La depresión en pacientes con diagnóstico de diabetes mellitus tipo 2

RESUMEN Fundamento: durante la evolución de la diabetes mellitus pueden aparecer complicaciones crónicas que afectan la esperanza y la calidad de vida relacionadas con la salud por lo que se perjudica la salud física y mental de los pacientes. Objetivo: determinar el comportamiento de la depresión en pacientes con diagnóstico de diabetes mellitus del consultorio médico de la familia #21 del municipio Rodas provincia Cienfuegos. Métodos: se realizó un estudio descriptivo de corte transversal, en el período de mayo de 2020 a mayo de 2021, el universo y la muestra estuvieron en correspondencia con los 36 pacientes diabéticos dispensarizados en el consultorio, a los que se les aplicó una encuesta y el Inventario de Depresión Rasgo-Estado. Se estudiaron las variables: edad, sexo, tipo de tratamiento, síntomas de depresión, complicaciones y nivel de depresión. El análisis y procesamiento de la información se hizo mediante el paquete estadístico SPSS versión 15 para Windows, los resultados se expresaron en números y porcientos. Resultados: predominó el sexo femenino en un 58,3 %, el grupo etáreo más representado fue el de 48-57 (50 %). Predominó el grupo de pacientes que consumen hipoglicemiantes orales (55 %). Hubo prevalencia de los pacientes con depresión (72,2 %), siendo más frecuente los que reciben tratamiento con hipoglicemiantes orales (47,2) y existió una elevada incidencia en el sexo femenino (41,6 %). Predominaron los pacientes con complicaciones renales (19,4 %) y cardiovasculares (16,6 %). El 75 % de los pacientes presentaron depresión baja. Conclusiones: en el estudio predominó el sexo femenino y el grupo etáreo de 48-57 años. Existió una prevalencia elevada de las complicaciones asociadas a la aparición de depresión y el consumo de hipoglicemiantes orales. Más de la mitad de los pacientes estudiados presentaron síntomas manifiestos de depresión. Prevalecieron los pacientes que presentaron depresión baja.

ABSTRACT Background: during the evolution of diabetes mellitus, chronic complications may appear that affect life expectancy and health-related quality of life, thus harming the physical and mental health of patients. Objective: to determine the behavior of depression in patients diagnosed with diabetes mellitus of the Family Medical Office #21 of the Rodas municipality, Cienfuegos province. Methods: a descriptive cross-sectional study was carried out, in the period from May 2020 to May 2021, the universe and the sample were in correspondence with the 36 diabetic patients dispensed in the office, to whom a survey was applied and the Adult Depression Test. The variables were studied: age, sex, type of treatment, symptoms of depression, complications, level of depression. The analysis and processing of the information was done using the statistical package SPSS version 15 for Windows, the results were expressed in numbers and percentages. Results: predominance of the female sex in 58.3 %, the most represented age group is that of 48-57 (50 %). The group of patients consuming oral hypoglycemic drugs (55 %) predominated. There was a prevalence of patients with depression (72.2 %), being more frequent those receiving treatment with oral hypoglycemic agents (47.2) and there was a high incidence in females (41.6 %). Patients with renal (19.4 %) and cardiovascular (16.6 %) complications predominated. 75 % of the patients presented low depression. Conclusions: the female sex and the age group of 48-57 predominated in the study. There was a high prevalence of complications associated with the appearance of depression and the consumption of oral hypoglycemic agents. More than half of the patients studied presented manifest symptoms of depression. Patients who presented low depression prevailed.

Trastornos mentales y calidad de vida relacionada con la salud en profesionales de Unidades de Cuidados Intensivos / Mental disorders and health-related quality of life in Intensive Care Units professionals

Resumen Los profesionales de la salud de las Unidades de Cuidados Intensivos (UCI) enfrentan situaciones de sufrimiento humano, competitividad y demanda, que podrían perjudicar su calidad de vida y su salud mental. El objetivo del estudio fue describir los trastornos mentales comunes y la calidad de vida relacionada con la salud en profesionales de la salud de la UCI en Salvador, Brasil. Este estudio transversal con 195 profesionales utilizó un cuestionario sociodemográfico y laboral, el Self-Reporting Questionnaire (SRQ-20) de trastornos mentales comunes y el 36-Item Short Form Health Survey (SF-36v2) de calidad de vida relacionada con la salud. El 29.7 % de los profesionales presentaron trastornos mentales comunes, especialmente entre profesionales de enfermería (RP = 2.28; IC 1.19-4.39; p = .007). La calidad de vida relacionada con la salud para todos los profesionales estuvo disminuida, principalmente en función social (44.25 ± 10.15) y rol emocional (45.86 ± 10.58). El SRQ-20 correlacionó fuertemente con los dominios dolor corporal (r = -.502), salud general (r = -.526), vitalidad (r = -.656), función social (r = -.608), salud mental (r = -.631) y el componente de salud mental (r = -.638) del SF-36v2 (p < .01). Los profesionales con trastornos mentales comunes mostraron una calidad de vida relacionada con la salud más deteriorada, esencialmente en dominios del componente de salud mental, y refirieron también dolor corporal. Es necesario discutir e implementar estrategias de evaluación, prevención y promoción de la salud mental entre los profesionales de las UCI para que sean consideradas dentro de las políticas de salud laboral.

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer-A Randomized Clinical Trial.

BACKGROUND: Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL. METHODS: A prospective clinical study was designed with two parallel arms. The study population consisted of women diagnosed with BCRL in stage I and II, belonging to different institutions in Córdoba and Aragon, Spain. Sociodemographic and HRQoL-related variables, pain, tightness, heaviness and functionality were obtained before and after treatments. RESULTS: 51 women participated in the study, 25 received the conventional treatment and 26 the TAPA, with a mean age of 59.24 ± 9.55 years. HRQoL was significantly related to upper-limb function and pain on the participants' affected side. In addition, covariance analysis (ANCOVA) showed that the TAPA treatment interfered less in the performance of activities of daily life and produced significant improvements in the social dimension of HRQoL. CONCLUSIONS: the non-use of compressive elements in the rehabilitative treatment of the BCRL that is proposed with TAPA improves aspects such as self-image and participation in social and recreational activities.

Calidad de vida relacionada con la salud en adolescentes con hipotiroidismo congénito permanente / Health-related quality of life of adolescents with congenital hypothyroidism

Introducción: El hipotiroidismo congénito puede afectar el estado emocional, las relaciones sociales y el nivel de independencia del adolescente. Estos aspectos pueden influir en la percepción de su calidad de vida relacionada con la salud. Objetivo: Evaluar la calidad de vida relacionada con la salud en adolescentes con hipotiroidismo congénito permanente e identificar su posible relación con algunas características sociodemográficas y clínicas. Método: Se realizó un estudio observacional descriptivo de corte transversal en 40 adolescentes, varones y mujeres entre 10 y 19 años, registrados por el Programa Cubano de Diagnóstico Precoz de Hipotiroidismo Congénito, con el cuestionario genérico PedsQL TM ®, versión 4.0 para uso pediátrico. Resultados: Los mayores puntajes correspondieron a los adolescentes entre 10-14 años, del sexo masculino, nivel educacional primario, sin consumo de sustancias nocivas y que mostraron satisfacción con la vida familiar y un buen control de la enfermedad. Conclusiones: La mayoría de los adolescentes tienen una buena percepción de su calidad de vida relacionada con la salud. La dimensión y la función que más aportaron fueron la física y la social, respectivamente(AU)

