Psychometric properties of the Brazilian version of the European Health Literacy Survey Questionnaire short form.

The aim of this study was to analyze the psychometric properties of the Portuguese Brazilian version of the instrument for measuring health literacy European Health Literacy Survey Questionnaire short form (HLS-EU-Q16). The study sample consisted of 783 Brazilian adults with a mean age of 38.6 years. The data were analyzed through an extensive and robust process of testing the properties with the combination of exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and item response theory (IRT) techniques, aiming to search for strong validation evidence in the internal structure and stability step for other sub-samples. The instrument's reliability was tested using Cronbach's alpha and McDonald's Omega. The analyses indicated the existence of only one dimension and good reliability values. The model tested with cross-validation indicated satisfactory, adequate, consistent and stable levels for EFA, IRT via item discrimination and CFA, both for primary indicators as factor loadings, communalities, item discrimination as well as for the model adequacy indicators. It is concluded that the Brazilian Portuguese version of the HLS-EU-Q16 proved to be a one-dimensional, consistent, accurate and stable model for measuring health literacy in Brazilian adults.

Health literacy (HL) is a field of scientific knowledge that has been related to the knowledge and skills of people to access, understand, evaluate and apply information in health. Among the currently existing instruments for measuring the HL construct in its broader aspects, involving multidimensional characteristics, there is the short version of European Health Literacy Survey Questionnaire (HLS-EU-Q16). The aim of this study was to investigate the psychometric properties of the Brazilian Portuguese version of the HL instrument European Health Literacy Survey Questionnaire in its short form, also known as HLS-EU-Q16. The instrument was applied to a sample of 783 Brazilian adults. Our results demonstrated that the Brazilian version of HLS-EU-Q16 presented good psychometric properties to measure HL in Brazilian adults.

Dental vulnerability scale in primary health care: evidence of content and structure internal validity.

BACKGROUND: Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC). METHODS: The items were developed based on a qualitative exploratory analysis. A total of 172 items were prepared and submitted to a panel of specialists, with content validity analyzed with the Content Validity Ratio (CVR), resulting in an the initial version of the instrument composed by 41 items. Internal structure validity was analyzed by Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and by applying 3 reliability indicators (Cronbach's Alpha, McDonald's Omega and Greatest Lower Bound - GBL), with a sample of 1227 individuals. RESULTS: The final configuration indicated a scale of 15 items divided into 4 dimensions (overall health, oral health, infrastructure, and healthcare services) with explained variance of 72.11%. The factor loads varied from 0.37 to 0.96. The model adjustment indices were set at × 2/df(51) = 3.23, NNFI = 0.95, CFI = 0.98, GFI = 0.96, AGFI = 0.97, RMSEA = 0.04 and RMSR = 0.03. CONCLUSION: DVS presented satisfactory evidence of validity, indicating its suitability to be used by healthcare professionals, students and managers to plan oral health actions and services at PHC.

Systematic review of the psychometric properties of instruments to measure sexual desire.

BACKGROUND: Sexual desire is one of the domains of sexual function with multiple dimensions, which commonly affects men and women around the world. Classically, its assessment has been applied through self-report tools; however, an issue is related to the evidence level of these questionnaires and their validity. Therefore, a systematic review addressing the available questionnaires is really relevant, since it will be able to show their psychometric properties and evidence levels. METHOD: A systematic review was carried out in the PubMed, EMBASE, PsycINFO, Science Direct, and Web of Science databases. The search strategy was developed according to the following research question and combination of descriptors and keywords, including original studies with no limit of publication date and in Portuguese, English, and Spanish. Two reviewers carried out the selection of articles by abstracts and full texts as well as the analysis of the studies independently. The methodological quality of the instruments was evaluated by the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. RESULTS: The search resulted in 1203 articles, of which 15 were included in the review. It identified 10 instruments originally developed in the English language. Unsatisfactory results on methodological quality were evidenced in cultural adaptation studies with no description of the steps of the processes and inadequacy of techniques and parameters of adequacy for models. The Principal Component Analysis with Varimax rotation predominated in the studies. CONCLUSIONS: The limitation of the techniques applied in the validation process of the reviewed instruments was evident. A limitation was observed in the number of adaptations conducted and contexts to which the instruments were applied, making it impossible to reach a better understanding of the functioning of instruments. In future studies, the use of robust techniques can ensure the quality of the psychometric properties and the accuracy and stability of instruments. A detailed description of procedures and results in validation studies may facilitate the selection and use of instruments in the academic and/or clinical settings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018085706.

