Self-efficacy measurement instruments for individuals with coronary artery disease: A systematic review.

INTRODUCTION: Over the past decade, there has been a heightened interest in evaluating self-efficacy among patients with coronary artery disease (CAD). A significant number of instruments have been developed and validated, yet the need remains to assess the quality of their studies and their properties. OBJECTIVES: To evaluate the measurement properties and link the content extracted from self-efficacy instrument items for individuals with CAD to the International Classification of Functioning, Disability, and Health (ICF). METHODOLOGY: The study was conducted following the Cochrane systematic review guidelines and COnsensus norms for Selection of health Measuring INstruments (COSMIN), registered under CRD42021262613. The search was carried out on MEDLINE (Ovid), Web of Science, EMBASE, and PsycINFO, including studies involving the development and validation of self-efficacy instruments for individuals with CAD, without language or date restrictions. Data extraction was performed in May 2022 and updated in January 2023 and all the steps of this review were carried out by two different collaborators and reviewed by a third when there were divergences. Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommended by COSMIN was used to determine the quality of evidence as high, moderate, low, or very low. Instrument categorization was carried out per COSMIN recommendations, according to the construct of interest and study population into three categories (A, B, or C). RESULTS: A total of 21 studies from 12 instruments were identified. The best-rated instruments received a recommendation of B, which means, additional validation studies are needed. Barnason Efficacy Expectation Scale (BEES) showed high-quality evidence for structural, construct, criterion, and internal consistency validity; Cardiac Self-Efficacy Scale (CSES) demonstrated high quality for content, structural, cross-cultural validity, and internal consistency; Self-efficacy for Appropriate Medication Use (SEAMS) achieved a high level for structural, criterion, and internal consistency validity; Cardiovascular Management Self-Efficacy Scale exhibited high-level validity for structural, criterion, construct, and internal consistency. The CSES showed content linkage with all domains of the ICF, as well as the highest number of linkages with the categories. CONCLUSIONS: Instruments with a B-level recommendation hold potential for use. More studies assessing measurement properties are needed to reinforce or improve these recommendations. The CSES stands out as the most comprehensive instrument concerning the ICF.

Translation and cross-cultural adaptation of the Model Disability Survey (MDS) for Brazil.

OBJECTIVE: This study has as objective the translation and cross-cultural adaptation of the Model Disability Survey (MDS), a World Health Organization instrument that provides comprehensive information on disability/functioning, for Brazil. METHODS: This is a cross-sectional methodological study, carried out through five stages - initial translation, synthesis of translations, reverse translation, review by a specialist committee, and pre-test -, considering properties such as semantic, idiomatic, experimental, and conceptual equivalence. Translators, researchers, a mediating team, health professionals, a methodologist and a language specialist were needed to pass through the stages. Statistical analysis was produced from absolute and relative frequencies, measures of central tendency and dispersion, normality tests and content validity index (CVI) > 0.80. RESULTS: The MDS has 474 items, which generated 1,896 analyzes of equivalence. Of these, 160 items had a CVI < 0.80 in at least one of the four types of equivalence and required adjustments. After adaptations and approval by the judges, the pre-final version went on to the pre-test with 30 participants from four regions of the Brazilian Northeast. Regarding this sample, 83.3% are women, single, with an average age of 33.7 years (SD 18.8), self-declared as black or brown, active workers, with technical education and living with three residents. Interviews lasted 123 minutes on average, where 127 health conditions were mentioned, and the most frequent cited were anxiety and back pain. Answers were analyzed and 63 items were cited as needing some adjustment, two of which were submitted for analysis by the committee because they presented a CVI < 0.80. The instrument, guide and presentation cards were adjusted after a new pre-test. CONCLUSIONS: The MDS was translated and cross-culturally adapted to Brazilian Portuguese and showed adequate content validity.

Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis.

AIMS: To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases. METHODS: A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023. RESULTS: We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators. CONCLUSIONS: This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.

Effects of home healthcare for adults with chronic respiratory diseases and post-COVID-19 syndrome on hospital bed turnover rate: a protocol of systematic review with meta-analysis.

