Objective. To adapt and evaluate the psychometric properties of the Brazilian version of the SCHFI v 6.2. Methods. With the approval of the original author, we conducted a complete cross-cultural adaptation of the instrument (translation, synthesis, back translation, synthesis of back translation, expert committee review, and pretesting). The adapted version was named Brazilian version of the self-care of heart failure index v 6.2. The psychometric properties assessed were face validity and content validity (by expert committee review), construct validity (convergent validity and confirmatory factor analysis), and reliability. Results. Face validity and content validity were indicative of semantic, idiomatic, experimental, and conceptual equivalence. Convergent validity was demonstrated by a significant though moderate correlation (r = −0.51) on comparison with equivalent question scores of the previously validated Brazilian European heart failure self-care behavior scale. Confirmatory factor analysis supported the original three-factor model as having the best fit, although similar results were obtained for inadequate fit indices. The reliability of the instrument, as expressed by Cronbach's alpha, was 0.40, 0.82, and 0.93 for the self-care maintenance, self-care management, and self-care confidence scales, respectively. Conclusion. The SCHFI v 6.2 was successfully adapted for use in Brazil. Nevertheless, further studies should be carried out to improve its psychometric properties.

Background-Dietary vitamin K is thought to be an important factor that interferes with anticoagulation stability, but the clinical applicability of this interaction has not been evaluated adequately in prospective studies. Methods and Results-In a randomized controlled trial that enrolled outpatients with a recent international normalized ratio (INR) outside the therapeutic target, we compared 2 strategies to optimize long-term oral anticoagulation: (1) a conventional approach based on changes in anticoagulant prescription and (2) a dietary vitamin K-guided strategy based on simple modifications of the amount of vitamin K-rich foods ingested per week. The primary efficacy end point was the percentage of patients who achieved a prespecified INR target at 90 days after randomization. Study population (nϭ132) predominantly included men with mechanical heart prostheses (58%) or atrial fibrillation (35%). Over time, patients allocated to the vitamin K-guided strategy reached the prespecified INR more frequently so that after 90 days of follow-up, 74% were on target compared with 58% of patients managed conventionally (Pϭ0.04). Patients allocated to the dietary vitamin K-guided strategy had the same magnitude and direction of INR variation as those observed with the conventional approach in the short term (15 days) for both underanticaogulated and overanticoagulated patients.Minor bleeding or use of parenteral vitamin K were also marginally less frequent in patients managed according to the dietary intervention (1 [1.5%] versus 7 [11%]; Pϭ0.06). Conclusions-A vitamin K-guided management strategy to adjust long-term oral anticoagulation is feasible and safe and may result in an increased chance of reaching target levels of INR.

Cross-sectional study developed to relate the international normalized ratio (INR), used as a parameter to monitor the levels of blood clotting, stability to adherence, age, level of education, socioeconomic level, interaction with other drugs, comorbidities, vitamin K intake, anticoagulation time and drug cost. 156 patients were included, mean age 57±13 years, (53.8%) male, 61 (39.1%) had high adherence, 91 (58.3%) medium and 4 (2.6%) low adherence to treatment, 117 (75%) had INR stability up to 50% and 39 (25%) ≥ 75%, patients with shorter time of anticoagulation presented higher stability, those who spent less on the drug remained more stable and had better adherence. It was concluded that more than 90% of patients had high and medium adherence and that the anticoagulation time and drug cost were the factors related to the anticoagulation stability. Adhesión farmacológica al anticoagulante oral y factores que influyen en la estabilidad del índice de estandarización internacionalSe trata de un estudio transversal, desarrollado con el objetivo de relacionar la estabilidad del índice de estandarización internacional (INR), utilizado como parámetro para monitorizar los niveles de coagulación de la sangre, con adhesión, edad, escolaridad, nivel socioeconómico, interacción con otras medicaciones, comorbilidad, ingesta de vitamina K, tiempo de anticoagulación (ACO) y costo con medicamentos. Se incluyeron 156 pacientes, edad promedio 57±13 años, 53,8% perteneciente al sexo masculino; 61 (39,1%) tuvieron alta adhesión, 91 (58,3%) promedio y 4 (2,6%) baja adhesión al tratamiento; 117 (75%) presentaron estabilidad del INR de hasta 50% y 39 (25%) ≥ a 75%; los pacientes con menor tiempo de ACO presentaron mayor estabilidad; aquellos que gastaban menos con la medicación permanecían más estables y con mejor adhesión.Se concluyó que más del 90% de los pacientes presentaron adhesión alta y promedio, y que el tiempo de anticoagulación y el costo con la medicación fueron los factores relacionados a la estabilidad de la ACO.