Validity of the Katz Index to assess activities of daily living by informants in neuropathological studies.

OBJECTIVE: To analyze the evidences of construct validity of the Katz Index for the retrospective assessment of activities of daily living (ADL) by informants, to assist neuropathological studies in the elderly. METHOD: A cross-sectional study analyzed the functional ability of ADL measure by the Katz Index, of 650 cases randomly selected from the Brazilian Brain Bank of the Ageing Brain Study Group (BBBABSG) database. Sample was divided in two subsamples for the analysis (N=325, each) and then stratified according to cognitive decline assessed by the Clinical Dementia Rating Scale (CDR). Factor analyses with calculations of internal consistency and invariance were performed. RESULTS: Factor analysis evidenced a unidimensional instrument with optimal internal consistency, in all subgroups. Goodness of fit indices were obtained after two treatments of covariance, indicating adequacy of the scale for assessing ADL by informants. The scale is invariant to cognitive decline meaning that it can be used for subjects with or without cognitive impairment. CONCLUSION: Katz Index is valid for the retrospective assessment of basic ADL by informants, with optimal reliability.

Children and adolescents hospitalized with chronic conditions: sleep patterns, resilience and quality of life.

OBJECTIVE: To evaluate the sleep pattern of children and adolescents with chronic conditions during hospitalization and correlate it with resilience, quality of life, clinical and sociodemographic data. METHOD: Quantitative, descriptive and cross-sectional study. Data collection took place between May 2022 and January 2023, with children and adolescents with chronic conditions from two hospitals in Rio de Janeiro. The instruments used were the Actigraph, Sandra Prince-Embury's Resilience Scale for Children and Adolescents and the Pediatric Quality of Life Inventory. Data analysis involved descriptive statistics and correlation tests. RESULTS: 40 hospitalized children and adolescents between the ages of nine and 18 took part. The results showed compromised sleep, especially in terms of duration and time awake after sleep onset. Quality of life scores were low and resilience levels were classified as medium to high. Correlations were found between resilience and sleep. In addition, sleep was influenced by diagnosis and treatment. CONCLUSION: Children and adolescents hospitalized with chronic conditions experience significant sleep disturbances and have a low quality of life, but have satisfactory levels of resilience.

Family Vulnerability Scale: validity evidence in primary health care.

OBJECTIVE: Investigate evidence of validity of the Family Vulnerability Scale (EVFAM-BR) as an instrument to support population-based management in primary health care (PHC), in the scope of Health Care Planning (PAS). METHODS: This is a psychometric study to assess any additional evidence of the internal structure of EVFAM-BR using confirmatory factor analysis (CFA) and network analysis (NA). A preliminary version of the scale with 38 items was submitted to patients of PHC facilities that use the PAS methodology, distributed across the five regions of Brazil. For the primary CFA data, factor loadings and predictive power (R2) of the item were used. Seven model adjustment indices were adopted and reliability was measured by three indicators, using Bayesian estimation. RESULTS: The preliminary version of the scale was applied to 1,255 patients. Using the AFC, factor loadings ranged from 0.66 to 0.90 and R2 from 0.44 to 0.81. Both the primary indicators and the model adequacy indices presented satisfactory and consistent levels. According to the NA, the items were appropriately associated with their peers, respecting the established dimensions, thus demonstrating sustainability and stability of the proposed model. CONCLUSIONS: The evidence of validity presented by EVFAM-BR indicates, for the first time in Brazil, a concise instrument that is able to assertively measure family vulnerability, potentially supporting population-based management.