INTRODUCTION: Chronic respiratory diseases (CRDs) have a high prevalence, morbidity and mortality worldwide. After the COVID-19 pandemic, the number of patients readmitted after hospital discharge increased. For some populations, early hospital discharge and home healthcare may reduce health costs in patients treated at home when compared with those hospitalised. This study aims to systematically review the effectiveness of home healthcare for patients with CRDs and post-COVID-19 syndrome. METHODS AND ANALYSIS: We will search on MEDLINE, CENTRAL, Embase and PsycINFO. We will include randomised controlled trials (RCTs) and non-RCT studies reported in full text and abstracts. No language restriction will be applied. We will include studies related to adults with a diagnosis of CRDs or post-COVID-19 syndrome that compared in-patient hospital care with any home healthcare. We will exclude studies with participants with neurological, mental diseases, cancer or pregnant women. Two review authors will screen abstracts and select the eligible studies. To investigate the risk of bias, we will use the Cochrane 'Risk of Bias' tool for RCT, and the Risk of Bias In Non-randomised Studies-of Interventions for non-RCT. We will use the five Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) considerations to assess the quality of the evidence. Patients and the public will be involved in the preparation, execution and implementation phases of the review. ETHICS AND DISSEMINATION: No ethical approval is required because only published data will be analysed. The publication of the results in peer-reviewed journals and at relevant conferences will guide the direction of future research in the field and healthcare practice. The results will also be disseminated in plain language on social media to disseminate the knowledge to society and the public interested in the topic.

Translation of the Involvement Matrix tool into Brazilian Portuguese / Tradução da ferramenta Involvement Matrix para o português brasileiro

Abstract Introduction Patient and public involvement has numerous benefits for research; however, there are challenges to its implementation, such as the lack of tools to guide participant engagement in research. The Involvement Matrix (IM) is a tool that facilitates discussion about the role that participants play in research projects, promoting more active public involvement. Objective To translate IM materials into Brazilian Portuguese in order to facilitate their use and guide researchers. Methods Authorization to translate the original material into Brazilian Portuguese was obtained from the authors. Next, the translated material underwent backtranslation. The resulting version was verified by the original IM authors, ensuring semantic and content accuracy. Results The Involvement Matrix (IM) was translated into Portuguese and then backtranslated into English. The researchers discussed the translated version with the IM authors, with minimal adjustments needed in the backtranslation, and no changes made to the Portuguese version. After the approval of the final Brazilian Portuguese version, the translated tools were made available, including a Practical Guide, a Word Version, a Checklist, a Fact Sheet, an Overview with Examples, and an Animated Video with Brazilian Portuguese subtitles. Conclusion The various IM materials are adequately translated and freely available for use in Brazil. It is a valuable tool to guide public and patient involvement in research.

Resumo Introdução O envolvimento do paciente e do público traz diversos benefícios para a pesquisa, no entanto, existem desafios para sua implementação, como a falta de ferramentas que orientem o engajamento dos participantes em pesquisas que os envolvem. A Involvement Matrix (IM) é uma ferramenta que facilita o diálogo sobre o papel que o participante da pesquisa deseja desempenhar em projetos de pesquisas pro-movendo um envolvimento mais ativo desse público. Objetivo Traduzir os materiais da IM para o português brasileiro, a fim de disponibilizar seu uso no Brasil e ori-entar pesquisadores. Métodos Solicitou-se autorização aos autores do instrumento original para traduzi-lo para o português brasileiro. Em seguida, o material traduzido passou por um processo de retrotradução. O resultado foi verificado pelos autores da IM, garantindo a precisão semântica e de conteúdo. Resultados A Matriz de Envolvimento (ME) foi traduzida para o português e retrotraduzida ao inglês. Posteriormente, os pesquisadores da versão brasileira realizaram uma reunião com os autores da ME para esclarecer dúvi-das, havendo a necessidade de mínimos ajustes na retrotradução, sem mudanças da versão em português. Após a aprovação da versão final em português brasi-leiro, foram disponibilizadas as ferramentas traduzidas: um Guia Prático, uma Versão em Word, uma Lista de Verificação, uma Ficha Técnica, uma Visão Geral com Exemplos e um Vídeo Animado legendado em português brasileiro. Conclusão Os diversos materiais da ME estão adequadamente traduzidos e disponíveis gratuitamente para uso no Brasil. Trata-se de uma ferramenta valiosa para guiar o envolvimento do público e do paciente em pesquisas.

Translation and cross-cultural adaptation of the Model Disability Survey (MDS) for Brazil / Tradução e adaptação transcultural do Model Disability Survey (MDS) para o Brasil

