RESUMO
RESUMEN Antecedentes: diferentes publicaciones han estudiado la fisiopatología de la lesión de la vía biliar (LVB), pero pocas han investigado los efectos psicosociales y de calidad de vida relacionados con su reparación. Objetivo: comparar la calidad de vida de pacientes antes y después de la reparación definitiva de una LVB. Material y métodos: se usó como instrumento para evaluar la calidad de vida relacionada con la salud (CVRS) el cuestionario de salud SF-36 en una serie de pacientes operados entre diciembre de 2015 y junio de 2019 para la reparación de LVB. Resultados: sobre 48 casos de reparaciones de LVB, contestaron la encuesta 22 (46%). Se compararon los ítems del formulario SF 36: diferencia en la función física, el rol físico, el dolor corporal, la salud general, la vitalidad, la función social, el rol emocional, la salud mental y el ítem de transición de salud, y todos mostraron una mejoría estadísticamente significativa (p < 0,001) después de la reparación. En el análisis univariado se observó que la salud mental se vio afectada por la presencia de una lesión compleja (p = 0,019), el rol físico y el rol emocional antes de la reparación, y mostró relación con el tipo de lesión según Strasberg (p = 0,001 y p = 0,032). Aquellos que asociaron lesión vascular presentaron una asociación negativa con la función física (p = 0,019), la vitalidad (p = 0,033), la salud mental (p = 0,005) y el dolor (p = 0,026) antes de la reparación. Conclusión: la resolución definitiva de la LVB en un centro especializado en patología hepatobiliopancreática mostró producir una significativa mejoría en la calidad de vida.
ABSTRACT Background: Different publications have examined the pathophysiology of bile duct injury (BDI), bur few studies have investigated the effects of BDIs and their subsequent repair on psychosocial and health-related quality of life Objective: The aim of this study was to compare the quality of life of patients before and after definitive BDI repair. Material and methods: The SF-36 Health Survey was used as an instrument to assess health-related quality of life (HRQL) in a series of patients operated on between December 2015 and June 2019 for BDI repair. Results: Of 48 patients who underwent BDI repair, 22 (46%) responded to the survey. The SF-36 items, which includes different domains (physical functioning, physical role functioning, bodily pain, general health, vitality, social functioning, emotional role functioning, mental health, and health transition) were compared. All domains demonstrated statistically significant improvement (p < 0.001) following repair. On univariate analysis, mental health was affected by the presence of a complex injury (p = 0.019), and physical and emotional role functioning before BDI repair were associated with the type of injury of the Strasberg classification (p = 0.001 and p = 0.032, respectively). An associated vascular injury had a negative correlation with physical functioning (p = 0.019), vitality (p = 0.033), mental health (p = 0.005), and pain (p = 0.026) prior to repair. Conclusion: The definitive resolution of BDIs at a center specialized in hepatobiliary and pancreatic surgery resulted in a significant improvement of patients' quality of life.
RESUMO
Background and Objectives: Patients infected with SARS-CoV-2 can have persistent symptoms after acute illness, which affects their quality of life (QoL). Research and data about this topic in Latin American ambulatory patients are scarce. Materials and Methods: We conducted an observational, prospective, transversal, and analytical study. To measure QoL, we used a validated Spanish version of the MOS/RAND 36-Item Short Form Health Survey (SF-36). Results: We included 206 outpatients in the study. A total of 73.3% patients had persistence of one or more symptoms. The most frequent persistent symptoms were fatigue (36.9%), anxiety (26.2%), and headache (24.8%). No statistically significant difference in the SF-36 QoL scores and the frequency of persistent COVID-19 symptoms was found when comparing the ≤5 and >5 months groups, except for myalgia, which was less frequently observed in the >5 months group after COVID-19 (26.2% vs. 14.1%, p < 0.038). Female gender was associated with an increased risk of persistence of symptoms (OR = 2.95, 95% CI 1.56−5.57). Having comorbidities/sequelae attributed to COVID-19 and persistence of COVID-19 symptoms were associated risk factors for poor physical component summary (PCS); on the other hand, female gender, anxiety, and depression were associated with poor mental component summary (MCS). Conclusion: Most outpatients had persistent COVID-19 symptoms after infection. Persistence of symptoms was associated with poor MCS and PCS. It is important to follow-up not only patients discharged from the hospital after SARS-CoV-2 infection, but also those under ambulatory management to provide them with rehabilitation and psychological therapy to improve their QoL.