Brazilian Scale for Evaluation of Mental Health Care Needs: Additional Evidence.

OBJECTIVE: To investigate validity evidence of the Brazilian Scale for Evaluation of Mental Health Care Needs (CuidaSM). METHODS: This is a psychometric study, which seeks additional evidence of internal structure. Data collection was carried out in 11 Primary Health Care (PHC) services , which implement the Health Care Planning (HCP) methodology, distributed across the five Brazilian regions. The preliminary version of CuidaSM, containing a block self-referred by the user and another block evaluated by PHC professionals, was applied to users aged 18 or over who attended the PHC services for consultation with a higher education professional. The techniques of confirmatory factor analysis and network analysis were used to investigate validity evidence. For the primary data of the confirmatory factor analysis, the factorial loads and the item's predictive power (R2) were used. Six model adjustment indices were adopted and reliability was measured by three indicators using Bayesian estimation. RESULTS: A total of 879 users participated in the study. By confirmatory factor analysis, factorial loads ranged from 0.43 to 0.99 and R2 from 0.19 to 0.98. Both the primary indicators and the model adequacy indices were established at satisfactory and consistent levels. The network analysis showed that the items were appropriately associated with their peers, respecting the established dimensions, which again indicates the sustainability and stability of the proposed model. CONCLUSIONS: The study findings confirm a consistent and reliable model of the instrument, through a combination of techniques. Considering the importance of using solid instruments in clinical practice, CuidaSM is a promising tool for population-based management and network care organization, aligned with HCP proposals.

Validation of the internal structure of the Brazilian Dental Vulnerability Scale.

OBJECTIVE: This study aimed to evaluate evidence of validity of internal structure of the Brazilian Dental Vulnerability Scale (EVO-BR) when applied in Brazil. METHODS: This is a psychometric study that seeks to validate a scale elaborated by evidence of internal structure. Data collection was conducted in 18 basic health units that implement the Brazilian Healthcare Planning (PAS) methodology, across the five regions of Brazil. The initial version of the EVO-BR contained 41 items that measured dental vulnerability and was applied to users of the Brazilian Unified Health System (SUS) aged 18 years or older who were in basic health units for consultation with higher education professionals. To evaluate the evidence, the following statistical analyses were performed: exploratory factor analysis, confirmatory factor analysis, and network analysis. RESULTS: A total of 1,753 users participated in the study. To adjust the sample, we considered the factorability obtained from Kaiser-Meyer-Olkin (KMO) test = 0.65, Bartlett sphericity test = 8019.7, and a matrix determinant of 0.008. The initial parallel analysis indicated a four-dimensional model and had the items adjusted according to factor loading (ranging from 0.38 to 0.99), common factors (0.13 to 0.89), and Pratt's measure, until the model presented congruence in the statistical and interpretative principles simultaneously. The final model contained 15 items, maintaining the four dimensions indicated by the parallel analysis, and held an explained variance of 68.56%. CONCLUSIONS: The EVO-BR is a validated scale to measure dental vulnerability and, thus, can contribute to the organization of access to the oral health team in primary health care (PHC) by stratifying the population, as recommended in the Brazilian Healthcare Planning.

Family vulnerability scale: Evidence of content and internal structure validity.