ABSTRACT OBJECTIVE This study has as objective the translation and cross-cultural adaptation of the Model Disability Survey (MDS), a World Health Organization instrument that provides comprehensive information on disability/functioning, for Brazil. METHODS This is a cross-sectional methodological study, carried out through five stages - initial translation, synthesis of translations, reverse translation, review by a specialist committee, and pre-test -, considering properties such as semantic, idiomatic, experimental, and conceptual equivalence. Translators, researchers, a mediating team, health professionals, a methodologist and a language specialist were needed to pass through the stages. Statistical analysis was produced from absolute and relative frequencies, measures of central tendency and dispersion, normality tests and content validity index (CVI) > 0.80. RESULTS The MDS has 474 items, which generated 1,896 analyzes of equivalence. Of these, 160 items had a CVI < 0.80 in at least one of the four types of equivalence and required adjustments. After adaptations and approval by the judges, the pre-final version went on to the pre-test with 30 participants from four regions of the Brazilian Northeast. Regarding this sample, 83.3% are women, single, with an average age of 33.7 years (SD 18.8), self-declared as black or brown, active workers, with technical education and living with three residents. Interviews lasted 123 minutes on average, where 127 health conditions were mentioned, and the most frequent cited were anxiety and back pain. Answers were analyzed and 63 items were cited as needing some adjustment, two of which were submitted for analysis by the committee because they presented a CVI < 0.80. The instrument, guide and presentation cards were adjusted after a new pre-test. CONCLUSIONS The MDS was translated and cross-culturally adapted to Brazilian Portuguese and showed adequate content validity.

RESUMO OBJETIVO Traduzir e adaptar transculturalmente o Model Disability Survey (MDS), instrumento da Organização Mundial da Saúde que fornece informações abrangentes a respeito de deficiência/funcionalidade, para o Brasil. MÉTODOS Trata-se de um estudo metodológico de corte transversal, realizado por meio de cinco etapas - tradução inicial, síntese das traduções, retrotradução, revisão por comitê de especialistas e pré-teste -, considerando propriedades como equivalência semântica, idiomática, experimental e conceitual. Para realização das etapas foram necessários tradutores, pesquisadores, equipe mediadora, profissionais da saúde, metodologista e especialista em idiomas. A análise estatística foi produzida a partir de frequências absolutas e relativas, medidas de tendência central e dispersão, testes de normalidade e índice de validade de conteúdo (IVC) > 0,80. RESULTADOS O instrumento MDS apresenta 474 itens, o que gerou 1.896 análises de equivalências. Destes, 160 itens apresentaram IVC < 0,80 em pelo menos uma das quatro equivalências e necessitaram de ajustes. Após adequações e aprovação dos juízes, a versão pré-final seguiu para o pré-teste com 30 participantes, de quatro regiões do Nordeste brasileiro. Desta amostra, 83,3% são mulheres, solteiras, com idade média de 33,7 (DP 18,8) anos, autodeclaradas pretas ou pardas, trabalhadoras ativas, com escolaridade a partir do ensino técnico e que residiam com três moradores. O tempo médio das entrevistas foi de 123 minutos de duração. Foram mencionadas 127 condições de saúde, sendo as mais frequentes ansiedade e dores nas costas. As respostas foram analisadas e 63 itens foram citados como necessitando de algum ajuste, sendo dois destes encaminhados para análise pelo comitê por possuírem IVC < 0,80. O instrumento, manual e cartões de apresentação foram ajustados após um novo pré-teste. CONCLUSÕES O MDS foi traduzido e adaptado transculturalmente para o português brasileiro e apresentou adequada validade de conteúdo.

Effects of respiratory physiotherapy interventions on pulmonary mechanics of newborns: a protocol for a systematic review.

INTRODUCTION: Although respiratory physiotherapy techniques may reduce respiratory load in newborns, manual contact with the ribcage may interfere with pulmonary mechanics. Therefore, this systematic review aims to evaluate the effects of conventional and non-conventional respiratory physiotherapies on pulmonary mechanics of newborns. METHODS AND ANALYSIS: We will search PubMed, LILACS, SciELO, ScienceDirect, Cochrane Central and Web of Science databases. Searches will be conducted from September 2022. We will include randomised clinical trials reporting thoracoabdominal synchrony, lung volumes and capacities, respiratory discomfort and pain in newborns aged between 1 hour and 28 days and admitted to neonatal intensive care units. We will exclude studies not fully available or incomplete and studies conducted with newborns presenting structural alterations. Two independent researchers will perform the study selection, data extraction and quality assessment. After consensus, one reviewer will proceed with the process. We will include studies published in English or Portuguese, without publication date restriction. An overview of the included studies and extracted information will be reported and the quality of studies will be assessed. A meta-analysis will be conducted if data regarding between-group comparisons are available. ETHICS AND DISSEMINATION: Ethics approval is not required for this systematic review. Results will be presented in journals and national and international conferences, and findings will be shared on social media using accessible language. PROSPERO REGISTRATION NUMBER: CRD42021266729.

Self-efficacy instruments for individuals with coronary artery disease: a systematic review protocol.