Assuntos
COVID-19 , Humanos , Feminino , COVID-19/complicações , Qualidade de Vida , Pacientes Ambulatoriais , Estudos Prospectivos , SARS-CoV-2RESUMO
ABSTRACT Background: No study has focused on Health-Related Quality of Life (HRQoL) for Chagas Achalasia patients. Objective: To compare HRQoL between Chagas Achalasia patients and the general population; and to correlate HRQoL with clinical factors that can affect it. Methods: Sixty Chagas Achalasia patients and 50 controls were evaluated. All patients underwent esophageal manometry for the diagnosis of achalasia and esophagogram to determine the grade of megaesophagus. Three questionnaires were used: 1) clinical: the following data were collected: demographic, medical history, body mass index, occurrence of six esophageal symptoms (Esophageal Symptom Score: number of symptoms reported by patients), duration of dysphagia; 2) socio-economic-cultural status evaluation: patients and controls answered seven questions about their socio-economic-cultural conditions; 3) HRQoL: the validated Brazilian-Portuguese version of the Short-form Health Survey (SF-36) questionnaire (license QM020039) was used. It measures health in eight domains: 3a) four physical: physical functioning, role limitations relating to physical health, bodily pain, and general health perception; 3b) four mental: vitality, social functioning, role limitations relating to emotional health, and mental health. These domains can be summarized into Physical and Mental Summary scores. We analyzed correlations between SF-36 Physical/Mental Summary Component scores and the following clinical factors: Esophageal Symptom Score, duration of dysphagia, body mass index, grades of megaesophagus (defined by the esophagogram) and presence/absence of megacolon (defined by opaque enema). Results: Patients and controls had similar age, gender, medical history, and socio-economic-cultural lifestyles (P>0.05). All patients had dysphagia and megaesophagus. SF-36 scores were significantly lower in Chagas Achalasia patients than controls for all eight domains (physicals: P<0.002; mentals: P<0.0027). The Physical and Mental Summary Component scores were also lower in Chagas Achalasia patients than controls (P<0.0062). For patients, the Physical Summary score was negatively correlated to Esophageal Symptom Score (P=0.0011) and positively correlated to body mass index (P=0.02). No other correlations were found. Conclusion: Chagas Achalasia patients have an impaired HRQoL in all physical and mental domains. Patients reporting more symptoms had worse physical domains. Patients with higher body mass index had better physical domains.
RESUMO Contexto: Não encontramos na literatura estudos sobre a qualidade de vida em pacientes com acalásia chagásica especificamente. Objetivo: Comparar a qualidade de vida de pacientes com acalásia chagásica e a da população em geral. Também, correlacionar a qualidade de vida nestes pacientes com fatores clínicos que possam afetá-la. Métodos: Estudamos 60 pacientes com acalásia chagásica e 50 controles. Todos os pacientes foram submetidos à manometria esofágica para diagnóstico de acalásia e esofagograma técnica padrão para determinar o grau do megaesôfago. Usamos 3 questionários: 1) clínico: foram coletados os seguintes dados: demográficos, história clínica, índice de massa corporal, presença de seis sintomas esofágicos (definimos Escore de Sintomas Esofágicos como o número de sintomas relatados pelos pacientes), duração da disfagia; 2) avaliação sócio-econômico-cultural: sete questões sobre as condições sócio-econômico-culturais foram perguntadas para pacientes e controles; 3) qualidade de vida: foi avaliada pelo questionário SF-36, versão validada para o português-Brasil (licença QM020039). Este é um questionário genérico que mede a qualidade de vida em oito domínios: 3a) quatro físicos: capacidade funcional, aspectos físicos, dor corporal, estado geral de saúde; 3b) quatro mentais: vitalidade, aspectos sociais, aspectos emocionais, saúde mental. Estes oito domínios podem ser compilados em dois escores: Sumário dos Escores Físicos e Sumário dos Escores Mentais. Na análise de fatores clínicos que pudessem afetar a qualidade de vida dos pacientes, avaliamos: escores de sintomas esofágicos, duração da disfagia, índice de massa corporal, graus de megaesôfago e presença/ausência de megacólon. Resultados: Os dois grupos (pacientes e controles) apresentaram semelhantes idade, gênero, história médica e condições socioeconômico-culturais (P>0,05). Todos os pacientes tinham disfagia e megaesôfago. Com relação à qualidade de vida, pacientes com acalásia chagásica apresentaram valores significativamente menores do que os controles em todos os domínios do questionário SF-36 (domínios físicos: P<0,002; domínios mentais: P<0,0027). Os Sumários dos Escores Físicos e Mentais também foram significativamente menores em pacientes do que nos controles (P<0.0062). A análise dos fatores clínicos que poderiam afetar a qualidade de vida nos pacientes mostrou que o Sumário dos Escores Físicos se correlaciona negativamente com o Escores Dos Sintomas Esofágicos (P=0,0011) e positivamente com o índice de massa corporal (P=0,02). Não observamos qualquer outra correlação. Conclusão: Pacientes com Acalásia Chagásica têm pior qualidade de vida que a população em geral, em todos os domínios físicos e mentais. Pacientes que relataram mais sintomas apresentaram pior qualidade de vida nos domínios físicos. Pacientes com valores maiores de índice de massa corporal apresentaram melhor qualidade de vida nos domínios físicos.
