No abstract

This is a literature review report to describe characteristics (frequency, intensity and correlates) of fatigue in cases of heart failure. MedLine and LILACS were the examined databases. Out of 89 articles identified, 27 were selected for data extraction. Fatigue frequency ranged from 69% to 88% and fatigue intensities are incomparable due to differences in measurement scales. Quality of life, illness progression, physical activity, social and demographic variables, comorbidity, treatment and who assessed the fatigue were variables studied in relation to fatigue. The diversity of fatigue assessment methods causes difficulties to integrate results on fatigue frequency, characteristics and related factors. No study was found on fatigue characteristics in samples of Brazilian heart failure patients.

Fatigue is a human response in varied acute and chronic conditions and also in general population. This article reports a study conducted to estimate reliability and validity of the Dutch Fatigue Scale (DUFS) and the Dutch Exertion Fatigue Scale (DEFS) adapted for Brazilian use. Three-hundred heart failure patients and 64 healthier volunteers answered the DUFS and DEFS translated into Portuguese. Factorial analysis of DUFS and DEFS items yield a solution with one factor for each scale (explained variance = 53.9%), and good reliability estimates were obtained by the Chronbach's alpha (DUFS=.85 e DEFS=.92). In the patient sample, scales scores were positively associated with heart failure functional class (DUFS and DEFS p=.00), depression scores (DUFS r s=.63; p=.00 and DEFS r s=.55; p=.00), and sleep disturbance (DUFS and DEFS p=.00). Brazilian versions of DUFS and DEFS presented psychometric properties similar to those of the original ones.

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We developed an m-Health platform to support clinical pathways in a child and adolescent neuropsychiatry unit. The Assioma platform was created for tablets, smartphones and PCs, to support data collection and clinical workflow, to promote constant communication between patients, caregivers and clinicians, and to promote active family involvement in day hospital (DH) procedures. Through the Assioma application for tablets, caregivers filled out an anamnestic questionnaire and explored contents on the DH procedures and neurodevelopmental conditions. The application for smartphones included an agenda function for the DH pathways. Through the application for desktops, clinicians could export anamnestic information in text and Excel formats, send real-time notifications, and push relative contents to families’ account. We tested the usability and satisfaction of the Assioma platform in a group of children, caregivers (N = 24) and clinicians (N = 6). Both families and clinicians gave high scores to almost all usability items. The overall satisfaction reached the highest levels at 50% satisfied for families and at 33% for clinicians. Our results indicate that the Assioma platform has the potential to optimize clinical pathways, increasing compliance and clinical efficiency, and to reduce in-person contacts supporting social distancing for clinical pathways, a crucial need during the COVID-19 pandemic.

Il contributo esamina le conseguenze pervasive del maltrattamento precoce alla luce della prospettiva teorica del Trauma Complesso come Disturbo dello Sviluppo (Courtois & Ford, 2009) e del Modello Process Oriented (Di Blasio, 2005) sui fattori di rischio familiari. L'indagine qualitativa, condotta tramite una revisione socio-anamnestica delle cartelle e un'intervista strutturata al clinico referente del minore, riguarda un campione di 87 soggetti in etŕ evolutiva tra i 3 e i 18 anni, in carico al centro specialistico contro i maltrattamenti all'infanzia "Il Faro" di Bologna. I dati indicano una generale compromissione delle principali funzioni psichiche esplorate, associata a specifici fattori di rischio distali e prossimali nell'ambiente familiare. I risultati sollecitano un'attenta valutazione multidimensionale (psicosociale e clinica) delle variabili cruciali per la futura salute mentale.

Objectives: To describe fatigue and fatigue by efforts in people without chronic diseases and to verify the association between fatigue or fatigue by efforts with gender, age, education, marital cohabitation, depression, physical activity, smoking, body mass index (BMI), dyspnea and depression. Methods: It is a descriptive study comprising 93 patients from outpatient attendance who reported about smoking, fatigue, fatigue by efforts, depression, and physical activity. Results: Of the 93 volunteers (65.6% female -average age 33.4 ± 10.1 years), 52.7% had fatigue and 34.4% had fatigue by efforts. The average score of fatigue was 16.3 ± 6.6 (scale from 8 to 40) and fatigue by efforts12.6 ± 4.4 (scale from 9 to 45). The fatigue was more intense (p = 0.005) and more frequent (p = 0.001) in women and was positively correlated with depression (rs=0,47; p=0,000). The fatigue by efforts was positively correlated with depression (rs=0,39; p=0,000) and was more frequent among women (p = 0.001). Conclusion: The characteristics of fatigue in a sample of patient companions are similar to those of patients with chronic diseases. The interpretation of data on fatigue, in patients with chronic diseases, should consider the fatigue data, in the general population. Keywords: Fatigue; Nursing Diagnoses; Adult health RESUMO Objetivos: Descrever a fadiga e fadiga ao esforço em pessoas sem doenças crônicas e verificar associação entre fadiga ou fadiga ao esforço e sexo, idade, escolaridade, convivência marital, depressão, atividade física, tabagismo, Índice de Massa Corporal (IMC), dispnéia e depressão. Métodos: Estudo descritivo abragendo 93 acompanhantes de pacientes ambulatoriais que informaram sobre tabagismo, fadiga, fadiga ao esforço, depressão, e atividade física. Resultados: Dos 93 voluntários (65,6% mulheres, média de idade 33,4±10,1 anos), 52,7% tinham fadiga e 34,4% fadiga ao esforço. O escore médio de fadiga foi 16,3±6,6 (escala de 8 a 40) e de fadiga ao esforço 12,6±4,4 (escala de 9 a 45). A fadiga foi mais intensa (p=0,005) e mais freqüente (p=0,001) nas mulheres e correlacionou-se positivamente com depressão (r s =0,47; p=0,000). A fadiga ao esforço correlacionou-se positivamente com depressão (r s =0,39; p=0,000) e foi mais freqüente entre as mulheres (p=0,001). Conclusão: As características da fadiga em amostra de acompanhantes de pacientes são semelhantes às de pacientes com doenças crônicas. A interpretação de dados sobre fadiga em doenças crônicas precisaria considerar dados de fadiga na população geral. Descritores: Fadiga; Diagnóstico de enfermagem; Saúde do adulto RESUMEN Objetivos: Describir la fatiga y la fatiga por esfuerzo en personas sin enfermedades crónicas y, verificar la asociación entre fatiga o fatiga por esfuerzo con sexo, edad, escolaridad, convivencia marital, depresión, actividad física, tabaquismo, Índice de Masa Corporal (IMC), disnea y, depresión. Métodos: Es un estudio descriptivo abarcando 93 acompañantes de pacientes de ambulatorios que informaron sobre tabaquismo, fatiga, fatiga por...