INTRODUCTION: Self-efficacy is associated with management of diseases, psychological well-being, improved quality of life and rehabilitation adherence. Several instruments related to behaviour or specific disease (eg, coronary artery disease (CAD)) assess self-efficacy. The evaluation of cardiac self-efficacy in individuals with CAD will support healthcare professionals to improve self-efficacy via interventions; therefore, a suitable instrument is crucial. This systematic review aims to assess measurement properties, methodological quality and content of outcome measures of cardiac self-efficacy instruments for individuals with CAD. METHODS AND ANALYSIS: The study has been developed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and Consensus Norms for Selection of Health Measuring Instruments (COSMIN). The following databases will be searched: MEDLINE (Ovid), Web of Science, EMBASE and PsycINFO. Studies assessing measurement properties of cardiac self-efficacy instruments for individuals with CAD will be included. No date or language restrictions will be applied to the search. Two independent authors will be responsible for assessing the eligibility of studies. Methodological quality of studies will be assessed using the COSMIN RoB Checklist, and the Grading of Recommendations, Assessment, Development and Assessment will be used to assess the quality of each study. Two authors will independently evaluate the content of instruments and link this to the International Classification of Functioning, Disability and Health. ETHICS AND DISSEMINATION: This study does not require ethics committee approval since it is based on previously published data. Evidence from this systematic review will be disseminated through publication in peer-reviewed journals and presentation at scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021262613.

Co-Design of an Intervention to Increase the Participation in Leisure Activities Including Adolescents with Cerebral Palsy with GMFCS Levels IV and V: A Study Protocol.

The participation of adolescents with cerebral palsy (CP) within the community is reduced compared to their peers and is a barrier to their socialization, self-determination and quality of life. Patient and Public Involvement (PPI) is a key strategy for successful interventions, especially when involvement of the stakeholders takes place at all stages of the research. Co-design can be crucial for success as researchers, patients with CP and their families work together to bring the necessary elements to the interventions to be designed. The objectives will be: (1) To co-design an intervention aimed at improving the participation of adolescents with significant motor disabilities within the community in partnership with adolescents with CP, families and rehabilitation professionals. (2) To assess the feasibility of the co-design process in partnership with interested parties. The study will be based on Participatory Action Research (PAR) and will be held in Spain and Brazil. In both countries, the study will be carried out remotely with nine adolescents aged 12 to 17 years with CP, Gross Motor Function Classification System (GMFCS) levels IV-V, their families and six health professionals (physiotherapists and occupational therapists). Different dialogue groups will be created to involve adolescents, families and health professionals to the research's project. To manage their involvement in the co-design process, the Involvement Matrix (IM) will be used, and according to the IM phases, four steps will be included in the research: (1) Preparation; (2) Co-design; (3) Analysis: results of the intervention protocol and the study's feasibility and (4) Dissemination of results. Partnering with the public to design an intervention to improve participation can bring better results compared to protocols designed only by health professionals. In addition, it will allow for knowing the needs of adolescents with CP in terms of participation within the community. The study will also explore which roles were chosen by all participants and how they felt while actively participating in the process of co-designing an intervention protocol and their own perspectives on the use of the involvement matrix.

Translation, cross-cultural adaptation and psychometric evaluation of the Brazilian version of the Cystic Fibrosis Knowledge Scale (CFKS).

BACKGROUND: Information on the level of knowledge about cystic fibrosis (CF) among affected people and their families is still scarce. OBJECTIVE: This study aimed to translate, cross-culturally adapt and analyze the psychometric properties of the Brazilian version of Cystic Fibrosis Knowledge Scale (CFKS). MATERIALS AND METHODS: The translation and cross-cultural adaptation involved the stages of translation, synthesis of translations, reverse translation, synthesis of reverse translations, review by a multi-professional committee of experts and pre-testing. The reliability, viability, construct, predictive, concurrent and discriminant validity were investigated. RESULTS: The sample consisted of 40 individuals with cystic CF, 47 individuals with asthma, 242 healthcare workers and 81 students from the health area. The Brazilian version of the CFKS presented high internal consistency (α = 0.91), moderate floor and ceiling effects, without differences in the test-retest scores. An analysis of factorial exploration identified three dimensions. Confirmatory factor analysis led to an acceptable data-model fit. There was good predictive validity, with a difference in the scores among all the evaluated groups (p <0.001), as well as good discriminant validity since individuals with asthma had greater knowledge of asthma compared to CF (r = 0.401, p = 0.005; r2 = 0.162). However, there was no difference between the diagnosis time and knowledge about CF (r = -0.25, p = 0.11; r2 = 0.06), either between treatment adherence and knowledge about CF (r = -0.04, p = 0.77; r2 = 0.002). CONCLUSION: The Brazilian version of the CFKS indicated that the scale is able to provide valid, reliable and reproducible measures for evaluating the knowledge about CF.

Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Buteyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma. METHODS AND ANALYSIS: We will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database's inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the 'Risk of Bias' tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions. ETHICS AND DISSEMINATION: This study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research. PROSPERO REGISTRATION NUMBER: CRD42020193132.

