ResumoObjetivo: Validar uma escala de auto-eficácia para adesão ao tratamento anti-retroviral em crianças e adolescentes com HIV/AIDS, levando em consideração a perspectiva dos pais/responsáveis, e avaliar a sua reprodutibilidade. Métodos: O estudo foi realizado no Hospital-Dia do Centro deReferência e Treinamento em DST/AIDS de São Paulo. Foram entrevistados os pais/responsáveis de 54 crianças e adolescentes de 6 meses a 20 anos que passaram em consulta de rotina pelo serviço. Os dados de auto-eficácia foram levantados pela escala de auto-eficácia para seguir prescrição anti-retroviral (AE), que foi calculada de duas maneiras: análise fatorial e fórmula já definida. A consistência interna da escala foi verificada pelo coeficiente α de Cronbach. A validade foi avaliada pela comparação das médias dos escores entre grupos de pacientes aderentes e não aderentes ao tratamento anti-retroviral (teste de Mann-Whitney) e cálculo do coeficiente de correlação de Spearman entre os escores e parâmetros clínicos. A reprodutibilidade foi verificada por meio do teste de Wilcoxon, pelo coeficiente de correlação intraclasse (CCI) e pelo gráfico de Bland-Altman.Resultados: A escala de AE apresentou boa consistência interna (α = 0,87) e boa reprodutibilidade (CCI = 0,69 e CCI = 0,75). Quanto à validade, a escala de AE conseguiu discriminar pacientes aderentes e não aderentes ao tratamento anti-retroviral (p = 0,002) e apresentou correlação significativa com a contagem de CD4 (r = 0,28; p = 0,04). Conclusões:A escala de AE pode ser utilizada para avaliar a adesão à terapia anti-retroviral em crianças e adolescentes com HIV/ AIDS, levando em consideração a perspectiva dos pais/cuidadores. J Pediatr (Rio J). 2008;84(1):41-46: Escala, adesão, terapia, HIV, criança, adolescente, reprodutibilidade. AbstractObjective: To validate and evaluate the reproducibility of a selfefficacy (SE) scale for adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/guardians.Methods: The study was carried out at the Hospital-Dia, Centro de Referência e Treinamento em DST/AIDS (CRT/SP), in São Paulo, Brazil. The parents/guardians of 54 children and adolescents aged 6 months to 20 years were interviewed during routine consultations at our service. Data on SE were collected using the Self-Efficacy for Following Anti-Retroviral Prescription Scale, and SE scores were calculated in two different ways: factor analysis and a predefined formula. The scale's internal consistency was verified using Cronbach's α coefficient. Validity was tested by comparing the mean scores of a group of patients who did adhere to antiretroviral treatment with those of a group that did not (Mann-Whitney test) and by calculating the Spearman correlation coefficient for agreement between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, intraclass correlation coefficients (r icc ) and Bland-Altman plots. Results:The SE scale demonstrated good internal consistency (α = 0.87) and go...
Objective: To validate and evaluate the reproducibility of a self-efficacy (SE) scale for adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/guardians. Methods:The study was carried out at the Hospital-Dia, Centro de Referência e Treinamento em DST/AIDS (CRT/ SP), in São Paulo, Brazil. The parents/guardians of 54 children and adolescents aged 6 months to 20 years were interviewed during routine consultations at our service. Data on SE were collected using the Self-Efficacy for Following Anti-Retroviral Prescription Scale, and SE scores were calculated in two different ways: factor analysis and a predefined formula. The scale's internal consistency was verified using Cronbach's α coefficient. Validity was tested by comparing the mean scores of a group of patients who did adhere to antiretroviral treatment with those of a group that did not (Mann-Whitney test) and by calculating the Spearman correlation coefficient for agreement between scores and clinical parameters. Reproducibility was verified using the Wilcoxon test, intraclass correlation coefficients (r icc ) and BlandAltman plots. Results:The SE scale demonstrated good internal consistency (α = 0.87) and good reproducibility (r icc = 0.69 and r icc = 0.75). In terms of validity, the SE scale was capable of differentiating adherent patients from those who did not adhere to their antiretroviral treatment (p = 0.002) and exhibited a significant correlation with CD4 counts (r = 0.28; p = 0.04). Conclusions:The SE scale can be used to assess adherence to antiretroviral therapy in children and adolescents with HIV/AIDS, taking into account the perspective of parents/carers.
The immunological response to meningococcal C conjugated vaccine can be evaluated by two different tests: the serum bactericidal antibody assay (SBA), which evaluates the qualitative bactericidal capacity of the antibodies, and the Enzyme-Linked Immunosorbent Assay (ELISA), which quantifi es the specifi c serogroup C meningococcal immunoglobulin-G. Incompatibilities between the results of both tests have been reported. Technically, ELISA is simpler, safer, and easier to reproduce when compared to the SBA; thus, an assessment of the validity of ELISA as a protective correlate compared to the SBA gold standard should be performed. This study tested the validity of ELISA for the evaluation of the protective response to the C meningococcal conjugate vaccine in adolescents with HIV compared with the gold standard SBA, to evaluate the reliability of ELISA to infer the protection of the individual. Blood samples of 92 individuals were analyzed (43 HIV+ and 49 HIV−). We observed a positive intraclass correlation coeffi cient between the ELISA and SBA responses for HIV+ after vaccination (r icc =0.97; 95% CI, 0.91 to 0.99), and for HIV− before vaccination (r icc =0.98; 95% CI, 0.95 to 0.99). In the HIV+ group, the sensitivity and specifi city were both 100% for SBA, and 93.5% and 91.6%, respectively, for ELISA. The observed concordance between the tests suggests that in the HIV+ group the measures of antibodies by ELISA could be extrapolated to predict an individual's protection, suggesting ELISA's reliability. Until now, ELISA was unable substitute the gold standard SBA. Further studies are necessary to reproduce our fi ndings.
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