Introduction: Congenital hypothyroidism can affect the emotional state, social relationships and the level of independence of adolescents. These aspects can influence the perception of their health-related quality of life. Objective: To evaluate the health-related quality of life of adolescents with permanent congenital hypothyroidism and to identify possible relationship with some sociodemographic and clinical characteristics. Methods: A cross-sectional descriptive observational study was carried out in 40 adolescents, male and female, between 10 and 19 years old, who were registered by the Cuban Program for Early Diagnosis, using the generic PedsQL TM ® questionnaire, version 4.0 for pediatric use, as an instrument. Results: The highest scores corresponded to adolescents between 10-14 years old, male, primary educational level, without harmful substance use and who showed satisfaction with family life and good control of the disease. Conclusions: Most adolescents have good perception of their health-related quality of life. The dimension and function that contributed the most were physical and social, respectively(AU)

Estado nutricional como preditor de qualidade de vida em pacientes em hemodiálise / Nutritional status as predictor of quality of life in patients undergoing hemodialysis / Estado nutricional como predictor de calidad de vida en pacientes en hemodiálisis

Objetivo: avaliar a associação entre qualidade de vida e estado nutricional de pacientes em hemodiálise, segundo medidas antropométricas e bioquímicas. Métodos: estudo transversal realizado com 1.024 pacientes de 11 centros de hemodiálise de uma região metropolitana da região sudeste do Brasil. Resultados: por meio da regressão linear múltipla, foram identificados os preditores nutricionais de cada domínio da qualidade de vida. Destacamos a albumina sérica, o Índice de Massa Corporal (IMC) e a circunferência da cintura, dentre as medidas associadas tanto a saúde física quanto a mental desta população. Conclusão: a inadequação do estado nutricional está associado a pior qualidade de vida física e mental de indivíduos em hemodiálise. Além do monitoramento do estado nutricional, a avaliação nutricional prediz a qualidade de vida e torna-se uma ferramenta fundamental para um melhor desfecho de saúde, uma vez que a baixa qualidade de vida é um dos principais problemas desta população

Objective: to evaluate the association between quality of life and nutritional status of hemodialysis patients, according to anthropometric and biochemical measurements. Methods: cross-sectional study conducted with 1,024 patients from 11 hemodialysis centers in a metropolitan region of southeastern Brazil. Results: through multiple linear regression, the nutritional predictors of each domain of quality of life were identified. We highlight serum albumin, Body Mass Index (BMI) and waist circumference, among the measures associated with both physical and mental health in this population. Conclusion: inadequate nutritional status is associated with worse physical and mental quality of life in hemodialysis individuals. In addition to monitoring the nutritional status, nutritional assessment predicts quality of life and becomes a fundamental tool for a better health outcome, since low quality of life is one of the main problems in this population

Objetivo: evaluar la asociación entre calidad de vida y estado nutricional de pacientes en hemodiálisis, según medidas antropométricas y bioquímicas. Métodos: estudio transversal realizado con 1.024 pacientes de 11 centros de hemodiálisis de una región metropolitana del sureste de Brasil. Resultados: mediante regresión lineal múltiple, se identificaron los predictores nutricionales de cada dominio de la calidad de vida. Destacamos la albúmina sérica, el índice de masa corporal (IMC) y la circunferencia de la cintura, entre las medidas asociadas a la salud tanto física como mental en esta población. Conclusión: el estado nutricional inadecuado se asocia con una peor calidad de vida física y mental en los individuos en hemodiálisis. Además de monitorear el estado nutricional, la evaluación nutricional predice la calidad de vida y se convierte en una herramienta fundamental para un mejor resultado de salud, ya que la baja calidad de vida es uno de los principales problemas en esta población

Estado nutricional como preditor de qualidade de vida em pacientes em hemodiálise / Nutritional status as predictor of quality of life in patients undergoing hemodialysis / Estado nutricional como predictor de calidad de vida en pacientes en hemodiálisis

Objetivo: avaliar a associação entre qualidade de vida e estado nutricional de pacientes em hemodiálise, segundo medidas antropométricas e bioquímicas. Métodos: estudo transversal realizado com 1.024 pacientes de 11 centros de hemodiálise de uma região metropolitana da região sudeste do Brasil. Resultados: por meio da regressão linear múltipla, foram identificados os preditores nutricionais de cada domínio da qualidade de vida. Destacamos a albumina sérica, o Índice de Massa Corporal (IMC) e a circunferência da cintura, dentre as medidas associadas tanto a saúde física quanto a mental desta população. Conclusão: a inadequação do estado nutricional está associada a pior qualidade de vida física e mental de indivíduos em hemodiálise. Além do monitoramento do estado nutricional, a avaliação nutricional prediz a qualidade de vida e torna-se uma ferramenta fundamental para um melhor desfecho de saúde, uma vez que a baixa qualidade de vida é um dos principais problemas desta população.

Objective: to evaluate the association between quality of life and nutritional status of hemodialysis patients, according to anthropometric and biochemical measurements. Methods: cross-sectional study conducted with 1,024 patients from 11 hemodialysis centers in a metropolitan region of southeastern Brazil. Results: through multiple linear regression, the nutritional predictors of each domain of quality of life were identified. We highlight serum albumin, Body Mass Index (BMI) and waist circumference, among the measures associated with both physical and mental health in this population. Conclusion: inadequate nutritional status is associated with worse physical and mental quality of life in hemodialysis individuals. In addition to monitoring the nutritional status, nutritional assessment predicts quality of life and becomes a fundamental tool for a better health outcome, since low quality of life is one of the main problems in this population.

Objetivo: evaluar la asociación entre calidad de vida y estado nutricional de pacientes en hemodiálisis, según medidas antropométricas y bioquímicas. Métodos: estudio transversal realizado con 1.024 pacientes de 11 centros de hemodiálisis de una región metropolitana del sureste de Brasil. Resultados: mediante regresión lineal múltiple, se identificaron los predictores nutricionales de cada dominio de la calidad de vida. Destacamos la albúmina sérica, el índice de masa corporal (IMC) y la circunferencia de la cintura, entre las medidas asociadas a la salud tanto física como mental en esta población. Conclusión: el estado nutricional inadecuado se asocia con una peor calidad de vida física y mental en los individuos en hemodiálisis. Además de monitorear el estado nutricional, la evaluación nutricional predice la calidad de vida y se convierte en una herramienta fundamental para un mejor resultado de salud, ya que la baja calidad de vida es uno de los principales problemas en esta población.

Cirugía oncoplástica como alternativa en el tratamiento de pacientes con cáncer de mama

RESUMEN Fundamento: la cirugía plástica ayuda a la mejora de la calidad de vida de las pacientes con cáncer de mama. La reconstrucción mamaria ha evolucionado no solo en las cuestiones estéticas, sino también, a favor de lograr menor morbilidad en las pacientes afectadas. Objetivo: describir los resultados obtenidos con la aplicación de técnicas oncoplásticas en pacientes con cáncer de mama. Método: se realizó un estudio descriptivo de una serie de 41 pacientes en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus desde marzo de 2018 hasta octubre de 2020. La muestra incluyó a todas las pacientes intervenidas por cáncer de mama a las que se realizaron técnicas oncológicas conservadoras y radicales, así como, cirugía plástica. Fueron analizadas variables demográficas, clínicas y terapéuticas. Se utilizaron los procedimientos aritméticos y tabulares de la estadística descriptiva. Se mostraron las variables cuantitativas como promedios y desviación estándar, los datos cualitativos como frecuencias y porcentajes. Resultados: la edad media fue de 45 años, con una mínima de 26 años y una máxima de 67. En las pacientes sin deformidad mamaria previa se aplicaron tratamientos radicales, conservadores, reconstrucción con cirugía ahorradora de piel y mastoplastias con mínimas incisiones. En las pacientes con deformidades mayores el tratamiento que predominó fue conservador y las reconstrucciones con mastoplastias. Los estadios tumorales que prevalecieron fueron los T2N1M0 y T1N1M0. El mayor número de complicaciones se observó en las pacientes sometidas a cirugía ahorradora de piel y en aquellas con tratamientos radicales. Conclusiones: la cirugía oncoplástica es una alternativa de tratamiento quirúrgico que actualmente se emplea con más frecuencia en las pacientes con cáncer de mama. Se obtienen resultados similares a los de la cirugía convencional en cuanto a incidencia de complicaciones, recidivas y muerte.