Galeria ilustrada da classificação internacional de funcionalidade e incapacidade em saúde: relato de experiência / Illustrated gallery of the international classification of functionality and disability in health: experience report / Galería ilustrada de la clasificación internacional de funcionalidad y discapacidad en salud: informe de experiencia

Introdução: A Síndrome Congênita do Zika constitui uma nova condição de saúde, advinda do surto do vírus Zika no Brasil no início do ano 2015. É caracterizada por um conjunto de anormalidades que envolve a desproporção craniofacial, irritabilidade, espasticidade, convulsões, dificuldades alimentares, anormalidades oculares e perda auditiva. Objetivo:Relatar a experiência do uso da Galeria Ilustrada da Classificação Internacional de Funcionalidade, Incapacidade e Saúde como auxílio para coleta de dados em pesquisa sobre funcionalidade e incapacidade em crianças com Síndrome congênita do Zika. Metodologia: Foram construídos 3 instrumentos visuais baseados na versão resumida da Classificação Internacional de Incapacidade e Funcionalidade em Saúde e aplicados com 32 pais de crianças com diagnóstico confirmado da Síndrome congênita do Zika. Foram capturadas as imagens da galeria ilustrada nos domínios de atividade e participação, funções do corpo e fatores ambientais, de modo a facilitar a elaboração de respostas das entrevistas. Resultados: O instrumento visual permitiu aos participantes da pesquisa um processo de entrevista dinâmico, compreensível e espontâneo através de uma melhor compreensão dos conceitosda Classificação Internacional de Incapacidade e Funcionalidade em Saúde, e desse modo permitiu aos pesquisadores obter suas percepções a respeito da condição de saúde dos filhos dos entrevistados. Conclusões: Ferramentas visuais envolvendo a galeria ilustrada podem ser utilizadas como auxílio na coleta de dados em pesquisas qualitativas que envolvem a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (AU).

Introduction:Congenital Zika Syndrome is a new health condition, arising from the Zika virus outbreak in Brazil in early 2015. It is characterized by a set of abnormalities involving craniofacial disproportion, irritability, spasticity, seizures, eating difficulties, eye abnormalities and hearing loss.Objective:To report the experience of using the Illustrated Gallery of the International Classification of Functioning, Disability and Health as an aid to data collection in research on functionality and disability in children with congenital Zika Syndrome.Methodology:Three visual instruments were builtbased on the abridged version of the International Classification of Disability and Functioning in Health and applied to 32 parents of children with a confirmed diagnosis of congenital Zika Syndrome. Images from the illustrated gallery were captured in the domains of activity and participation, body functions and environmental factors, in order to facilitate the elaboration of interview responses. Results:The visual instrument allowed research participants a dynamic, understandable and spontaneous interview process through a better understanding of the concepts of the International Classification of Disability and Functioning in Health, and thus allowed the researchers to obtain their perceptions about the condition of your children's health. Conclusions:Visual tools involving the illustrated gallery can be used as an aid in data collection in qualitative research involving the International Classification of Functioning, Disability and Health (AU).

Introducción:El síndrome de Zika congénito es una nueva condición de salud, que surge del brote del virus del Zika en Brasil a principios de 2015. Se caracteriza por un conjunto de anomalías que involucran desproporción craneofacial, irritabilidad, espasticidad, convulsiones, dificultades para comer, anomalías oculares y auditivas. pérdida. Objetivo:Informar la experiencia de utilizar la Galería Ilustrada de la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud como ayuda para la recopilación de datos en la investigación sobre la funcionalidad y la discapacidad en niños con síndrome congénito del Zika. Metodología:Se construyeron tres instrumentos visuales basados en la versión abreviada de la Clasificación Internacional de Discapacidad y Funcionamiento en Salud y se aplicaron a 32 padres de niños con diagnóstico confirmado de síndrome congénito del Zika. Se capturaron imágenes de la galería ilustrada en los dominios de actividad y participación, funciones corporales y factores ambientales, con el fin de facilitar la elaboración de las respuestas de la entrevista. Resultados:El instrumento visual permitió a los participantes de la investigación un proceso de entrevista dinámico, comprensible y espontáneo a través de una mejor comprensión de los conceptos de la Clasificación Internacional de Discapacidad y Funcionamiento en Salud, y así permitió a los investigadores obtener sus percepciones sobre elestado de salud de sus hijos. Conclusiones:Las herramientas visuales que involucran la galería ilustrada se pueden utilizar para ayudar en la recopilación de datos en la investigación cualitativa que involucra la Clasificación Internacional de Funcionamiento, Discapacidad y Salud (AU).

Relationship between anxiety symptoms, clinical control and quality of life of children with asthma: A cross-sectional study.

