Objective:To assess health-related quality of life, its predictors and magnitude of changes in health-related quality of life in patients with chronic wounds receiving specialized outpatient treatment. Method: Secondary, retrospective, descriptive, quantitative study with patients with chronic wounds from two specialized outpatient services in Brazil assessed through Ferrans & Powers Quality of Life Index-Wound Version, Visual Analog Pain Scale, Global Assessment Scale, Pressure Ulcer Scale for Healing, sociodemographic and clinical questionnaires at baseline and after 60 days of treatment. Data were analyzed by ANOVA, Spearman Coefficient, Mann-Whitney test and multivariate logistic regression. Results: Twenty-seven patients participated in the study. The overall health-related quality of life scale, health and functioning subscale and socioeconomic subscale scores increased after 60 days of treatment compared to baseline. Pain reduction was a predictor of changes in overall health-related quality of life score as well as religious practice in the family subscale. 92.6% patients perceived moderate to extensive changes in health-related quality of life. Conclusion: there was improvement of health-related quality of life for the sample studied in the period; pain and religious practice have emerged as predictors of changes in health-related quality of life. DESCRIPTORS INTRODUCTIONChronic wounds are among health conditions which the patient may suffer for several years, often causing impairment of work activities that results in early retirement and restrictions in daily living and leisure activities (1)(2)(3)(4) , thus reducing the quality of life (QoL) at any stage of the life cycle and across all life domains (2) . Chronic wounds lead to feelings of frustration, anxiety, isolation, depression, low self-esteem, and negative self-concept, thus reducing the QoL of patients (1,4) . The way patients experience their lives, deal with the problem, and perceive family support are challenges faced by nurses. Emotions and thought patterns emerge as key determinants of overall health (5) . Thus, the assessment of health-related quality of life (HRQoL) is an important way for evaluating the results of health interventions by focusing on biopsychosocial needs in search of improved living conditions (6) . There are numerous definitions of HRQoL that include fundamental ideas. The concept should indicate whether the health status measured or estimated is relatively desirable (7) . The assessment of HRQoL is an attempt to quantify the consequences of diseases and treatments, according to the subjective perception of patients (8) .For the purpose of this study, QoL is defined as "a person's sense of well-being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her", as proposed by the authors of the instrument (9) . This theoretical framework laid the foundation of Ferrans and Powers Quality of Life Index (FPQLI) (10) , a generic instrument for evaluating QoL, from which ...
Dedicatória À minha querida mãe Alzira, por seu grande amor e suas orações diária. Ao meu querido pai Francisco que, com certeza, estaria orgulhoso por mim. Ao meu sobrinho Fabrício, cujas lembranças fazem parte do meu dia a dia. Ao meu amado Sidnei, por seu carinho e apoio em todos os momentos. Agradecimentos Primeiramente, agradeço a Deus, por me dar a vida e ter me ajudado a alcançar mais uma vitória. À minha orientadora, professora Dra Vera Lúcia Conceição de Gouveia Santos, pela sabedoria em suas orientações, pelo privilégio e oportunidade de concluirmos este trabalho. Pela sua compreensão, paciência e incentivo nos momentos difíceis. À Dra Montserrat Ferrer e Dr. Jordi, por compartilhar seus valiosos conhecimentos e ter me recebido tão bem em Barcelona. Ao meu querido Sidnei pela confiança, paciência e dedicação constante, e por compartilhar na elaboração dessa tese. À toda minha família (minhas irmãs, meu irmão, meus cunhados, sobrinhos e sobrinhas) pelo apoio e incentivo constante. À Flávia, minha professora de inglês que sempre me ajudou e me apoiou para a conclusão deste trabalho. Aos enfermeiros Frank, Cíntia, Poliana e Patrícia que me ajudaram na coleta dos dados. À Àngels por ter me ajudado nas análises dos dados e a todos do Instituto IMIM (Barcelona) por terem me proporcionado momentos muito felizes. Às colegas do Departamento de Enfermagem do Hospital Beneficência Portuguesa de São Paulo pela colaboração em minhas atividades profissionais. Enfim, a todos que, direta ou indiretamente, colaboraram para a realização dessa tese. Descritores: Qualidade de vida, mudança de vida, cicatrização de ferida, lesão.ABSTRACT OLIVEIRA, AS. Ferrans & Powers Quality of Life Index -Wound Version: a study about responsiveness [thesis]. São Paulo (SP): School of Nursing/ USP; 2012.The small number of research about for Ferrans & Powers Quality of Life Index (FPQLI) that have been psychometric property of responsiveness, as well as the fact that the Wound Version (FPQLI-WV) was tested only regarding its reliability and validity prompted our study which, in order to continue the validation process, aimed at analyzing responsiveness of this instrument in patients with chronic wounds. This is a methodological prospective observational quantitative study. Was conducted with 39 patients with chronic wounds undergoing treatment at two outpatient services dedicated to wound treatment including three assessments using FPQLI-WV (at enrollment, 30 days and 60 days later). The FPQLI-WV consists of 34 items distributed into 4 domains: health and functioning (HF), socio-economic (SE), psychological/spiritual (PS) and family (F). Responsiveness was studied through data distribution methods, using effect size and also anchor-based methods, using global assessment of change, intensity of pain and wound healing. Results showed that mean total scores of FPQLI-WV in the three assessments were 21.2, 23.1 and 24.2, respectively . Regarding responsiveness, the small changes to be detected 30 days of treatment. This was ratified in 60 days ...