ABSTRACT Background: plastic surgery helps to improve the quality of life of patients with breast cancer. Breast reconstruction has evolved not only in aesthetic matters, but also in favor of achieving less morbidity in each patient affected. Objective: to describe the results obtained with the application of oncoplastic techniques in patients with breast cancer. Method: a descriptive study of a series of 41 patients was carried out at the Camilo Cienfuegos Provincial General Hospital in Sancti Spíritus from March 2018 to October 2020. The sample included all the patients operated on for breast cancer in which techniques were performed. Conservative and radical oncology, as well as, plastic surgery. Demographic, clinical and therapeutic variables were analyzed. The arithmetic and tabular procedures of descriptive statistics were used. Quantitative variables were shown as means and standard deviation. Qualitative data such as frequencies and percentages. Results: the mean age was 45 years, with a minimum of 26 years and a maximum of 67. In patients without previous breast deformity, radical and conservative treatments, reconstruction with skin-sparing surgery and mastoplasties with minimal incisions were applied. In patients with major deformities, the predominant treatment was conservative and reconstructions with mastoplasties. The tumor stages that prevailed were T2N1M0 and T1N1M0. The highest number of complications was observed in patients undergoing skin-sparing surgery and in those with radical treatments. Conclusions: oncoplastic surgery is an alternative surgical treatment that is currently used more frequently in patients with breast cancer. Similar results are obtained to conventional surgery in terms of incidence of complications, recurrences and death.

Modelo predictivo para el vaticinio de la baja calidad de vida relacionada con la salud en mujeres de edad mediana / A Predictive Model of Low Quality of Life Related to Health in Middle-Aged Women

Introducción: La calidad de vida ha sido una preocupación e interés para los investigadores, es definida como constructo social con limitaciones para su estudio, que se enmarcan en tres grupos de problemas: conceptuales, metodológicos e instrumentales. Objetivo: Desarrollar un modelo predictivo para el vaticinio de baja calidad de vida relacionada con la salud en mujeres de edad mediana. Métodos: Investigación de desarrollo tecnológico (I+D+I). Se estipuló un tamaño de muestra de 532 mujeres, para la validación del modelo, se escogieron por muestreo simple aleatorio a 200 mujeres de edad mediana. Variables utilizadas: edad, edad de la menopausia, apoyo familiar percibido, cantidad de enfermedades e intensidad del síndrome climatérico. Resultados: Se creó un modelo estadístico para el vaticinio de la baja calidad de vida relacionada con la salud, se presentan la aplicación de la regresión logística múltiple. En esta se aprecia el ajuste del modelo, evaluado por el estadígrafo X2 de Hosmer y Lemeshow (X2 Hosmer-Lemeshow = 8,656), que resultó significativo (p = 0,374). Conclusiones: El incremento de la edad en años, el apoyo familiar percibido y la intensidad del síndrome climatérico constituyen factores de riesgo de baja calidad de vida relacionada con la salud en las mujeres investigadas.El modelo estadístico es adecuado para su uso en el vaticinio de la baja calidad de vida relacionada con la salud en mujeres de edad mediana(AU)

Introduction: Quality of life has been a concern and interest for researchers. It is defined as a social construct with limitations for its study, which are framed into three groups of problems: conceptual, methodological and instrumental. Objective: To develop a predictive model of low quality of life related to health in middle-aged women. Methods: Technological development research (R+D+I). A sample size of 532 women was chosen. For the validation of the model, 200 middle-aged women were chosen by simple random sampling. The variables used were age, age at menopause, perceived family support, number of illnesses, and intensity of climacteric syndrome. Results: A statistical model was created for predicting low quality of life related to health. The application of multiple logistic regression is presented. This shows the fit of the model, evaluated by Hosmer and Lemeshow's X2 statistic (X2 Hosmer-Lemeshow=8.656), which was significant (P=0.374). Conclusions: Age increase in years, perceived family support and intensity of climacteric syndrome are risk factors for low quality of life related to health in the women investigated. The statistical model is suitable to be used for predicting low quality of life related to health in middle-aged women(AU)

ANALYSIS OF THE EFFECTIVENESS OF THE FUNCTIONAL ORGANIZATIONAL MODEL FOR KNOWN PROPHYLAXIS OF CHRONIC NONINFECTIOUS DISEASES BASED ON THE ASSESSMENT OF THE QUALITY OF LIFE OF PATIENTS AT THE MEDICAL INSTITUTION.

OBJECTIVE: The aim: Study of the indicators of quality of life of patients served by a multidisciplinary health care institution with the functionally-organizational model of coded prevention of chronic noninfectious diseases is implemented. PATIENTS AND METHODS: Materials and methods: To evaluate the effectiveness of the model's use we used the assessment of the dynamics of QL indices, which was assessed according to the EUROHISQOL 8-item index methodology among 376 patients aged over 18 years. RESULTS: Results: Most of the respondents (61.4%) were dissatisfied to varying degrees with their state of health and, on average, evaluated their QL (56.1%). ЗThe overall assessment of the quality of life of the surveyed population was on a 20-point scale of 13.5 (3.19) points in 2017 before the introduction of the program of managed prevention of СNCDs and 14.6 (3.48) points after its three-year operation, with an increase integrated indicator on average by 1.1 (95% CI 0.59 - 1.60) points (p <0.001). Among the areas of QOL assessment, the assessments in the physical sphere and the environment increased at most (p<0.05). It is determined that the overall level of QOL of patients with NCDs is 40% due to medical and social factors that can be positively influenced by medical care using a model of managed prevention. CONCLUSION: Conclusions: The analysis of changes in the quality of life of patients of multidisciplinary institutions who have risk factors for СNCDs or suffer from chronic non-communicable diseases, showed that the introduction of a functional-organizational model of managed prevention at the health care institution level can improve integrated assessment of QOL and positively affect the overall complex of medical and social factors, including managed risk factors. This indicates the effectiveness of this model of managed prevention at the level of a multidisciplinary health care institution.

Physical exam in the evaluation of bladder pain syndrome (BPS): A key component for differential diagnosis. / La exploración física en la evaluación del síndrome de dolor vesical (SDV): un importante elemento para la orientación terapéutica.

OBJECTIVES: To describe in more detail the usual clinical practice regarding physical examination (PE) in Bladder Pain Syndrome (BPS) and to evaluate if the performance of PE relates to changes in severity of symptoms and in Health Related Quality of Life (HRQoL). MATERIAL AND METHODS: Epidemiological, observational, national and multicentric study that included 319 patients with BPS (79 of new diagnosis and 240 in follow-up). Demographic and clinical data were collected. The diagnostic study was performed according to the usual clinical practice, including as the case: PE and biopsy. The patients completed the "Bladder Pain/Interstitial Cystitis Symptom Score" (BPIC-SS) and "EuroQoL-5D-5L" (EQ-5D-5L) questionnaires. To describe the continuous variables, the mean, standard deviation (SD) and quartiles analyzed were used, and for categorical variables, number and percentage of patients by response category. The questionnaires' results were described according to the visual analog scale (VAS). Health status was evaluated in patients with myofascial pain. RESULTS: PE was performed in 296 cases. 28.4% of the patients presented pelvic myofascial pain. The variation of the BPIC-SS score in the explored patients was 7.77 points, compared to 1.73 in the unexplored ones. The variations in EQ-5D-5L were 0.13 and 0.04 points, respectively. CONCLUSIONS: Myofascial involvement was observed in 28.4% of the 296 cases of BPS who receiveda PE. It is important to implement a systematic, comprehensive method of PE at the national level in order to achieve a more precise characterization of BPS and a better evolution of the patient's symptoms and HRQoL.