RESUMO
PURPOSE:: To assess how preexisting disabling comorbidities (DC) affect the recovery rate of quality of life (QOL) over time in sepsis survivors. METHODS:: A prospective study was conducted on sepsis survivors who answered the 36-Item Short Form Health Survey (SF-36) 7 days after discharge from the intensive care unit. Subsequent interviews were held at 3, 6, and 12 months. The results of the physical component score (PCS) and mental component score (MCS) of the SF-36 were evaluated. Patients were divided into 2 groups to compare patients with DC (DC group) and without DC (no-DC group). Quantile regression was used to model changes in PCS and MCS between different time points. RESULTS:: Seventy-nine sepsis survivors were enrolled. After controlling for baseline age and QOL, the QOL scores were lower among patients with DC than in no-DC patients. The QOL of DC group got worse when compared to no-DC group. Recovery rate of PCS and MCS was higher in the DC group than in the no-DC group (PCS: 20.51 vs 16.96, P < .01; MCS: 19.24 vs 9.66, P < .01). Their baseline QOL was recovered only by 6 months after the sepsis episode. CONCLUSION:: Quality-of-life impairment and its recovery rhythm in patients with sepsis appear to be conditioned by coexisting DC.
Assuntos
Qualidade de Vida , Sepse/psicologia , Sobreviventes/psicologia , Adulto , Idoso , Comorbidade , Feminino , Inquéritos Epidemiológicos , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Introdução: A qualidade de vida (QV) de trabalhadores vem sendo alvo de pesquisas há algum tempo no Brasil. Sendo assim verifica-se a necessidade de avaliar QV e parâmetros antropométricos de participantes, funcionários e estagiários, de instituição de ensino que realizaram a prática da ginástica laboral com o objetivo de melhorar sua rotina diária de trabalho. Material e Métodos: Foi realizada ginástica laboral para os participantes e a versão brasileira do questionário SF-36 foi aplicada, além disto, foram avaliados peso e altura e calculado o índice de massa corporal (IMC). Resultados: Foram avaliados 21 indivíduos, sendo 19% masculinos e 81% femininos, com idade média de 35,47±12,90 anos. A amostra tinha média de peso de 63,26±5,80 gramas e média de 1,64±3,90 centímetros de altura e foi calculado o IMC, e obteve-se média de 23,25±2,90. Os aspectos motores, emocionais, além dos sociais e mentais têm determinantes no aspecto que influenciam a QV dos praticantes demonstrando que a realização de tal atividade, mesmo que em um período curto (três meses) parece trazer influências benéficas no cotidiano do praticante de tal atividade, pois a maioria dos entrevistados relatam boa saúde física e emocional, e sem prejuízos de suas atividades laborais. Conclusões: Os participantes estão satisfeitos e motivados com a liberdade de expressão, participações em decisões e satisfação com a QV no trabalho, sendo assim com o conhecimento do grau de satisfação dos trabalhadores, instituições podem ajuda a direcionar estratégias de prevenção, orientação e suporte dos seus trabalhadores, afim de proporcionar um ambiente saudável de trabalho. Observou-se que a prática de ginástica laboral contribui para estes resultados.(AU)
Introduction: Quality of life (QOL) of workers has been the subject of research for some time in Brazil. Therefore, there is the need to assess QOL and anthropometric parameters of participants, employees and trainees, teaching institution that carried out the practice of gymnastics in order to improve their daily work routine. Methods: gymnastics was held for the participants and the Brazilian version of the SF-36 questionnaire was applied were assessed height and weight and calculated body mass index (BMI). Results: A total of 21 subjects, 19% male and 81% female, mean age 35.47 ± 12.90 years. The sample had an average weight of 63.26 ± 5.80 grams and average of 1.64 ± 3.90 cm in height and calculated BMI, and obtained an average of 23.25 ± 2.90. The engines, emotional aspects, as well as social and mental are determinants in the aspect that influence QOL of practitioners demonstrating that the performance of such activity, even in a short period (three months) seems to bring beneficial influences on practicing everyday in such activity because the majority of respondents reported good physical and emotional health, and without prejudice to their work activities. Conclusions: Participants are satisfied and motivated with freedom of expression, participation in decisions and satisfaction with QOL at work, so with knowledge of the degree of employee satisfaction, institutions can help to direct prevention strategies, guidance and support of its employees in order to provide a healthy working environment. It was found that practicing gymnastics contributes to these results.(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Programa de Saúde Ocupacional , Exercício Físico , Inquéritos e Questionários , GinásticaRESUMO