INTRODUCTION: Territory view based on families' vulnerability strata allows identifying different health needs that can guide healthcare at primary care scope. Despite the availability of tools designed to measure family vulnerability, there is still a need for substantial validity evidence, which limits the use of these tools in a country showing multiple socioeconomic and cultural realities, such as Brazil. The primary objective of this study is to develop and gather evidence on the validity of the Family Vulnerability Scale for Brazil, commonly referred to as EVFAM-BR (in Portuguese). METHODS: Items were generated through exploratory qualitative study carried out by 123 health care professionals. The data collected supported the creation of 92 initial items, which were then evaluated by a panel of multi-regional and multi-disciplinary experts (n = 73) to calculate the Content Validity Ratio (CVR). This evaluation process resulted in a refined version of the scale, consisting of 38 items. Next, the scale was applied to 1,255 individuals to test the internal-structure validity by using the Exploratory Factor Analysis (EFA). Dimensionality was evaluated using Robust Parallel Analysis, and the model underwent cross-validation to determine the final version of EVFAM-BR. RESULTS: This final version consists of 14 items that are categorized into four dimensions, accounting for an explained variance of 79.02%. All indicators were within adequate and satisfactory limits, without any cross-loading or Heywood Case issues. Reliability indices also reached adequate levels (α = 0.71; ω = 0.70; glb = 0.83 and ORION ranging from 0.80 to 0.93, between domains). The instrument scores underwent a normalization process, revealing three distinct vulnerability strata: low (0 to 4), moderate (5 to 6), and high (7 to 14). CONCLUSION: The scale exhibited satisfactory validity evidence, demonstrating consistency, reliability, and robustness. It resulted in a concise instrument that effectively measures and distinguishes levels of family vulnerability within the primary care setting in Brazil.

Validity and reliability of the Brazilian Portuguese version of the Florida Patient Acceptance Survey for patients with implantable cardioverter defibrillators.

Device acceptance is a crucial factor in identifying implantable cardioverter defibrillator (ICD) patients at risk for psychosocial distress and unfavorable quality of life outcomes. The purpose of this study was to examine the evidence of the validity of internal structure (construct) and reliability of the Florida Patient Acceptance Survey (FPAS) in a sample of ICD patients, comparing the psychometric indicators of the complete (FPAS-18 item) and abbreviated (FPAS-12 item) versions. The sample included 151 participants (97 males, mean age of 55.7 ± 14.1 years) who completed the cross-culturally adapted version of the FPAS instrument for the Brazilian context. The psychometric properties of both versions of the FPAS instrument were evaluated by two distinct approaches:•Exploratory and confirmatory factor analysis: used to test the internal structure of the instrument•Cronbach's Alpha and McDonald's Omega: used to determine the reliability of the instrument The two versions of the FPAS-Br instrument showed consistent evidence of internal structure validity and reliability. However, the FPAS-Br 12-item showed a better psychometric adjustment, confirmed by the analysis of the quality indicators of the models.

Content validity evidence of the Brazilian version of the Cognitive Symptom Checklist-Work-21.

OBJECTIVE: to cross-culturally adapt and assess the content validity evidence of the Cognitive Symptom Checklist-Work-21 for the Brazilian context. METHOD: a psychometric study of cross-cultural adaptation, covering the stages of translation, reconciliation, back-translation, intercultural equivalence assessment and content validity evidence analysis, considering Content Validity Ratio parameters in breast cancer survivors. RESULTS: the translations were equivalent to the original version. Colloquial expressions were modified, tense, verbal adjusted, and two items containing multiple commands were separated. The final version now contains 22 items, presenting semantic, conceptual, idiomatic and experimental equivalences. The pre-test indicated good understanding and ease in the response process. CONCLUSION: the final version was defined as "Lista de verificação de sintomas cognitivos relacionados ao trabalho - 22 itens", showing good linguistic equivalence and strong evidence of content validity in the Brazilian context.

Checklists for Assessing Skills of Children With Type 1 Diabetes on Insulin Injection Technique.