OBJECTIVE: To investigate the relationship between anxiety symptoms and factors related to clinical control and quality of life of children with asthma aged 7-12 years. METHODS: A cross-sectional comparative study involving children recruited from a reference center for asthma treatment in the city of Natal-RN. Diagnosis, control and severity were performed following GINA recommendations (2019). Sociodemographic information and spirometry results from a bronchodilator test were collected. Modified Fisher's scale, clinical control questionnaires (c-ACT and ACT), quality of life assessment (PAQLQ) (total score and domains) and anxiety symptoms assessment (SCAS) (total score and domains) were applied. RESULTS: The sample consisted of 42 children with asthma. Symptoms of social phobia (as identified by SCAS), and household head education were related to clinical asthma control (p = .006; R 2 = .19). Total SCAS score, guardian's education and physical activity were related to total PAQLQ (p < .0001; R 2 = .33). SCAS was related to the activity limitation domain of PAQLQ (p = .004; R 2 = .17). SCAS, gender, and physical activity were related to the PAQLQ symptoms domain (p = .003; R 2 = .32). The guardian's education, physical activity practice, and the symptoms of separation anxiety, panic attack and agoraphobia (as identified by SCAS) were related to the emotional domain of PAQLQ (p = .004; R 2 = .45). CONCLUSION: The present study shows evidence of an association between anxiety symptoms, poorer clinical control, and health-related quality of life in children with asthma.

Barriers and facilitators to populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a rapid qualitative evidence synthesis protocol.

INTRODUCTION: The current COVID-19 pandemic has increased the need for populational adherence to measures for the prevention and control of respiratory infectious diseases. However, their effectiveness depends on the population's preventive behaviour, which may be divergent from public policies. Therefore, this study aims to summarise and evaluate the evidence on barriers and facilitators to populational adherence to prevention and control measures in COVID-19 and other respiratory infectious diseases. METHODS AND ANALYSIS: We will search on MEDLINE, Embase and PsycINFO for studies focusing on adults receiving protective behaviour recommendations to combat COVID-19 and other respiratory infectious diseases. The searches will be carried out from database's inception to the present. We will include studies that use qualitative methods in their data collection and analysis and studies that use mixed methods if they include any qualitative methods of analysis. Studies published in English, Portuguese and Spanish will be included. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the Critical Skills Appraisal Programme tool. For the assessment of the confidence in the synthesised findings, we will use the GRADE-Confidence in the Evidence from Reviews of Qualitative research. Data analysis will be conducted using the best-fit framework approach based on adapted dimensions from the Health Belief Model and the Behaviour Change Wheel. ETHICS AND DISSEMINATION: This study will be conducted on published evidence, and thus, no ethical approval is required. The findings of this rapid qualitative evidence synthesis will be disseminated to academic audiences, health policy-makers and the general population. We will publish the results in peer-reviewed journals, present our findings in conferences, and disseminate results via social media. We also aim to present the research findings in plain language and disseminate the knowledge to the general population to increase public interest. PROSPERO REGISTRATION NUMBER: CRD42020205750.

Patient- and proxy-reported outcome measures instruments for the assessment of asthma control among adult and pediatric population: A protocol for systematic review.

BACKGROUND: Asthma is a chronic airways inflammatory disease considered as a serious public health problem. Since asthma is a lifelong condition, the assessment of its control is important to achieve a better self-management. Based on the advances of the assessment tools, many instruments have been developed to assess asthma control. Therefore, this systematic review aims to assess the measurement properties, the methodological quality, and the content of outcome measures of the available patient- and proxy-reported asthma control instruments. METHODS: This is a systematic review protocol of the measurement properties of asthma control patient- and proxy-reported outcome instruments. Database searches will be primarily performed on MEDLINE, EMBASE, Web of Science, ScienceDirect and PsycINFO. A manual search of websites considered databases for questionnaires and reference lists will also be conducted. The methodological quality of the studies and the measurement properties will be critically appraised using the COSMIN risk of bias (RoB) checklist. The content of all measurement instruments will be compared based on the International Classification of Functioning, Disability and Health framework. RESULTS: The findings from this systematic review will be disseminated through publication in a peer-reviewed journal and presented at scientific conferences. CONCLUSION: The proposed systematic review will produce a comprehensive evaluation of the measurement properties of the currently available asthma control instruments for both adult and pediatric populations. We aim to help researchers and practitioners in their choice of an adequate instrument and to highlight the gaps in currently available tools. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42019126042.

Psychometric evaluation of the Brazilian version of the pediatric asthma control and communication instrument.