Objective: To adapt and validate a Brazilian Portuguese version of the European Heart Failure Self-Care Behavior Scale. Methods: The cross-cultural adaptation (translation, synthesis, back-translation, expert committee review, and pretesting) and validation (assessment of face validity, content validity, and internal consistency reliability) were carried out in accordance with the literature. The European Heart Failure Self-Care Behavior Scale assesses key components of self-care: recognition of the signs and symptoms of decompensated heart failure (HF) and decision-making when these signs and symptoms arise. It comprises 12 items (range 12-60, where lower scores indicate better self-care).Results: The sample comprised 124 HF patients with a mean age of 62.3 ± 12 years. The Cronbach's Alpha internal consistency was 0.70 and the intraclass correlation coefficient for reproducibility was 0.87. Conclusion: Face and content validity, internal consistency and reproducibility have lended validity and reliability for the use of the instrument in Brazil.Descriptors: Heart Failure; Self-care, Nursing Education; Validation Studies. Adaptación transcultural y validación de la European Heart Failure Self-care Behavior Scale para el Portugués de Brasil Objetivo: Adaptar y validar European Heart Failure Self-Care Behavior Scale para uso en lengua portuguesa de Brasil. Métodos: El proceso de adaptación cultural (traducción, síntesis, retro traducción, revisión por comité de expertos y pré test), validación (validez de facie, de contenido y confiabilidad) fue realizado según la literatura. La European Heart Failure Self-Care Behavior Scale evalúa los componentes-clave para el auto cuidado: IntroductionRecent studies have emphasized the importance of systematic education on the disease and selfcare for patients with heart failure (1)(2) . The objectives of this process are to teach, strengthen, improve and constantly evaluate the abilities of patients to manage their self-care (1) . Systematic disease education contributes to the prevention of factors that might precipitate decompensation, thus reducing the number of readmissions (2) . However, information and guidance dispensed to patients in settings such as hospitals, heart failure clinics, and their own homes are not always evaluated with regard to the effectiveness of implementation (3) .In the context of heart failure, self-care can be defined as adherence to medication, lifestyle recommendations (diet and physical exercise), and disease management at the earliest signs of decompensation (3) . While several questionnaires are available for assessment of self-care and disease knowledge, there are few studies suggesting brief and practical tools targeted to heart failure patients (3)(4)(5) .In the scope of heart failure, self-care has been a focus of interest for the development of tools that could assess patient behaviors. The first such instrument, originally called the Self-management of Heart Failure Instrument, was developed by United States nurse researchers and was d...

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Background Caregivers can contribute enormously to the self-care of patients with heart failure (HF). The Caregiver Contribution to Self-care of Heart Failure Index (CC-SCHFI) measures these contributions across 3 scales: self-care maintenance, which evaluates caregiver contributions to symptom monitoring and treatment adherence; self-care management, which evaluates caregiver contributions in dealing with symptoms; and caregiver confidence, which assesses caregiver self-efficacy in managing all contributions to self-care. Although the CC-SCHFI has been used in several investigations, only 1 study has evaluated its psychometric characteristics. Objective The aim of this study was to evaluate the psychometric properties of the CC-SCHFI in Brazil. Methods A cross-sectional design was used in this study. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. Results The sample comprised 99 caregivers of patients with HF. Most were women (73%), with a mean age of 48 ± 14 years; 57% were patients' spouses. Confirmatory factor analysis confirmed the original factor structure of the instrument, with supportive fit indices for all 3 scales (comparative fit index, 0.95–1.00; root-mean-square error of approximation, 0.00–0.057). Reliability estimates were adequate for each CC-SCHFI scale (0.77–0.96). Conclusions The CC-SCHFI is a valid and reliable scale to measure caregiver contributions to self-care maintenance, caregiver contributions to self-care management, and caregiver confidence in HF.

Onze cuidados de enfermagem prioritários foram citados pelos enfermeiros e mapeados em oito intervenções de enfermagem NIC, incluindo a Thrombolytic Therapy Management (4270). CONCLUSÕES: Houve correspondência entre todos os cuidados de enfermagem prioritários para pacientes com acidente vascular encefálico tratados com a terapia trombolítica e as intervençães de enfermagem NIC. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os cuidados de enfermagem citados pelos enfermeiros foram corroborados pela NIC, produzindo evidências para a prática clínica.

ARTIGO ORIGINALFeijó MKEF, Lutkmeier R, Ávila CW, Rabelo ER. Fatores de risco para doença arterial coronariana em pacientes admitidos em unidade de hemodinâmica. Rev Gaúcha Enferm., Porto Alegre (RS) 2009 dez;30(4):641-7. (220, 73%), dislipidemia (150, 50.5%), obesidad (87, 29%), diabetes mellitus (81, 27%), tabaquismo (77, 25.5%), consumo de alcohol (67, 22%) y alimentación pobre en frutas y verduras (15, 5%). La correlación entre el número de FR y las variables analizadas (escolaridad, sueldo mínimo, edad, estado civil, actividad profesional FATORES DE RISCO RESUMEN Estudio transversal cuyo objetivo fue evaluar la prevalencia de factores de riesgo (FR) para enfermedad arterial coronaria (EAC) en pacientes sometidos a procedimientos cardíacos en una unidad de hemodinamia. Se incluyeron 302 pacientes de 62±11 años, predominantemente blancos (270, 89%) y de sexo masculino (172, 57%). Los FR más prevalentes fueron sedentarismo (227, 75%), seguido de la hipertensión