BACKGROUND: School-aged children often participate in type 1 diabetes (T1D) self-care tasks. Despite widespread discussion about the importance of developing self-care skills in childhood, few explain how the health care team should assess the skills of children with T1D when performing insulin injections. OBJECTIVE: We sought to assess content validity evidence in two checklists regarding injection technique performed by children. METHODS: Two checklists were designed based on a systematic review of the insulin injection technique. Experts in pediatric diabetes, health literacy, and diabetes education assessed the checklists regarding their clarity, objectivity, and relevance. Content validity was assessed using the content validity ratio (CVR). RESULTS: Eleven providers (72% nurses or physicians, professional experience 19.4 ± 10.1 years, 45% of specialists in endocrinology, and 18% in pediatrics) participated in the assessment. Experts considered items containing the word homogeneity inappropriate. Items related to the needle insertion angle and the skin fold did not reach the CVR critical value. The final version of the checklist for syringe injection comprised 22 items with CVR = 0.91, and the checklist for pen injection comprised 18 items with CVR = 0.87. CONCLUSIONS: The checklists presented clear, objective, and relevant content that assesses the skills of children with T1D for insulin injection. The checklists formally present the order of the technique and all the steps for insulin injection and allow a quantitative assessment of the operational skills of children. The developed instruments offer providers the possibility of continuous assessment of the progress of the pediatric clientele until they reach independence in diabetes self-care.

Evidence of validity of internal structure of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12) in Brazilian adolescents with chronic health conditions.

This study explored the evidence of validity of internal structure of the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Wellbeing Scale (FACIT-Sp-12) in Brazilian adolescents with chronic health conditions. The study involved 301 Brazilian adolescents with cancer, type 1 diabetes mellitus, or cystic fibrosis. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and Item Response Theory (IRT) were used to test the internal structure. Reliability was determined with Cronbach's Alpha and McDonald's Omega. The EFA suggested a one-dimensional scale structure in contrast to the original 2-factor model or the 3-factor model which were not reproduced in the current CFA. All quality indicators for the EFA one-factor exceeded the required criteria (FDI = 0.97, EAP = 0.97, SR = 3.96 and EPTD = 0.96, latent GH = 0.90. and the observed GH = 0.85). The FACIT-Sp-12 for adolescents yielded strong evidence for a 1-factor model and with good reliability.

Instruments to assess the role of the clinical pharmacist: a systematic review.

BACKGROUND: The clinical pharmacist is an essential member of the healthcare team and plays an important role in health care in the primary care and the hospital setting. Knowledge regarding the instruments that evaluate the different activities of the clinical pharmacist, as well as the evaluation of the psychometric properties of these instruments, is necessary. METHODS: A literature search was performed in the PubMed and Scopus electronic databases without time and language restrictions. For the search strategy, the "pharmaceutical services," "validity studies," and "professional performance" domains were used. To assess the quality of the instruments, the five sources of validity evidence of contemporary psychometry were used, and the Joanna Briggs Institute's standardized instrument was used to assess the methodological quality of the studies. After screening 4096 articles, 32 studies were selected. RESULTS: A total of 32 studies were included, and 32 instruments were identified to be used by pharmacists acting in various pharmaceutical practice scenarios. It was found that the available instruments were developed or adapted from others, with variation in the methods, constructs, dimensions, and domains, as well as the psychometric properties. Most of the instruments addressed community pharmacies, and evidence of content validity and internal structure was found most frequently. A standardized and validated instrument that comprehensively assessed the performance of the clinical pharmacist, addressing clinical activities, was not identified for all practice environments. CONCLUSIONS: Without standardized and validated instruments specifics to assess the performance of the clinical pharmacist, it is hard to establish the main clinical activities performed by pharmacists in their pharmaceutical practice environments and to propose training actions to improve professional practice. Despite the large number of instruments available and considered validated by the authors, it is questioned to what extent the validity indicators presented in the different studies really show the validation status. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD 42018099912.

Psychometric properties of the adapted instrument European Health Literacy Survey Questionnaire short-short form.