BACKGROUND: There is a lack of questionnaires capable of evaluating the clinical control of Brazilian children and adolescents with asthma over a wide age range. The Pediatric Asthma Control and Communication Instrument (PACCI) has been validated, but only with English- and Spanish-speaking children in the United States. OBJECTIVES: To evaluate the psychometric properties of the Brazilian version of the PACCI questionnaire. METHODS: A cross-sectional psychometric study conducted with children and adolescents aged 01 to 19 years with a clinical diagnosis of asthma, and their respective parents/guardians. The following assessments were conducted: socioeconomic status; clinical control using the Childhood Asthma Control Test (c-ACT), Asthma Control Test (ACT); caregiver quality of life using the Pediatric Asthma Caregivers Quality of Life Questionnaire (PACQLQ); and pulmonary function test (spirometry). Validity was evaluated as follows: exploratory and confirmatory factor analysis; Cronbach's alpha analysis (α); floor and ceiling effects; receiver operator characteristic curve analysis. RESULTS: A total of 128 participants were included, most of them male (54.7%). The Brazilian version of PACCI had adequate internal consistency (α = .76) and moderate floor and ceiling effects. The internal structure presented acceptable adjustment indices, considering the extraction of four factors. The factors presented adequate α values. Asthma control factor 1 correlated with c-ACT/ACT and PACQLQ. Control domain scores greater than four points (sum of score) and above 1 point (problem index) were indicative of uncontrolled asthma. CONCLUSION: The Brazilian version of PACCI was able to provide valid and reliable measures in evaluating the clinical control of asthma in Brazilian children and adolescents.

How data provided by the Brazilian information system of primary care have been used by researchers.

In this article, we have investigated how researchers use the data provided by the Brazilian Information System of Primary Care . We also searched, for the first time, studies that evaluated the quality and reliability of the information provided by the Primary Care Information System. An integrative review of the literature was performed using the keywords 'information systems, primary care and SIAB' on search databases, and 53 of 174 articles were selected. These publications were classified into two large subgroups: those using the Primary Care Information System as 'data source' and those that took it as the 'object of study'. The first group included 35 studies, 18 of which used demographic and social health data records, and nine described data about diseases, specifically hypertension and diabetes. These data were used by researchers for association with health indicators (20%) or comparison with other information systems (17%), sample or population calculus (9%), estimation of prevalence and characterization of the epidemiological profile of a population (26%) or, more generally, to carry out the assessment of health status (29%). The Primary Care Information System as the 'object of study' group included 18 works, describing the knowledge and practices of professionals in relation to the information system. These researchers pointed out issues in the process of production and information consolidation, mainly due to the lack of training and supervision of community health workers and bureaucratization of their work process. Although some issues in the quality of data provided by the Primary Care Information System were reported by researchers, these findings were not corroborated by two studies that assessed the reliability of information disclosed by this system. Despite changes in the Brazilian health policies, the issue of data quality in health information systems continues to be a challenge preventing data from being used for decision-making and knowledge production.

Effects of aerobic interval training on glucose tolerance in children and adolescents with cystic fibrosis: a randomized trial protocol.

BACKGROUND: Individuals with cystic fibrosis (CF) may develop CF-related diabetes (CFDR). This comorbidity is related to a poorer quality of life, microvascular complications, a decline in lung function, and an increase in exacerbations, as well as delayed growth and puberty. Evidence exists that physical exercise contributes to glycemic control in individuals with non-CF-related diabetes. This exercise is usually continuous with moderate intensity and long duration, which can cause muscle dyspnea and fatigue in CF individuals. Aerobic interval training (AIT) emerges as a safe and effective alternative for treating these individuals. The objective of this study is to evaluate the effects of AIT on glucose tolerance in children and adolescents with CF. METHODS: This study will be a two-arm, prospectively registered, randomized controlled trial with blind assessors and twenty 6- to 18-year-old individuals with cystic fibrosis (CF) from two different Brazilian states. People with CF will be randomly allocated to either the experimental or control group using block randomization, stratified by puberty stage,. Participants from both groups will receive an educational intervention and will be asked to continue their usual daily treatment for the full duration of the study. Those in the experimental group will perform AIT on a cycle ergometer at home three times a week, for 8 consecutive weeks. The sample characterization will include an assessment of puberty stage, socioeconomic status, dyspnea, and anthropometry. The primary outcome will be the change in glucose tolerance, while the secondary outcomes will include lung function, exercise tolerance, respiratory muscle strength, quality of life, and CF exacerbations. All outcomes will be assessed at baseline, week 9, and week 17. DISCUSSION: This is the first study to evaluate the effects of AIT on glucose tolerance in children and adolescents with CF. This study will serve as a basis for guiding clinical practice and decision-making in treating glucose intolerance and CF-related diabetes (CFRD) in children and adolescents with CF. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration System: NCT03653949. Registered on August 31, 2018.