This objective of this study was to review literature on the responsiveness or sensitivity to changes of Ferrans & Powers instruments (IQVFP), for assessing quality of life (QV) using both the generic and specific versions. The articles were identified using the databases PubMed / Medline, Lilacs and SciELO and the electronic site of the authors, using the keywords: quality of life, responsiveness, sensitivity to change, Ferrans and Powers Index, and measurement tool. Of the 31 articles identified, 20 were assessed in full. As to the objectives, 85% were related to QV and interventions, and 15% about responsiveness, mostly developed with cardiac patients (11/55%). Among the three studies of responsiveness, two tested the psychometric properties of reliability and responsiveness. The other was a literature review. It was concluded that the number of studies that tested the responsiveness of the instruments IQVFP is low, requiring new studies to assess this property of measurement. Keywords: Quality of life;Health status indicators;Heart diseases; Evaluation/menthods; Review RESUMOEste estudo objetivou realizar uma revisão bibliográfica sobre a responsividade ou sensibilidade às mudanças dos instrumentos de avaliação de qualidade de vida de Ferrans & Powers (IQVFP), nas versões genérica e específica. Os artigos foram localizados por meio das bases de dados Pubmed/Medline, Lilacs e SciELO e no próprio sítio eletrônico das autoras, utilizando as palavras-chaves: quality of life, responsiveness, sensitivity to change, Ferrans and Powers Index, measure tool. Dos 31 artigos encontrados, 20 foram acessados na íntegra. Quanto aos objetivos, 85% relacionavam QV e intervenções e 15% sobre responsividade, sendo a maioria desenvolvida com pacientes cardíacos (11/ 55%). Dentre os três estudos sobre responsividade, em dois foram testadas as propriedades psicométricas de confiabilidade e responsividade. O outro tratava de revisão de literatura. Concluiu-se que o número de pesquisas que testou a responsividade dos instrumentos de IQVFP é reduzido, havendo necessidade de novos estudos que avaliem essa propriedade de medida. Descritores: Qualidade de vida; Indicadores básicos de saúde; Cardiopatias; Avaliação/métodos; Revisão RESUMENEn este estudio se tuvo por objetivo realizar una revisión bibliográfica sobre la receptividad o sensibilidad a los cambios de los instrumentos de evaluación de calidad de vida de Ferrans & Powers (ICVFP), en las versiones genérica y específica. Los artículos fueron localizados por medio de las bases de datos Pubmed/Medline, Lilacs e SciELO y en el propio sitio electrónico de las autoras, utilizando las palabras-clave: quality of life, responsiveness, sensitivity to change, Ferrans and Powers Index, measure tool. De los 31 artículos encontrados, 20 fueron accedidos en su totalidad. En cuanto a los objetivos, el 85% relacionaban CV e intervenciones y el 15% sobre receptividad, siendo la mayoría desarrollada con pacientes cardiacos (11/ 55%). De los tres estudios sobre receptividad, en dos fueron...
RESUMENEn esta investigación se tuvo como objetivo realizar una revisión sistemática de la literatura respecto a la utilización del yodo tópico y/o compuestos en el tratamiento de las heridas agudas. Los ensayos clínicos fueron localizados por medio de la Base de Datos Cochrane, utilizándose los siguientes descriptores: iodine, acute wound, treatment, healing, infection, surgery, surgical. Veinte (52,6%), de 38 artículos, se encuadraron en los criterios de inclusión, siendo analizados en cuanto a las características de los periódicos y de los estudios y clasificados en: yodo versus otros agentes tópi-cos (4/ 20%); yodo versus apósitos (1/ 5%); yodo versus solución fisiológica (5/ 25%); yodo versus sin yodo (8/ 40%) y yodo en diferentes concentraciones (2/ 10%). Resultados favorables para el yodo se obtuvieron en el 45% de los artículos. En cuanto a las tendencias de los resultados, tres de cinco artículos se mostraron favorables para la cicatrización de heridas y prevención de infección y nueve de 15 artículos fueron desfavorables al uso del yodo tópico cuando sólo la prevención de infección fue investigada. DESCRIPTORES ABSTRACTThe purpose of this study was to carry out a systematic review of the literature regarding the use of topic iodine and/or compounds in the treatment of acute wounds. The clinical trials were searched at the Cochrane's database using the following descriptors: iodine, acute wound, treatment, healing, infection, surgery, surgical. Twenty studies (52.6%) out of 38 met the criteria for inclusion. The articles were analyzed regarding journal and study characteristics and classified into five groups: iodine versus other topic agents (4/ 20%); iodine versus types of dressings (1/ 5%); iodine versus saline solution (5/ 25%); iodine versus no iodine (8/ 40%); and iodine at different concentrations (2/ 10%). Favorable results for the use of iodine and/or compounds occurred in 45% of the studies. Three out of 5 studies showed favorable results for healing and prevention of infection and 9 out of 15 studies were not favorable when only infection prevention was investigated. KEY WORDS RESUMOEsta pesquisa objetivou realizar revisão sistemática da literatura relacionada ao uso de iodóforos tópicos no tratamento de feridas agudas. Os ensaios clínicos foram localizados por meio da Base de Dados Cochrane, utilizando-se os seguintes descritores: iodine, acute wound, treatment, healing, infection, surgery, surgical. Vinte (52,6%), dentre 38 artigos, enquadraramse nos critérios de inclusão, sendo analisados quanto às características dos periódicos e dos estudos e classificados em: iodóforo versus outros agentes tópicos (4/ 20%); iodóforo versus coberturas (1/ 5%); iodóforo versus soro fisiológico (5/ 25%); iodóforo versus sem iodóforo (8/ 40%) e iodóforos em diferentes concentrações (2/ 10%). Resultados favoráveis para os iodóforos ocorreram em 45% dos artigos. Quanto às tendências dos resultados, três dentre cinco artigos mostraram-se favoráveis para a cicatrização de feridas e prevenção de infecção e nov...
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