OBJECTIVE: to investigate the psychometric properties of the Brazilian Portuguese version of the health literacy questionnaire European Health Literacy Survey Questionnaire short-short form (HLS-EU-Q6) in Brazilian adults. METHOD: the instrument was translated and pre-tested in a sample of 50 individuals. Subsequently, it was applied to a sample of 783 adult individuals. The data went through an appropriate process of testing the properties, with the combination of techniques of Exploratory Factor Analysis, Confirmatory Factor Analysis and Item Response Theory. For the assessment of reliability, the Cronbach's alpha and McDonald's Omega indicators were used. Cross-validation with full data analysis was applied. RESULTS: the majority of the participants was female (68.1%), with a mean age of 38.6 (sd=14.5) years old and 33.5% studied up to elementary school. The results indicated a unidimensional model with an explained variance of 71.23%, adequate factor load levels, commonality and item discrimination, as well as stability and replicability of the instrument to other populations. CONCLUSION: the Brazilian version of HLS-EU-Q6 indicated that the instrument is suitable for indiscriminate application in the population to which it is intended to assess health literacy levels.

Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults.

OBJECTIVE: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. METHODS: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach's alpha and McDonald's omega). RESULTS: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. CONCLUSIONS: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

Validity Evidence of the Brazilian Version of the Florida Shock Anxiety Scale for Patients with Implantable Cardioverter Defibrillators. / Evidências de Validade da Versão Brasileira da Florida Shock Anxiety Scale para Portadores de Cardioversor-Desfibrilador Implantável.

BACKGROUND: In spite of proven effectiveness of implantable cardioverter defibrillators (ICDs), shock therapy delivered by the device may result in increased levels of anxiety and depression, leading to deleterious effects on quality of life. OBJECTIVE: To carry out the translation, cross-cultural adaptation and validation of the Florida Shock Anxiety Scale (FSAS) scale into Brazilian Portuguese. METHODS: In this psychometric study, construct validity was performed by exploratory (EFA) and confirmatory (CFA) factor analyses, and by item response theory (IRT). The adjustment indexes of the CFA were: Robust Mean-Scaled Chi Square/df NNFI, CFI (Comparative Fit Index), GFI (Goodness Fit Index), AGFI (Adjusted Goodness Fit Index), RMSEA (Root Mean Square Error of Approximation) and RMSR (Root Mean Square of Residuals). Reliability was evaluated through Cronbach's Alpha, McDonald's Omega and Greatest Lower Bound (GLB). The analyses were carried out with the programs SPSS 23 and Factor 10.8.01. A 5 percent significance level was used. RESULTS: The final Portuguese version of the FSAS was administered to 151 ICD patients, with a mean age of 55.7 ± 14.1 years, and predominantly male. The parallel analysis indicated that the FSAS is unidimensional, with an explained variance of 64.4%. The correlations ranged from 0.31 to 0.77, factor loadings from 0.67 to 0.86, and communalities from 0.46 to 0.74. The adjustment indexes of the CFA were above the quality threshold. Satisfactory reliability evidence was provided by the FSAS. CONCLUSIONS: The FSAS-Br showed consistent validity and reliability evidence. Therefore, it can be used in ICD patients in Brazil. (Arq Bras Cardiol. 2020; 114(5):764-772).