OBJETIVOS: Conocer en mayor detalle la práctica clínica habitual de la exploración física (EF) del Síndrome de Dolor Vesical (SDV) y evaluar los cambios en síntomas y Calidad de Vida Relacionada con la Salud (CVRS) según los resultados de la EF.MATERIAL Y MÉTODOS: Estudio epidemiológico, observacional, nacional y multicéntrico que incluyó 319 pacientes con SDV (79 de nuevo diagnóstico y 240 en seguimiento). Se recogieron datos demográficos y clínicos. El estudio diagnóstico se realizó según práctica  clínica habitual, incluyendo según el caso: EF y biopsia. Las pacientes cumplimentaron los cuestionarios "BladderPain/Interstitial Cystitis-Symptom Score" (BPIC-SS) y "EuroQoL-5D-5L" (EQ-5D-5L). Para describir las variables continuas se utilizaron la media, desviación estándar (DE) y cuartiles analizados y para las cualitativas, el número y porcentaje de pacientes por categoría de respuesta. Los resultados de los cuestionarios se describieron según la escala visual analógica (EVA). Se evaluó el estado de salud en pacientes con dolor miofascial. RESULTADOS: Se realizó EF en 296 casos. El 28,4% de los pacientes presentaban dolor miofascial. La variación de la puntuación BPIC-SS en los pacientes explorados fue de 7,77 puntos, en comparación con los 1,73 en los no explorados. Las variaciones en EQ-5D-5L fueron 0,13 y 0,04 puntos, respectivamente. CONCLUSIONES: La implicación miofascial se observó en el 28,4% de los 296 casos de SDV sometidos a EF. Es importante implementar un método sistemático e integral de EF a nivel nacional para lograr una caracterización más precisa del SDV y una mejor evolución de los síntomas y CVRS del paciente.

Asociación entre calidad de vida relacionada con salud y factores sociodemográficos y antropométricos en una institución de salud de Medellín, Colombia / Association between quality of life related to health and sociodemographical and anthropometric factors in a colombian health institution / Associação entre qualidade de vida relacionada à saúde e fatores sociodemográficos e antropométricos em uma instituição de saúde colombiana

Introducción. La calidad de vida relacionada con la salud se define como la percepción subjetiva e influenciada por el estado de salud actual sobre la capacidad para realizar aquellas actividades importantes para un individuo, la cual puede verse afectada en el adulto mayor por procesos de envejecimiento. Objetivo. Caracterizar la calidad de vida relacionada con la salud y las posibles asociaciones con factores antropométricos y sociodemográficos de la población adulta mayor. Materiales y métodos. Se realizó un estudio descriptivo con intención analítica y de corte transversal en el que se evaluó la calidad de vida relacionada con la salud en adultos mayores. La población de estudio estuvo constituida por 145 personas con edades entre los 70 y 92 años que participaron voluntariamente en el estudio y a quienes se les aplicó el cuestionario SF-36 con preguntas sociales y demográficas, además se realizó toma de medidas de talla y peso. Con la información recolectada se procedió a realizar un análisis univariado. Resultados. El 60,7 % de los participantes presentó una buena calidad de vida relacionada con salud. Dentro de las características sociodemográficas se encontró que el 63,4 % eran mujeres, el 67,6 % pertenecían a estrato medio-alto, el 67,6 % tenía escolaridad básica-media, el 81,4 % pertenecía al régimen contributivo y el 48,3 % tenía sobrepeso. Conclusiones. Es necesario implementar programas de protección y cubrimiento en seguridad social al adulto mayor que beneficien especialmente al género femenino, a adultos mayores de edades avanzadas y a los pertenecientes al régimen subsidiado de seguridad social.

Introduction: Quality of life is related to health, thus defined as the subjective perception of an individual ́s current capacity to carry out meaningful activities. Such perception is influenced by the current state of health which is turn affected by aging processes. Objective: To characterize the quality of life related to health and its possible associations with the anthropometric and sociodemographic characteristics. Methodology: A cross-sectional study was carried out to assess health-related quality of life in the elderly. The study counted 145 participants, ranging from the ages between sixty and ni- nety-two, who voluntarily participated in the study; A health- related quality of life questionnaire (SF-36) with social and demographic questions was administered. Height and weight measurements were also taken. With this information, a univariate analysis was carried out. Results: For the total result of the SF-36 questionnaire, it was found that 60.7% of the participants presented a good quality of life related to health.63.4% of the participants in this study were women and, 67.6% of the overall sample were placed as having upper-middle income. Also, most of the participants were found to have basic schooling (67.6). Regarding social security, 81.4% of the sample belonged to social security health plans and (48.3%) was found to have overweight. Conclusions: As a result of the analysis carried out, recommendations such as the implementation of social security protection and coverage programs for the elderly, specifically benefitting the females, older adults and those belonging to the subsidized social security system, can be provided.

Introdução. A qualidade de vida relacionada à saúde é definida como a percepção subjetiva e influenciada pelo estado atual de saúde sobre a capacidade de realizar as atividades importantes de uma pessoa, frequentemente afetadas pelo processo de envelhecimento. Objetivo. Caracterizar a qualidade de vida relacionada à saúde e possíveis associações com fatores antropométricos e sociodemográficos na população idosa. Materiais e métodos. Foi realizado um estudo descritivo com intenção analítica e um estudo transversal, avaliando a qualidade de vida relacionada à saúde em idosos. A população do estudo foi composta por 145 pessoas com idades entre 70 e 92 anos, que participaram voluntariamente do estudo e para quem foi aplicado o questionário SF-36 com questões sociais e demográficas, além de medidas de altura e peso. Com as informações coletadas, foi realizada uma análise univariada. Resultados. 60,7% dos participantes apresentaram boa qualidade de vida relacionada à saúde. Entre as características sociodemográficas, verificou-se que 63,4% eram mulheres, 67,6% pertenciam à classe média alta, 67,7% possuíam ensino médio-médio (67,6), 81,4% pertenciam ao sistema contributivo e 48,3% estavam acima do peso. Conclusões. É necessário implementar programas de proteção e cobertura da previdência social para idosos que beneficiem especialmente o sexo feminino, idosos de idade avançada e pertencentes ao sistema subsidiado.

