaz e com menor custo financeiro.

Objective: to update the knowledge on the maintenance of permeability of Central Vascular Access Devices (CVAD) in cancer patients. Content: Patients on chemotherapy often require safe, long-term CKD. Obstruction occurs in 36% of patients with CVAD inserted in a 2-year period, which can be classified as mechanical due to drug / mineral precipitation and clot formation. The nursing staff is responsible for taking care to maintain the permeability of these devices through Flushing and Locking. The use of heparin showed low evidence when compared to saline (SF), regarding the reduction of obstruction. Conclusion: the use of DES to maintain CVAD is safe, effective and has a lower financial cost.

Objetivo: actualizar los conocimientos sobre el mantenimiento de la permeabilidad del dispositivo de acceso vascular central (DAVC) en pacientes con cáncer. Contenido: los pacientes que usan quimioterápicos a menudo necesitan DAVC seguros y de larga permanência. La obstrucción ocurre en el 36% de los pacientes con DAVC insertados en el período de 2 años y puede ocorir por precipitación de medicamento / minerales y por la formación de coágulos. El equipo de enfermería es responsable de realizar los cuidados para mantener la permeabilidad de estos dispositivos a través del Flushing y Locking. El uso de heparina demostró una baja evidencia en comparación con el Suero Fisiológico (SF), en relación con la disminución de la obstrucción. Conclusión: el uso de SF en el mantenimiento de los DAVC se muestra seguros, eficaz y con menor costo financiero.

Dietary sources of salt intake in adults and older people: a population-based study in a Brazilian town.

OBJECTIVE: To assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population. DESIGN: Population-based cross-sectional survey. SETTING: Salt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake).ParticipantsAdults and older people (n 517) aged 20-80 years, living in Artur Nogueira, São Paulo, Brazil. RESULTS: Mean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10·5 and 11·0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68·2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11·7 v. 9·6 g salt/d; P<0·0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake. CONCLUSIONS: Salt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference.

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence.

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence / Qualidade de vida de coronariopatas após implementação de estratégias de planejamento para adesão medicamentosa / Calidad de vida de pacientes con enfermedad coronaria después de implementación de estrategias de planificación para adherencia a medicamentos

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring. .

OBJETIVO: comparar a qualidade de vida relacionada à saúde - geral e específica - de pacientes coronariopatas entre os grupos Intervenção e Controle, após a implementação das estratégias de Planejamento de Ação e de Enfrentamento de Obstáculos para adesão medicamentosa e verificar a relação entre adesão e qualidade de vida, relacionada à saúde. MÉTODO: trata-se de estudo controlado e randomizado. RESULTADOS: a amostra (n=115) foi aleatorizada nos grupos Intervenção (n=59) e Controle (n=56). Foram obtidas medidas de adesão medicamentosa e de qualidade de vida relacionada à saúde geral e específica, na fase inicial do estudo e após dois meses de seguimento. CONCLUSÃO: os achados evidenciaram que a combinação de estratégias de intervenção - Planejamento de Ação e de Enfrentamento de Obstáculos para adesão medicamentosa não influenciou a qualidade de vida relacionada à saúde de pacientes coronariopatas em seguimento ambulatorial. .

OBJETIVO: comparar la calidad de vida relacionada a la salud (CVRS) - general y específica de pacientes con enfermedad coronaria entre los grupos Intervención y Control después de la implementación de las estrategias de Planificación de Acción y de Enfrentamiento de Obstáculos para adherencia a medicamentos y verificar la relación entre adherencia y CVRS. MÉTODO: se trata de estudio controlado y aleatorio. RESULTADOS: la muestra (n=115) fue del tipo aleatorio en los grupos GI (n=59) y GC (n=56). Fueron obtenidas medidas de adherencia a medicamentos y de CVRS general y específica, en la fase inicial del estudio y después de dos meses de seguimiento. CONCLUSIÓN: los hallazgos evidenciaron que la combinación de estrategias de intervención - Planificación de Acción y de Enfrentamiento de Obstáculos para adherencia a medicamentos no influenció la CVRS de pacientes con enfermedad coronaria en seguimiento en ambulatorio. .

Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior.

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.

Cultural adaptation to Brazil and psychometric performance of the Evidence-Based Practice Questionnaire / Adaptação cultural para o Brasil e desempenho psicométrico do Evidence-Based Practice Questionnaire

Objectives To culturally adapt the instrument “Evidence-Based Practice Questionnaire” (EBPQ) to the Portuguese language and assess its psychometric qualities. Methods The steps of cultural adaptation of measurement instruments were followed. Reliability was verified through internal consistency, stability by test-retest, and construct validity by the contrasted groups approach. Results High Cronbach’s alpha (0.91 to 0.68) and satisfactory Intraclass Correlation Coefficient (0.90) were obtained in all domains. In assessing construct validity, significant differences were found between groups of nurses with different backgrounds. Conclusion The steps of cultural adaptation of measurement instruments have been successfully completed. The Brazilian version obtained presents reliable psychometric properties for its use in this population. .