FUNDAMENTO: A despeito da comprovada efetividade do cardioversor-desfibrilador implantável (CDI), as terapias de choque deflagradas pelo dispositivo podem causar níveis elevados de ansiedade e depressão, provocando efeitos deletérios na qualidade de vida. OBJETIVO: Realizar a tradução, adaptação transcultural e validação do instrumento Florida Shock Anxiety Scale (FSAS) para a língua portuguesa falada no Brasil. MÉTODOS: Nesse estudo psicométrico, a validade de construto foi realizada pela análise fatorial exploratória (AFE) e confirmatória (AFC) e pela Teoria de Resposta ao Item. Os índices de ajustamento da AFC foram: Robust Mean-Scaled Chi Square/df NNFI, CFI (Comparative Fit Index), GFI (Goodness Fit Index), AGFI (Adjusted Goodness Fit Index), RMSEA (Root Mean Square Error of Approximation) e RMSR (Root Mean Square of Residuals). A confiabilidade foi verificada pelo Alfa de Cronbach, Ômega de McDonald e Greatest Lower Bound. As análises foram realizadas no SPSS 23.0 e Factor 10.8.01, com nível de significância de 5%. RESULTADOS: A versão final em português do FSAS foi administrada em 151 portadores de CDI, com idade média de 55,7 ± 14,1 anos e predomínio do sexo masculino. A análise paralela indicou que o FSAS é unidimensional, com variância explicada de 64,4%. As correlações variaram de 0,31 a 0,77; as cargas fatoriais de 0,67 a 0,86 e as comunalidades de 0,46 a 0,74. Os índices de ajustamento da AFC estabeleceram-se acima dos limites de qualidade. Encontramos evidências satisfatórias de confiabilidade da escala FSAS. CONCLUSÃO: O instrumento FSAS-Br apresentou evidências consistentes de validade e confiabilidade, podendo, portanto, ser utilizado em portadores de CDI do Brasil. (Arq Bras Cardiol. 2020; 114(5):764-772).

Cross-cultural adaptation and validation of the Self-efficacy Scale to Brush Teeth at Night.

This study aims to perform cross-cultural adaptation and validation of the "Self-efficacy scale to brush teeth at night" with a Brazilian adult population. Translation and cross-cultural adaptation to the Brazilian-Portuguese language were done according to the stages recommended in the literature. Construct validity was carried out by mean of exploratory and confirmatory factorial analysis in a sample of 198 adult subjects. The reliability of the instrument was measured by Alpha and Omega indices. The model was observed to have been established as one-dimensional for all indicators, with explained variance of 85.7%; factorial loads between 0.85 and 0.91; and with communalities between 0.72 and 0.83. The goodness of fit of the model shown by the confirmatory model were between 0.98 and 0.99; with factorial loads between 0.85 and 0.93, and regression values between 0.69 and 0.84, all above the minimum indices established for instrument quality. For reliability, the Alpha and Omega values had identical indices of 0.95 showing high levels of reliability of the model. The G-H index replicability was 0.96, indicating the stability of solution in other contexts and samples. We concluded that all indicators represented excellent evidence of scale validity to measure self-efficacy to brush teeth at night.

Health profile of older adults assisted by the Elderly Caregiver Program of Health Care Network of the City of São Paulo.

OBJECTIVE: To assess the health profile of community-dwelling older adults, according to sex, assisted by the Elderly Caregiver Program of the City of São Paulo. METHODS: Secondary data of 535 older adults, assisted by ten Elderly Caregiver Program teams from the southern region of São Paulo, were collected from medical records and the Multidimensional Evaluation of Older People in Primary Care, after verifying the inclusion and exclusion criteria for the study and obtaining subjects' consent. RESULTS: Older adults assisted by this program were predominantly female (77.6%), mean age of 76.2±8.0 years. They had negative self-rated health (67.8%), difficulties in instrumental activities of daily living (68.4%) and signs of mood changes (60.3%). A high prevalence of older adults with vision problems (58.8%), polypharmacy (58.1%), memory-related complaints (55.8%) and multiple morbidities (50.6%) were observed. The prevalence of multiple morbidities, polypharmacy, cognitive impairment and signs of mood changes were higher in women. On the other hand, men reported more hearing problems than women. CONCLUSION: The poorer health conditions of the older adults in this study, evidenced by a high prevalence of subjects with negative self-rated health, difficulties in instrumental activities of daily living, multiple morbidities, polypharmacy and other complaints (sensorial changes, depressive and cognitive symptoms), reinforce the importance of this program as a long-term care policy and as a way to ensure these older adults can continue living in their communities.