Desarrollo y validación del cuestionario específico de calidad de vida relacionada con la menstruación CVM-22 / Development and Validation of the Specific Quality of Life Questionnaire Related to Menstruation CVM-22

Introducción: La menstruación frecuentemente se acompaña de dolor pélvico, nauseas, diarrea o cefaleas que puede afectar la calidad de vida durante la misma. Objetivo: Desarrollar y validar un cuestionario específico para medir la calidad de vida relacionada con la menstruación. Métodos: Se ha confeccionado el cuestionario -CVM-43 para valorar el impacto de la menstruación sobre la calidad de vida de las mujeres durante su periodo. La validez de contenido se llevó a cabo por consenso de seis jueces expertos y aportaciones de 30 mujeres. Tras depurar el cuestionario y pasar la prueba piloto, el CVM-22 se administró a 215 mujeres de 18 a 35 años. La confiabilidad del cuestionario se obtuvo aplicando el 945;Cronbach, la validez de constructo por el análisis factorial y la factibilidad por el porcentaje de ítems respondidos y tiempo de cumplimentación. Resultados: En el análisis factorial exploratorio (KMO= 0,910, X2= 2384,54, df= 231 y plt; 0,000), se identificaron tres factores que fueron posteriormente confirmados por el análisis factorial confirmatorio con una varianza del 53,94 por ciento. La fiabilidad test-retest resultó de 0,9 y la confiablidad total fue de 0,917. El tiempo medio necesario de cumplimentación fue de 2,06 ± 0,37. Conclusión: El CVM-22 presenta una buena factibilidad, confiabilidad y validez para evaluar la calidad de vida de las mujeres menstruantes de habla hispana; no obstante, es preciso realizar nuevos análisis del cuestionario con una población con mayor rango de edad y perfiles sociodemográficos distintos, y evaluar la sensibilidad de la escala, para consolidar la validación del CVM-22(AU)

Introduction: Menstruation is often accompanied by pelvic pain, nausea, diarrhea or headaches that can affect the quality of life during that period. Objective: To design and validate a specific questionnaire to measure the quality of life related to menstruation. Methods: A questionnaire -CVM-43 has prepared to assess the impact of menstruation on the quality of life for women during that period. Content validity was carried out by consensus of six expert judges and contributions from 30 women. After debugging the questionnaire and passing the pilot test, the CVM-22 was ran to 215 women aged 18 to 35 years. The reliability of the questionnaire was obtained by applying #945;Cronbach, construct validity by factor analysis and feasibility by the percentage of items answered and time of completion. Results: Three factors were identified in the exploratory factor analysis (KMO = 0.910, X2 = 2384.54, df = 231 and p lt;0.000), which were later confirmed by the confirmatory factor analysis with 53.94 percent variance. The test-retest reliability was 0.9 and the total reliability was 0.917. The average time of completion was 2.06 ± 0.37. Conclusion: CVM-22 presents good feasibility, reliability and validity to assess the quality of life of Spanish-speaking menstruating women. Nevertheless, it is necessary to perform new analyzes of the questionnaire with older population and different sociodemographic profiles, and to evaluate the scale sensitivity in order to consolidate CVM-22 validation(AU)

Calidad de vida relacionada con la salud en pacientes con arritmia ventricular una medición con el ASTA, en dos momentos / Health-related quality of life in patients with ventricular arrhythmia a measurement with the ASTA, at two moments

Objetivo: Establecer una comparación en las mediciones de calidad de vida relacionada con la salud y carga de los síntomas con el ASTA en pacientes con arritmia ventricular, antes y después de implante de cardiodesfibrilador. Método: observacional analítico, con diseño de serie de casos y de abordaje cuantitativo. Participaron 83 pacientes, con diagnóstico de arritmia ventricular de dos instituciones de la ciudad de Bucaramanga, con dos mediciones, antes y después de implante de cardiodesfibrilador. Instrumento: Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA), versión validada al español. Análisis: se utilizó estadística descriptiva y para determinar el cambio en los puntajes de las mediciones iniciales y finales, se utilizó, la prueba pareada de T Student. Resultados: los pacientes con arritmia ventricular que recibieron implante de cardiodesfibrilador, son en su mayoría hombres con una media de edad de 60,97 años, de estratos socioeconómicos bajos, ocupación hogar y labores agrícolas, el puntaje en la escala de calidad de vida inicial fue de 10.97 y de 9.52 para la medición final post-implante, con un valor de p: 0.001, para la comparación entre los dos puntajes, lo que muestra una diferencia estadísticamente significativa. Conclusión: la evaluación de la calidad de vida del paciente con arritmia ventricular medida por un instrumento especifico, muestra una afectación de la calidad de vida, con una leve mejoría en la medición a un mes posterior al implante del cardiodesfibrilador y visualiza la importancia de intervenciones de Enfermería en etapas tempranas del pre-implante en diferentes aspectos.

Objective: To establish a comparison in health-related quality of life measurements and symptoms burden with ASTA in patients with ventricular arrhythmia, before and after implantation of a cardiodefibrillator. Method: observational analytical, with case series design, with a quantitative approach. A total of 83 patients participated, with a diagnosis of ventricular arrhythmia from two institutions in the city of Bucaramanga, with two measurements, before and after implantation of a cardiodefibrillator. Instrument, Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA), version validated in Spanish. Analysis: descriptive statistics were used and, to determine the change in the scores of the initial and final measurements, the paired test of T -Student was used. Results: patients with ventricular arrhythmia, and who received a cardio-defibrillator implant, are mostly men, with a mean age of 60.97 years, from low socioeconomic strata, household occupation and agricultural work, the score in the quality scale of initial life was of 10.97 and of 9.52 for the final measurement after implant, with a value of p: 0.001, for the comparison between the two scores, which shows a statistically significant difference. Conclusion: the evaluation of the quality of life of the patient with ventricular arrhythmia, measured by a specific instrument, shows an affectation of the quality of life, with a slight improvement in the measurement one month after the implantation of the cardiodefibrillator. And the importance of nursing interventions in the early stages of pre-implantation in different aspects is visualized.

Perspectiva temporal e fatores associados entre pessoas que vivem com HIV: implicações para o cuidado de saúde / Time perspective and associated factors among people living with HIV: implications for health care

O objetivo deste estudo foi analisar as associações estabelecidas das variáveis sociodemográficas, clínicas, comportamentais e atitudinais com as perspectivas temporais assumidas por pessoas vivendo com HIV, com vistas a contribuir para o planejamento do cuidado de saúde e do autocuidado. Realizou-se um estudo analítico transversal, com 281 pessoas vivendo com HIV nas cidades do Rio de Janeiro e Niterói acompanhadas em centros de referência de atendimento a pessoa com HIV. Adotou-se a amostragem do tipo não probabilística, de conveniência, escolhida a partir de informações disponibilizadas pelos serviços do quantitativo de clientes em seguimento compondo o universo deste estudo. Foram utilizados dois instrumentos de coleta de dados, a saber: o instrumento de dados sociodemográficos, clínicos, comportamentais e atitudinais(variáveis independentes); e o Inventário de Perspectiva Temporal do Zimbardo ­ ZTPI (variáveis dependentes). A análise de dados foi realizada através do Statistical Package for the Social Sciences (SPSS) versão 22.0. A análise dos dados referentes aos aspectos sociodemográficos se deu por meio de medidas de tendência central e de dispersão. Após verificação das análises de correlação foram realizadas análises de regressão linear simples e múltipla que foram conduzidas para avaliar a relação das variáveis sociodemográficas, clínicas, comportamentais e atitudinais com os escores de cada subescala da perspectiva temporal. Na avaliação da perspectiva temporal, encontrou-se escores médios que variaram de 2,75 (presente hedonista) a 3,85 (futuro). Nesse sentido, verificou-se que as pessoas que vivem com HIV da amostra estudada apresentaram maior orientação para o futuro e menor orientação para o presente fatalista e presente hedonista; a maior escolaridade foi associada a menor orientação para o passado negativo, enquanto que considerar-se doente favoreceu a orientação para o passado negativo; o maior tempo de uso da TARV foi associado a menor orientação para o passado positivo, enquanto que o estado de saúde positiva favoreceu a orientação para o passado positivo; a maior idade, o sexo feminino e o uso da TARV favoreceram a orientação para o presente fatalista, enquanto que a maior escolaridade foi associada a menor orientação para essa dimensão temporal; as maiores idade e escolaridade foram associadas a menor orientação para o presente hedonista; a ocupação com atividade remunerada e o estado de saúde positiva favoreceram a orientação para o futuro. Ressalta-se a importância de estudos futuros sobre a temática e, na prática, recomenda-se aos profissionais da saúde escuta qualificada através do acolhimento, no atendimento a pessoa vivendo com o HIV/aids. Esses profissionais ao considerarem a perspectiva temporal como preditor de comportamentos favoráveis ou de risco à saúde, poderão estimular o indivíduo a ser protagonista do autocuidado e seguir uma vida saudável, especialmente se envidarem esforços para uma abordagem integral do cuidado em saúde.

