OBJETIVO: Validar, adaptar e aferir a fidedignidade do Inventário de Depressão Maior (Major Depression Inventory - MDI) para a língua portuguesa. MÉTODOS: O questionário passou pelo processo de adaptação transcultural. Foi realizado um pré-teste para avaliar sua aplicabilidade. Para avaliação de reprodutibilidade, utilizou-se medida repetida com intervalo de 1 a 2 semanas e coeficiente de correlação intraclasse. O MDI e a escala de Hamilton foram aplicados em 30 pacientes com diagnóstico de depressão, que foram pareados com 90 controles aos quais foi aplicado o MDI. A curva ROC foi realizada com 120 pacientes e escore final do MDI. Para análise da validade interna, utilizou-se o alfa de Cronbach. RESULTADOS: Sensibilidade e especificidade foram 0,86 e 0,75, respectivamente, com escores 16/17. O alfa de Cronbach para a escala total foi 0,91. O coeficiente de Pearson entre o total do MDI e o total da escala de depressão de Hamilton foi 0,56. A análise fatorial revelou dois fatores: o primeiro explicava 53,9% da variação enquanto o segundo explicava somente 13,6%. A confiabilidade teste-reteste foi excelente (com coeficiente de correlação intraclasse variando de 0,50 e 0,93 para itens individuais e 0,90 para o escore total). CONCLUSÃO: As propriedades psicométricas do MDI se mostraram adequadas para aplicação na população brasileira, entretanto outros estudos se fazem necessários.
Background: Self-reported clinical worsening by people with Parkinson's disease (PD) during social distancing may be aggravated in Brazil, where the e/tele-health system is precarious.Objectives: This study aims to investigate self-reported changes in motor and non-motor aspects during social distancing in people with PD living in Brazil and to investigate the factors that might explain these changes.Methods: In this multicenter cross-sectional trial, 478 people with a diagnosis of idiopathic PD (mean age = 67, SD = 9.5; 167 female) were recruited from 14 centers distributed throughout the five geographical regions of Brazil. The evaluators from each center applied a questionnaire by telephone, which included questions (previous and current period of social distancing) about the motor and non-motor experiences of daily living, quality of life, daily routine, and physical activity volume.Results: Self-reported clinical worsening in non-motor and motor aspects of daily life experiences (Movement Disorder Society-Unified PD Rating Scale—parts IB and II—emotional and mental health, and fear of falling) and in the quality of life was observed. Only 31% of the participants reported a guided home-based physical activity with distance supervision. Perceived changes in the quality of life, freezing of gait, decreased physical activity volume, daily routine, and fear of falling explained the self-reported clinical worsening (P < 0.05).Conclusions: Self-reported clinical worsening in people with PD living in Brazil during social distancing can also be aggravated by the precarious e/tele-health system, as perception of decreased physical activity volume and impoverishment in daily routine were some of the explanatory factors. Considering the multifaceted worsening, the implementation of a remote multi-professional support for these people is urgent.
Introdução: Os anos finais do curso de graduação em Medicina estão cercados pelo aumento gradual de responsabilidades acumuladas durante o curso, que por muitas vezes, podem sobrecarregar os estudantes modificando a qualidade de vida dos mesmos. Objetivo: Analisar o perfil de qualidade de vida de formandos do curso de Medicina e a sua associação com a dificuldade em conciliar o internato e os estudos. Métodos: A amostra foi formada por 302 estudantes, de ambos os sexos, com média de idade de 25,4 anos, que frequentavam o internato obrigatório do curso de Medicina. Foram investigadas a qualidade de vida por meio do WHOQOL-bref, informações sociodemográficas e características do internato. Resultados: Os scores da qualidade de vida geral (63,52) e domínios Psicológico (73,17) e Físico (73,19) foram os indicadores de qualidade de vida com percepção mais negativa por parte destes estudantes. Da amostra, 29,1% relataram percepção neutra ou negativa destas questões. Os domínios Físico (p=0,004), Psicológico (p=0,008) e Meio ambiente (p=0,026) apresentaram poder preditivo de 15,8% da qualidade de vida geral. Além disso, os estudantes que possuíam dificuldades em conciliar o internato com o estudo tiveram menor qualidade de vida geral (p=0,026) e física (p=0,010). Conclusão: Os piores indicadores de qualidade de vida foram os domínios Psicológico, Físico e a qualidade de vida geral. Uma parcela da amostra relatou percepção neutra ou negativa de sua qualidade de vida. Alunos com dificuldade em conciliar o internato e os estudos apresentaram percepção mais negativa no domínio Físico e na qualidade de vida geral.
Influência da idade na percepção de finitude e qualidade de vidaInfluence of age on the perception of finitude and quality of life
Importance: The menopausal transition has been related to worsening mental health. The literature also points out that being physically active during menopause is associated with a favorable effect on climacteric symptoms, specifically on psychological aspects.Objectives: The aims of the study are to analyze the effects of physical activity on mental health during menopause through an umbrella review and to evaluate the quality of the included Systematic Reviews and meta-analyses (MAs).Evidence Review: A MeaSurement Tool to Assess Systematic Reviews was used to evaluate the methodological quality of the included studies and the Grading of Recommendations Assessment, Development and Evaluation was applied to assess the level of the evidence of the results. In addition, the effect size of the revised meta-analyses (MAs) was calculated.Findings: A total of 9 systematic reviews/MAs were included, published between 2014 and 2020. In the A MeaSurement Tool to Assess Systematic Reviews methodological quality assessment, 8 studies were classified as "high quality" and 1 as "low quality." In terms of quality of the evidence for each result through the Grading of Recommendations Assessment, Development and Evaluation classification, approximately 75% of the studies were classified as "moderate quality," 22.2% as "high quality," and 22.2% as "low quality," with the greatest bias concerning the high heterogeneity of the included studies. In addition, the studies showed low overlap. Despite the high heterogeneity, we can highlight the importance of the practice of physical activity by women in menopause, to prevent and/or reduce problems related to mental health.Conclusions and Relevance: There was a positive effect of the interventions on depression, however, with no difference between durations (short or long). Regarding stress, the interventions applied did not show a positive effect. The studies that investigated depression linked to anxiety presented conflicting results.
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