This study assessed the psychometric properties of the SF-36 questionnaire in a sample of 4344 Peruvian people aged 15 to 64 years. Internal consistency reliability was estimated using Cronbach's α coefficient, construct validity by known-groups comparison defined with respect to key sociodemographic characteristics, and factor structure by confirmatory factor analysis (CFA) at item level. Cronbach's α coefficient for the full questionnaire was 0.82 and ranged between 0.66 and 0.92 by scales. The 8 scales discriminated well between sexes, age, and socioeconomic groups. CFA showed that a model with 8 first-order factors and 2 second-order factors (namely, physical and mental health) was a feasible representation of the SF-36 factor structure and had better fit to data than alternative factor structures. The SF-36 showed appropriate psychometric properties regarding internal consistency, construct validity, and factor structure when tested in Peru. Future studies should focus on testing other psychometric properties of the SF-36, such as convergent and discriminant validity, test-retest reliability, and sensitivity to change.
Assuntos
Inquéritos e Questionários/normas , Adolescente , Adulto , Fatores Etários , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Psicometria , Reprodutibilidade dos Testes , Fatores Sexuais , Fatores Socioeconômicos , Adulto JovemRESUMO
OBJETIVO: O aumento da população idosa no Brasil justifica a necessidade de avaliar os aspectos que podem interferir na qualidade de vida de aposentados. MÉTODOS: A versão brasileira do questionário SF-36 foi aplicada em 87 aposentados para avaliação da qualidade de vida. Os resultados obtidos foram associados às características demográficas, socioeconômicas, condições de saúde e estilo de vida e foram estudados por meio de análise uni e multivariada. RESULTADOS: A idade média foi de 57,3 anos (desvio-padrão de 8,9 anos) e tempo médio de aposentadoria foi de 7,1 anos. A aposentadoria foi por invalidez em 55,2 por cento da amostra e 23,4 por cento dos aposentados trabalhavam no momento da pesquisa. Os fumantes somaram 11,5 por cento e 5,7 por cento eram dependentes de álcool. A depressão e hipertensão arterial sistêmica foram as doenças mais prevalentes, e 56,3 por cento dos aposentados praticavam algum tipo de atividade física regularmente. Após a análise multivariada, evidenciou-se melhor qualidade de vida apenas nos aposentados que praticavam atividade física regular ou que tinham alguma atividade de trabalho no momento da pesquisa. CONCLUSÃO: O questionário SF-36 foi um instrumento adequado, de aplicação relativamente rápida e de fácil uso para avaliação da qualidade de vida em aposentados. A qualidade de vida na amostra estudada foi associada ao estilo de vida dos pacientes e aponta para a necessidade de ações que contribuam de forma positiva para melhorar o estilo de vida nesta nova fase da vida.
OBJECTIVE: Increase of the elderly in the Brazilian population demands assessment of aspects that interfere with the retirees' quality of life. METHODS: The Brazilian version of SF-36 questionnaire was applied to 87 retirees at their homes. Data on quality of life was associated with demographic data, socioeconomic status, health conditions and life style. Statistical analysis of data was performed using single-variable and multivariate analysis. RESULTS: The mean age was 57.3 years (standard deviation 8.9 years) and the mean retirement time was 7.1 years. Fifty-five percent were early retirements due to disability and 23.4 percent of those queried were still working when research was carried out. Smokers were 11.5 percent and 5.7 percent were diagnosed as alcohol dependent by CAGE criteria. Depression and arterial systemic hypertension were the most prevalent conditions and 56.3 percent of the retirees practiced regular physical activity. Multivariate analysis disclosed that regular physical activity and post-retirement occupation were the only variables associated with improved quality of life. CONCLUSION: The SF-36 questionnaire was a suitable instrument, relatively quick and easy to use. The quality of life was associated with life style, as indicated by the practice of physical activities and post-retirement occupation. Actions are needed to enable retirees to improve their life style after retirement.