The objective of this study was to analyze the established associations of sociodemographic, clinical, behavioral and attitudinal variables with the time perspectives assumed by people living with HIV, with a view to contributing to the planning of health care and self-care. A cross-sectional analytical study was carried out, with 281 people living with HIV in the cities of Rio de Janeiro and Niteroi-Brazil, users who used referral centers to care for people with HIV. Non-probabilistic sampling, of convenience, was chosen, based on the information provided by the services of the quantitative of clients in a follow-up, composing the universe of this study. Two data collection instruments were used: the sociodemographic, clinical, behavioral and attitudinal data instrument (independent variables); and the Zimbardo Time Perspective Inventory - ZTPI (dependent variables). The data analysis was performed through the Statistical Package for Social Sciences (SPSS) version 22.0. The analysis of the data concerning the sociodemographic aspects occurred through measures of central tendency and dispersion. After verification of the correlation analyzes, simple and multiple linear regression analyzes were performed that were conducted to evaluate the relationship of sociodemographic, clinical, behavioral and attitudinal variables with the scores of each subscale of the time perspective. In the time perspective evaluation, mean scores ranged from 2.75 (hedonistic present) to 3.85 (future). In this sense, it was verified that the people living with HIV of the studied sample presented more orientation for the future and less orientation for the present fatalistic and hedonistic present; higher schooling was associated with less orientation to the negative past, while considering that patient favored orientation towards the negative past; the longer time of use of HAART was associated with less orientation to the positive past, while the positive health status favored orientation towards the positive past; older age, female sex and the use of HAART favored the orientation towards this fatalistic present, while higher schooling was associated with less orientation to this temporal dimension; older age and schooling were associated with lower hedonistic orientation; the occupation with paid activity and the positive state of health favored the orientation towards the future. The importance of future studies on the subject is emphasized and, in practice, it is recommended that health professionals receive qualified listening through the reception of a person living with HIV. These professionals, when considering the time perspective as a predictor of favorable behaviors or risk to health, may stimulate the individual to be the protagonist of self-care and to lead a healthy life, especially if efforts are made towards a comprehensive approach to health care.

Efecto de la tamsulosina en la calidad de vida de pacientes con hiperplasia prostática benigna / The effect of tamsulosin in the quality of life of patients with benign prostatic hyperplasia

Resumen Introducción La hiperplasia prostática benigna es el padecimiento urológico más frecuente en hombres mayores de 50 años; sus síntomas afectan la calidad de vida. Los bloqueadores alfa-adrenérgicos son una opción para mejorarla. Objetivo Determinar la calidad de vida de pacientes con hiperplasia prostática benigna antes y después del tratamiento con un bloqueador alfa-adrenérgico. Material y métodos Estudio pretest-retest en hombres de 45 a 75 años con hiperplasia prostática benigna. Se administró tamsulosina (0.4 mg/día) por tres meses y se evaluó la severidad de los síntomas y la calidad de vida con el International Prostate Symptom Score (IPSS) y EuroQol 5-D. Se usaron X2 y prueba de rangos y signos de Wilcoxon. Resultados Se incluyeron 50 pacientes de 63.3 ± 10.3 años, 34 (68.0%) tenían síntomas severos antes del tratamiento y 19 (38.0%) después de tres meses (p < 0.05). Con el IPSS, 33 (66.0%) pacientes estaban en categorías de «tan insatisfecho como insatisfecho¼ a «muy insatisfecho¼ antes de la intervención y seis (12.0%) después de ella. La escala visual análoga (EVA) del EuroQol 5-D mostró puntuación basal de 72.9 ± 11.2 versus 83.4 ± 7.6 después (p < 0.05). Conclusión La tamsulosina reduce la severidad de los síntomas y mejora la calidad en de vida en la hiperplasia prostática benigna después de administrarla tres meses.

Abstract Introduction Benign prostatic hyperplasia is an urological disorder most common in men over 50 years old; the symptoms affect the quality of life. Alpha-adrenergic blockers are an option to improve it. Objective To determine the quality of life of patients with benign prostatic hyperplasia before and after treatment with an alphaadrenergic blocker. Material and methods Pretest-retest study in men of 45 to 75 years with benign prostatic hyperplasia. Tamsulosin was administered (0.4 mg/day) for three months; the severity of symptoms and quality of life were assessed with IPSS and EuroQol 5-D. Ranges and sign of Wilcoxon test and X2 were used. Results Fifty patients were included of 63.3 ± 10.3 years of age, 34 (68.0%) had severe symptoms before the treatment and 19 (38.0%) after three months (p < 0.05). With IPSS, 33 (66.0%) patients were in the categories of «as dissatisfied as unsatisfied¼ and «very dissatisfied¼ before the intervention and six (12.0%) after. The VAS of the EuroQol 5-D showed a baseline score of 72.9 ± 11.2 versus 83.4 ± 7.6 after (p < 0.05). Conclusion Tamsulosin reduces severity of symptoms and improves quality of life in benign prostatic hyperplasia after giving it three months.

Using mixed-methods research to study the quality of life of coeliac women.

AIMS AND OBJECTIVES: To research the quality of life of Spanish women with coeliac disease. BACKGROUND: Women with coeliac disease express lower quality of life than men with coeliac disease. DESIGN: Explanatory sequential approach using mixed methods and with a gender perspective. METHODS: The research was carried out between May and July 2015. In its quantitative stage, it aimed to determine the health-related quality of life in a representative sample (n = 1097) of Spanish adult women with coeliac disease using a specific questionnaire named Coeliac Disease-Quality of Life. In its qualitative phase, it aimed to describe the life experiences of a woman with coeliac disease in a qualitative manner by means of interviews (n = 19) with a semistructured script. Quantitative data were analysed using spss version 20 and presented in descriptive statistics. Qualitative data were analysed using the directed content analysis. RESULTS: The quantitative process gave us the values on the four aspects studied: dysphoria, disease limitations, health problems and inadequate treatment. These aspects allowed us to create a qualitative process, based on which we generated an interview, from which four larger categories emerged. These categories were feelings at diagnosis, limitations in day-to-day life, social perceptions of the disease and personal meanings of coeliac disease. Thus, both phases of our project are totally connected. There was a high level of congruence between quantitative scores and narratives. CONCLUSION: This study shows us the strong points of mixed-methods strategy in health sciences. The mixed-methods strategy gave us a wider view of the experience of women living with coeliac disease. In our case, a strength and not a limitation is having performed the quality of life study in women with coeliac disease using a mixed methodology, approaching the experience of being a woman with coeliac disease in Spain in two different but complementary ways. The quantitative and qualitative data allowed us to interpret the experiences of our participants.