Sistemas de saúde e percepção de barreiras para admissão e aderência em programas de reabilitação cardíaca: estudo comparativo / Health systems and perception of barriers to admission and adherence in cardiac rehabilitation programs: a comparative study

Além da elevada prevalência de doenças cardiovasculares (DCV), iniquidades regionais no acesso aos serviços de saúde e subutilização de programas de reabilitação cardíaca (PRC) ainda são marcantes no cenário brasileiro. Objetivo: Esse estudo visou descrever e comparar barreiras para uso de PRC em usuários de diferentes sistemas de saúde e níveis de atendimento em um estado brasileiro. Métodos: Participantes de PRC e pacientes elegíveis de enfermarias e ambulatórios foram pareados pelos sistemas de saúde que utilizavam e responderam a Escala de Barreiras para Reabilitação Cardíaca (EBRC). Os testes U de Mann-Withney e Kruskal Wallis foram usados para comparar barreiras entre os sistemas de saúde e entre níveis de atendimento, respectivamente. Resultados: Cento e quarenta (87%) pacientes participaram do estudo. A média total dos itens da escala foi 1,98±0,48 e diferiu apenas entre participantes de PRC e pacientes internados (p<0,05). Algumas barreiras de acesso, necessidades percebidas e comorbidades/estado funcional foram maiores no sistema público do que no privado (p<0,05). A falta de conhecimento sobre PRC (3.75±1.66) e a falta de referência médica (2.32±1.53) destacaram-se no domínio necessidades percebidas, que teve o maior escore médio da amostra (2.31±0.71). Conclusões: Barreiras de acesso e necessidades percebidas foram maiores para usuários de serviços públicos. Viagens e trabalho foram barreiras maiores para participantes de PRC, enquanto para pacientes internados e ambulatoriais as maiores barreiras foram necessidades percebidas. Logo, a disseminação de PRC e estratégias para referência de elegíveis devem ser estimuladas em ambos os sistemas de saúde e níveis de atendimento.

In addition to the high prevalence of cardiovascular disease (CVD), regional iniquities in access to health services and underutilization of cardiac rehabilitation programs (CRP) are still significant in the Brazilian scenario. Objective:This study aimed to describe and compare barriers to the use of CRP in users of different health systems and levels of care in a Brazilian state. Methods: CRP participants and eligible inpatients and outpatients were matched by the health systems they used and responded to the Cardiac Rehabilitation Barriers Scale (CRBS). Mann-Whitney U and Kruskal Wallis tests were used to compare barriers in health systems and levels of care, respectively. Results: One hundred and forty (87%) adults with heart disease participated in the study. The total mean score of barriers on the scale was 1.98 ± 0.48 and only differed between CRP participants and inpatients (p<0.05). Some access barriers, perceived needs and comorbidities/functional status were higher in the public services than in the private services (p <0.05). Lack of knowledge about CRP (3.75 ± 1.66) and lack of medical referral (2.32 ± 1.53) were the major barriers in the perceived needs domain, which had the highest average score in the sample (2.31 ± 0.71). Conclusions: Access barriers and perceived needs were greater among users of public services. Travel and work were greater barriers for CRP participants, while for inpatients and outpatients the largest were perceived needs. Therefore, the dissemination of CRP and implementation of strategies for eligible referral should be encouraged in both health systems and levels of care.

Reliability of information on people with disabilities gathered by community health workers in highly consanguineous communities of Northeastern Brazil.

BACKGROUND: In Brazil, community health workers have gathered monthly information on people with disabilities to maintain the Primary Care Information System since 1998; however, few studies have used this database for scientific or public health policy purposes. OBJECTIVES: This study aimed to evaluate the reliability of information on people with disabilities gathered by community health workers in primary care services. METHOD: This was a cross-sectional population-based study conducted in two highly consanguineous communities, involving a population of 18,458 inhabitants in Northeastern Brazil. To study the prevalence of people with disabilities, estimations performed by health workers were compared with those obtained by researchers who interviewed 15.6% of the total population. To study the agreement of the information, data on 106 people with disabilities completed independently by researchers and health workers were compared to evaluate the degree of agreement for 28 variables analysed. Kappa statistics (κ) were used to calculate the inter-rater agreement. RESULTS: The prevalence of disability estimated by community health workers was 3.01 and 2.00% for city A and B, respectively, while the percentages obtained by researchers were 6.72 and 5.65%, respectively, showing an underestimation of prevalence according to community health workers. The Kappa index value obtained for all data analysed (2,589 items excluding losses) was 0.808 (p < 0.01), indicating an almost perfect consistency of information collected by health workers compared to by researchers. CONCLUSION: Community health workers collected information with a high degree of reliability, although the identification of the prevalence of disabled individuals was potentially impaired due to the work process.