Objetivo Adaptar culturalmente o instrumento EBPQ para a língua portuguesa e avaliar suas qualidades psicométricas. Métodos Foram seguidos os passos de adaptação cultural de instrumentos de medida. Foi verificada a confiabilidade por meio da avaliação da consistência interna e da estabilidade pelo teste-reteste e a validade de constructo com abordagem de grupos contrastados. Resultados Obteve-se Coeficiente Alfa de Cronbach elevado em todos os domínios (0,91 – 0,68) e Coeficiente de Correlação Intraclasse satisfatório (0,90). Na avaliação da validade de constructo, houve diferença significativa entre os grupos de enfermeiros com diferentes formações. Conclusão As etapas de adaptação cultural de instrumentos de medida foram concluídas com sucesso. A versão brasileira obtida apresenta propriedades psicométricas confiáveis para a sua utilização nessa população. .

Implementation Intentions on the Effect of Salt Intake among Hypertensive Women: A Pilot Study.

This experimental study was aimed at assessing the potential effect of a theory-driven intervention-implementation intentions-on reducing salt intake among hypertensive Brazilian women. Ninety-eight participants were randomly assigned to participate in an implementation intentions intervention aimed at promoting lower salt intake through decreased addition of salt and salty spices to meals (intervention group, n = 49; group, n = 49). Endpoints were assessed at baseline and at the 2-month follow-up. Primary endpoints were a self-reporting measure of salt intake given by salt addition to meals (discretionary salt + salty spices = total added salt) and the 24 h urinary-sodium excretion. Secondary endpoints included intention, self-efficacy, and habit related to adding salt to meals. Patients in the intervention group showed a significant reduction in salt intake as assessed by 24 h urinary-sodium excretion. A significant reduction in the measure of habit was observed for both groups. No differences were observed for intention and self-efficacy. The results of this pilot study suggest the efficacy of planning strategies to help hypertensive women reduce their salt intake.

Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior / Crenças relacionadas à adesão ao tratamento com antidiabéticos orais segundo a Teoria do Comportamento Planejado / Creencias relacionadas a la adhesión al tratamiento con antidiabéticos orales según la Teoría del Comportamiento Planificado

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior. .

OBJETIVO: identificar as crenças salientes comportamentais, normativas, de controle e de autoeficácia, relacionadas ao comportamento de adesão aos antidiabéticos orais, utilizando a Teoria do Comportamento Planejado. MÉTODO: estudo transversal, exploratório, com 17 diabéticos, em uso contínuo de antidiabético oral, em seguimento ambulatorial. As entrevistas individuais foram gravadas, transcritas e submetidas à análise de conteúdo, utilizando-se categorias pré-definidas. RESULTADOS: emergiram crenças comportamentais relacionadas às vantagens e desvantagens do uso dos medicamentos, como a possibilidade de evitar complicações do diabetes, evitar ou retardar o uso de insulina e percepção de reações adversas. Evidenciou-se que os filhos e o médico são importantes referentes sociais que influenciam a adesão medicamentosa. Dentre os fatores que facilitam a adesão destacaram-se o acesso gratuito aos medicamentos e a tomada dos medicamentos relacionada a marcadores temporais. A complexidade terapêutica, por outro lado, foi considerada fator que dificulta a adesão. A compreensão da forma de uso dos medicamentos e o esquecimento impactam a percepção da capacidade de aderir aos antidiabéticos orais. CONCLUSÃO: a adesão medicamentosa é um comportamento complexo, permeado por crenças comportamentais, normativas, de controle e autoeficácia que devem ser consideradas na avaliação dos determinantes do comportamento. .

OBJETIVO: identificar creencias destacadas comportamentales, normativas, de control y de autoeficacia, relacionadas al comportamiento de adhesión a antidiabéticos orales, utilizando la Teoría del Comportamiento Planificado. MÉTODO: estudio transversal, exploratorio, con 17 diabéticos, que usaban continuamente antidiabético oral, en seguimiento en ambulatorio. Las entrevistas individuales fueron grabadas, transcritas y sometidas al análisis de contenido, utilizando categorías predefinidas. RESULTADOS: surgieron creencias comportamentales relacionadas a las ventajas y desventajas del uso de los medicamentos, como la posibilidad de evitar complicaciones de la diabetes, evitar o retardar el uso de insulina y percibir reacciones adversas. Se evidenció que los hijos y el médico son importantes referentes sociales que influencian la adhesión medicamentosa. Entre los factores que facilitan la adhesión se destacaron el acceso gratuito a los medicamentos y la toma de medicamentos relacionada a marcadores temporales. Por otro lado, la complejidad terapéutica fue considerada un factor que dificulta la adhesión. La comprensión de la forma de uso de los medicamentos y el olvido impactan la percepción de la capacidad de adherir a los antidiabéticos orales. CONCLUSIÓN: la adhesión medicamentosa es un comportamiento complejo permeado por creencias comportamentales, normativas, de control y autoeficacia que deben ser consideradas en la evaluación de los determinantes del comportamiento. .