Calidad de vida en pacientes con diabetes mellitus tipo 2 / Quality of life in patients with type 2 diabetes mellitus

Introducción: la calidad de vida relacionada con la salud (CVRS) se centra en los aspectos relativos a la percepción de la salud experimentada y declarada por la persona, en diferentes dimensiones tales como física, mental, social, la percepción general de la salud y la satisfacción alcanzada medida en diferentes niveles. Objetivo: determinar la CVRS de los pacientes con diabetes mellitus tipo 2 que son atendidos en el Dpto. de Medicina Interna del Hospital Nacional (Itauguá, Paraguay) en 2016. Metodología: el instrumento medición utilizado fue el cuestionario Diabetes-39 que es una escala multidimensional, que es completada por el propio paciente. A mayor puntuación, peor CVRS. Resultados: fueron encuestados 101 diabéticos. La edad media fue 57±16 años (rango 29-93 años). Hubo 55 varones (54%) y 46 mujeres (46%). El estado civil predominante fue el de casado (64%) y hubo predomino de sujetos con escolaridad secundaria (47%). La media de CVRS fue 57, valor que se encuentra por encima del estándar establecido por el cuestionario. El 49% de la muestra presenta mala CVRS en contraste con 51% con buena CVRS. Los dominios más afectados por orden de puntuación fueron: energía y movilidad (60), ansiedad-preocupación (62) y funcionamiento sexual (66). Dentro de las variables estudiadas, el sexo masculino se constituyó en factor relacionado a la buena CVRS. Conclusiones:

Introduction: Health-related quality of life (HRQoL) focuses on aspects related to the perception of health experienced and declared by the person, in different dimensions such as physical, mental, social, general perception of health and The satisfaction achieved, measured at different levels. Objective: To determine the HRQoL patients with type 2 diabetes mellitus who are treated at the Department of Internal Medicine of the National Hospital (Itauguá, Paraguay) in 2016. Methodology: The instrument used as measurement was the Diabetes-39 questionnaire which is a multidimensional scale, which is completed by the patient. The higher the score, the worse HRQL. Results: 101 diabetics were surveyed. The mean age was 57 ± 16 years (range 29-93 years). There were 55 males (54%) and 46 females (46%). The predominant marital status was married (64%) and there were predominant subjects with secondary schooling (47%). The mean HRQoL was 57, a value that is above the standard established by the questionnaire. 49% of samples presented poor HRQL compared to 51% with good HRQL. The domains most affected by ranking order were: energy and mobility (60), anxiety-worriesome (62) and sexual functioning (66). Among the variables studied, the male sex was a factor related to good HRQoL. Conclusions: 49% of the sample had poor HRQL and 51% had good HRQL.

Qualidade de vida relacionada à saude em mulheres com reações adversas após tratamento com quimioterapia para câncer de mama / Quality of life related to health in women with adverse reactions after treatment with chemotherapy for breast cancer

Trata-se de estudo descritivo, exploratório, transversal, quantitativo, realizado com mulheres em tratamento quimioterápico para neoplasias de mama, em Aracaju-Sergipe-Brasil. O objetivo foi avaliar a qualidade de vida relacionada à saúde (QVRS) destas mulheres que apresentaram reações adversas pós quimioterapia. Foram utilizados instrumentos contendo dados sócio demográficos, clínicos e terapêuticos, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 e formulário de registro de toxicidades dos antineoplásicos. Na análise dos dados, foram utilizados análise descritiva, cálculos de percentual, teste de Shapiro-Wilk, coeficiente de correlação de Pearson ou de Spearman, teste de ANOVA ou Kruskal-Wallis. Os resultados mostraram dados de 206 mulheres, a partir da segunda sessão de quimioterapia, com média de idade de 53,1 anos, maioria procedente de Sergipe, com Carcinoma Ductal Infiltrante, estadiamento III. A maioria realizou cirurgia oncológica, não realizaram radioterapia devido à grande fila de espera, o protocolo de quimioterapia mais comum foi TAC (docetaxel, doxorrubicina e ciclofosfamida). Quanto às reações adversas, a maioria não apresentou alterações hematológicas e metabólicas no momento da coleta das informações, nas alterações funcionais, a fadiga foi presente em 80,8% dos casos, de forma moderada. Nas alterações gastrintestinais, diarreia, constipação, mucosite, náusea, vômito e dor abdominal foram citadas pela maioria. Nas alterações dermatológicas, a alopecia, hiperpigmentação na pele, alterações nas unhas, prurido na pele, descamação e eritema multiforme foram citadas pelas entrevistadas. Nas alterações cardiovasculares, hipotensão e HAS sobressaíram-se. Nas alterações neurológicas, neuropatia periférica, perda da audição e zumbido foram comuns. Os resultados da avaliação da QVRS foram analisadas à luz do referencial teórico de Ferrel et al. (1995) com os seguintes resultados: média do escore 76,01; escalas funcionais apresentaram escore baixo, com aspectos físico, emocional, cognitivo, funcional e social bastante afetados após o tratamento, o desempenho de papéis e função emocional foram os mais prejudicados; na escala de sintomas, os domínios mais prejudicados foram: dificuldades financeiras, fadiga e insônia. Na análise de correlação, o escore geral da QVRS apresentou correlação estatisticamente significante com a quantidade de reações adversas na medula óssea. Em todos os casos estatisticamente significantes o domínio emocional apresentou correlações positivas e o domínio dor, correlações negativas. A idade apresentou correlação estatisticamente significante e negativa com os domínios físico e dificuldades financeiras e positiva com perda de apetite. Pelo procedimento de comparações múltiplas, as diferenças ocorreram entre os estados civis casado e separado e também casado e solteiro, entre as religiões católica e evangélica, entre os ensinos fundamental e médio e entre médio e superior; para a extensão da doença os domínios dor e insônia apresentaram diferenças estatisticamente significantes entre as categorias de extensão. Para renda mensal, os domínios fisico, desempenho de papel, emocional, constipação e dificuldades financeiras apresentaram diferenças estatisticamente significantes entre as categorias de renda. Nos domínios fisico, desempenho de papel e emocional as diferenças ocorreram entre as faixas de 1 a 3 e mais de 6 salários. Concluiu-se que as reações adversas causadas pelo tratamento antineoplásico com quimioterapia afetaram de algum modo as pacientes, causando déficits em vários domínios, prejudicando assim sua QVRS

It is a descriptive, exploratory, cross-sectional, quantitative study with women undergoing chemotherapy for breast cancer, in Aracaju, Sergipe, Brazil. The objective was to evaluate the quality of life related to health (HRQoL) of these women who had post-chemotherapy adverse reactions. Instruments containing sociodemographic, clinical and therapeutic data, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 and toxicities registration form of antineoplastic were used. In the data analysis, descriptive analysis, percentage calculations, Shapiro-Wilk test, Pearson correlation coefficient or Spearman, ANOVA and Kruskal-Wallis test, were used. The results showed data of 206 women from the second session of chemotherapy, a mean age of 53.1 years, coming most of Sergipe, with Infiltrating Ductal Carcinoma, stage III. Most of them did cancer surgery, did not undergo radiotherapy because of the long time of waiting, the most common chemotherapy protocol was TAC (docetaxel, doxorubicin and cyclophosphamide). For side effects, most showed no hematologic and metabolic abnormalities at the time of data collection, in the functional changes, fatigue was present in 80.8% of cases, moderately. In gastrointestinal upset, diarrhea, constipation, mucositis, náusea, vomiting and abdominal pain were cited by the majority. The skin changes, alopecia, hyperpigmentation in skin, nail changes, skin rash, peeling and erythema multiforme have been mentioned by the interviewers. Cardiovascular changes, hypotension and hypertension stood up. In neurological disorders, peripheral neuropathy, hearing loss and tinnitus were common. The results of the evaluation of HRQoL were analyzed using the theoretical framework of Ferrel et al. (1995) resulting in: average score of 76.01; functional scales showed low scores, with physical, emotional, cognitive, functional and social aspects greatly affected after treatment, role playing and emotional function were the most affected; symptom scale, with most affected areas, financial difficulties, fatigue and insomnia. In the correlation analysis, the overall score of HRQoL showed a statistically significant correlation with the number of adverse reactions in the bone marrow. In all cases statistically significant emotional domain showed positive correlations and the pain domain, negative correlations. Age showed a statistically significant and negative correlation with physical areas and financial difficulties and positive with loss of appetite. Using multiple comparisons, the differences occurred between marital status and married separately and also married and unmarried, between the catholic and evangelical religions, between primary and secondary education and between secondary and higher education; to the extent of disease areas, pain and insomnia were statistically different between the extension categories. For monthly income, the physical domains, role performance, emotional, constipation and financial difficulties were statistically different between the categories of income. In the physical domain, role-playing and emotional differences occurred between tracks 1-3 and over 6 wages. It was concluded that the adverse reactions caused by anticancer chemotherapy affected in some way the patients, causing deficits in several areas, thus hampering their HRQoL

Qualidade de vida relacionada à saúde de pacientes com diabetes mellitus utilizando o Diabetes Quality of Life Measure (DQOL - Brasil) / Related Quality of Life in Patients with Diabetes Mellitus Health using the Diabetes Quality of Life Measure (DQOL-Brazil)

Trata-se de um estudo observacional transversal com o objetivo de analisar a qualidade de vida relacionada à saúde de pacientes com diabetes mellitus segundo o Diabetes Quality of Life Measure (DQOL-Brasil). O estudo foi realizado em uma Unidade Distrital de Saúde, do interior paulista, com 73 pacientes que participaram do projeto ATEMDIMEL- Apoio Telefônico no Monitoramento em Diabetes mellitus. A coleta de dados foi realizada de janeiro a abril de 2014, para a obtenção dos dados extraiu-se as variáveis sociodemográficas e clínicas, e do Diabetes Quality of Life Measure (DQOL-Brasil) do referido projeto. Para análise estatística foram utilizados testes t-Student, coeficiente de Spearman e para comparação de médias, teste de Mann-Whitney. O estudo foi aprovado pelo Comitê de Ética e Pesquisa em Humanos da Escola de Enfermagem de Ribeirão Preto, parecer número: 324.098. Os resultados mostraram que os pacientes tinham de 45 a 87 anos, com predomínio do sexo feminino (60,3%), casados (65,8%), aposentados (56,2%) e média de estudo de 6,7 anos. O tempo de diagnóstico mais prevalente foi de 11 a 20 anos e a hipertensão arterial sistêmica foi a principal comorbidade (75,3%). Os valores da glicemia em jejum foram maiores que 130 mg/dl para 56,2% dos pacientes e os de hemoglobina glicada alterada, 68,5%. Dos 73 pacientes, 38,4% referiram satisfação média com sua vida em geral e 43,8%, muito satisfeitos com o seu tratamento atual e a sua vida social e amizades. Da totalidade dos pacientes, 43,8% e 42,5% relataram que estavam insatisfeitos com sua vida sexual e com o tempo em que eles gastavam fazendo exercícios físicos, respectivamente. A maioria, 79,5% dos participantes referiu que nunca se sente constrangido ao relatar aos outros a sua doença e que isto não interfere na sua qualidade de vida, assim como, a faltar ao trabalho, escola ou responsabilidades domesticas por causa do seu DM (64,4). Quanto ao padrão de sono, 32,9% referiram frequência do sono ruim. Em relação a preocupações sociais e ou vocacionais, mais de 90% dos pacientes referiram que nunca tiveram preocupações e 41,1% relataram preocupação constante com uma possível complicação relacionada à doença. Em relação à média da QVRS, obteve- se que o domínio preocupação social vocacional apresentou melhor pontuação, 1,67, enquanto o domínio satisfação apresentou a pior, 2,77. Para o grupo de pacientes com alteração da hemoglobina glicada, o valor de QVRS foi pior em relação aqueles com hemoglobina glicada sem alteração (HbA1c <= 7), e o domínio satisfação foi o que apresentou o pior valor de QVRS, 2,87. Para o grupo de pacientes com o valor da hemoglobina glicada sem alteração, o melhor valor da QVRS se deu no domínio preocupação social vocacional, 1,52 e o pior no domínio satisfação, 2,72. Os resultados deste estudo podem oferecer subsídios para estudos de intervenção e o planejamento das ações nos serviços de saúde

It is a cross-sectional observational study with the purpose of analyzing the quality of life related to the health of patients with diabetes mellitus according to the Diabetes Quality of Life Measure (DQOL-Brazil). The study was conducted in a District Health Unit, the interior of São Paulo, with 73 patients who participated in the ATEMDIMEL project-telephonic support in monitoring in Diabetes mellitus. The data were collected from January to April 2014, for obtaining the data extracted sociodemographic and clinical variables, and the Diabetes Quality of Life Measure (DQOL-Brazil) of this project. For statistical analysis we used t-Student, Spearman's coefficient and comparison of averages, Mann-Whitney test. The study was approved by the Committee of ethics and human research from Ribeirão Preto nursing school, opinion number: 324,098. The results showed that the patients had from 45 to 87 years, with female predominance (60.3%), married (65.8%), retirees (56.2%) and average of the study was 6.7 years. The most prevalent diagnostic time was 11 to 20 years and the systemic arterial hypertension was the main comorbidities (75.3%). The fasting glycaemia values were greater than 130 mg/dl to 56.2% of the patients and the glycated hemoglobin changed, 68.5%. Of the 73 patients, 38.4% reported satisfaction with their life in general and 43.8% very satisfied with their current treatment and your social life and friendships. All of the patients, 43.8% and 42.5% reported that they were unsatisfied with their sex life and with the time they spent doing physical exercises, respectively. The most, 79.5% of the participants reported that never feels embarrassed to report their illness to others and that it does not interfere with your quality of life, as well as, to miss work, school, or household responsibilities because of his DM (64.4). As for the sleeping pattern, 32.9% reported frequency of bad sleep. In relation to social concerns and or liberating more than 90% of the patients reported that they never had concerns and 41.1% reported constant concern with possible complications related to the disease. In relation to the average of the HRQOL, that social concern vocational domain presented best score 1.67, while the domain satisfaction presented the worst 2.77. For the group of patients with change of hemoglobina glycated, the value of HRQOL was worse against those with glycated hemoglobin without change (HbA1c <= 7), and the domain was the satisfaction that presented the worst value of HRQOL, 2.87. For the group of patients with the glycated hemoglobin value unchanged, the best value of HRQOL in social concern vocational domain, 1.52 and the worst in the field, 2.72. The results of this study may offer subsidies for intervention studies and the planning of actions in health services

Meanings of quality of life held by patients with colorectal cancer in the context of chemotherapy / Significados da qualidade de vida no contexto da quimioterapia pelo paciente com câncer colorretal / Significados de la calidad de vida en el contexto de la quimioterapia para los pacientes con cáncer colorrectal

this study's aim was to interpret the meanings assigned to quality of life by patients with colorectal cancer undergoing chemotherapy.

o objetivo do estudo foi interpretar os significados atribuídos à qualidade de vida por pacientes com câncer colorretal em quimioterapia.

el objetivo era interpretar los significados atribuidos a la calidad de vida de los pacientes con quimioterapia para el cáncer colorrectal.