End-stage renal disease adherence questionnaire: translation and validation to the portuguese language

Non-adherence to medical plans is recognized as an important problem in dialysis patients, since it has been associated with increased morbidity and mortality, resulting in disproportionately high costs of care. The success of renal replacement therapy depends on the adherence of patients to the different aspects of the therapeutic strategy, which includes a complex drug regimen involving a wide variety of drugs and doses, several prescribed dialysis sessions with different durations, dietetic recommendations and restriction of fluid intake. In this work, we aimed to translate and validate a previously described self-reported end-stage renal disease questionnaire (ESRD-AQ) to the Portuguese language (PESRD-AQ). After ESRD-AQ translation, a validation was performed by experts and by using a cohort of 185 Portuguese dialysis patients. PESRD-AQ reliability analysis showed strong test–retest stability across all items, with an intra-class correlation of 0.931. The average of the item-level content validity index by experts for the 46 items was 0.98, ranging from 0.94 to 1. Moreover, we found that PESRD-AQ scores indicative of non-adherence were associated with alterations in some biological and biochemical markers of non-adherence, including interdialytic weight gain. In conclusion, our results showed that PESRD-AQ, which presented an acceptable reliability and validity, is a valid tool to be used for adherence evaluation by Portuguese-speaking dialysis patients.     

基于德尔菲法构建中药饮片处方点评内容

目的： 基于德尔菲法构建中药饮片处方点评内容,促进点评工作开展。方法： 在文献检索的基础上形成调查问卷,采用德尔菲法对22名专家共进行二轮问卷调查,然后对调查结果分析,计算积极系数、权威系数、均值、等级和、满分比、变异系数和协调系数等指标,评价专家评分的一致性,并结合均值和满分比对点评内容的重要性进行排序。结果： 专家的积极系数为100%,权威系数均在0.7以上。最终形成21条点评内容,变异系数在0.060~0.401之间,协调系数为0.321（P<0.01）,评分具有一致性,重要性排序有效可信。结论： 利用德尔菲法构建中药饮片处方点评内容,进行重要性排序,有利于点评工作开展。     

Epidemiology of Musculoskeletal Symptoms Among Milkers and Dairy Farm Characteristics in Sweden and Germany

International studies have shown that musculoskeletal symptoms (MSS) and disorders (MSD) are common among dairy farm milkers. Although dairy production is diverse, it has so far not been possible to explain the high risk by production parameters. Two national studies carried out under similar conditions were the incentive to merge the data and increase the sample size. The Standardized Nordic Questionnaire was used to assess MSS prevalence among 92 Swedish and 116 German male and female milkers. Eighty-four percent and 85% of the Swedish and German milkers reported MSS in at least one body part. Highest prevalence was reported in the lower back, shoulder, and neck. Females showed a significantly higher risk of MSS. Apart from that, small significant influence of MSS was found for other risk factors. These findings indicate that technical and organizational modifications of the work place design in milking parlors are needed.     

A Prospective Study Evaluating the Role of Obesity and Obstructive Sleep Apnea for Outcomes After Catheter Ablation of Atrial Fibrillation

Effect of Obesity and OSA on Outcomes Post AF Ablation . Background: Obesity and obstructive sleep apnea (OSA) have a strong association with atrial fibrillation (AF). The purpose of this study was to prospectively determine the effects of obesity, assessed by the body mass index (BMI) and OSA on the efficacy of catheter ablation of AF. Methods: The patient population consisted of 109 patients (mean age: 60 ± 10 years, 79% male, 67% paroxysmal, mean BMI 28 ± 5 kg/m²) who underwent catheter ablation of AF. Based on BMI, patients were classified as normal (<25 kg/m²), overweight (≥25 and <30 kg/m²), or obese (≥30 kg/m²). OSA was assessed by the Berlin questionnaire. Clinical success was defined as at least 90% reduction in AF burden after 3‐month blanking period. Mean duration of follow‐up was 11 ± 4 months. Results: Of the 75 patients with clinical success, 25 (33%) had normal BMI, 29 (39%) were overweight, and 21 (28%) were obese. Among the 34 patients with failed outcome, 5 (15%) had normal BMI, 14 (41%) were overweight, and 15 (44%) were obese (P = 0.04). Twenty‐eight of the 48 patients with OSA (58%) had clinical success as opposed to 47 of the 61 patients (77%) without OSA (P = 0.036). On multivariate analysis, only BMI emerged as an independent predictor of procedural failure ((OR 1.11, CI: 1.00–1.21, P = 0.03). Conclusions: The results of this prospective study show that obesity, a modifiable risk factor, is an independent predictor of procedural failure after catheter ablation of AF. Whether treating obesity may improve the results of catheter ablation of AF warrants further investigation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 521‐525, May 2010)     

程序康复对急性心肌梗死患者生活质量的影响

目的 :观察 2周程序康复能否改善急性心梗 (AMI)患者的生活质量 (QOL)。方法 :通过多种QOL问卷(QOLQ)对顺利完成早期康复计划的 2 1例AMI患者进行QOL评估。结果 :对完成程序康复的AMI患者 (平均住院时间为 15 .4 1± 3 .76天 )通过WHOQOL等量表进行QOLQ的测试 ,主观感受积分较对照组高 (P <0 .0 0 1) ,在生理、心理及环境领域的得分亦高于对照组 (P <0 .0 0 0 1)。结论 :AMI患者早期程序康复可改善患者的生活质量     

The Chinese Childbirth Self-Efficacy Inventory: the development of a short form

Aims and objectives. To examine the validity and reliability of the short form of the Childbirth Self‐Efficacy Inventory in a clinical Chinese pregnant population. Background. Childbirth self‐efficacy has become an important psychological construct for both childbirth educators and researchers because pregnant women's perception may influence the meaning and consequences of childbirth. Assessment done by the original Childbirth Self‐Efficacy Inventory limits the scientific rigor for generating additional research into the construct, as its items were repetitive and its structure is lengthy. Methods. This prospective study investigated 293 Chinese pregnant women in their third trimester of pregnancy. The women completed the short form of the Childbirth Self‐Efficacy Inventory, the Chinese Self‐efficacy Scale and the socio‐demographic questionnaire in an interview room of the study hospital. The re‐testing of the scale on the participants was carried out two weeks later in the same clinic. Results. Factor analysis and item‐subscale correlations supported the conceptual dimensions of the short form of the Chinese Childbirth Self‐Efficacy Inventory. The Cronbach's alpha coefficients for both subscales were over 0·9. The convergent validity with the Chinese Self‐Efficacy Scale was reflected by a moderate correlation for the two subscales. The efficacy expectancy subscale differentiated primigravid from multigravid women (t = 2·83, P < 0·01, CI = ?2·33 to 2·34). Conclusions. The reliability and validity information presented in this paper supports the use of the short form of the Childbirth Self‐Efficacy Inventory as a research instrument in measuring the childbirth self‐efficacy among the Chinese population. Further validation of the measure is warranted. Relevance to clinical practice. The reliable short form of the Childbirth Self‐Efficacy Inventory could be used in routine clinical practice in maternity care services to provide a point of reference for future research and development in both childbirth education and clinical practice.     

护士个性特征与心理健康水平关系的调查分析

目的探讨北京市某5家三级甲等医院护士个性特征与心理健康水平的关系。方法2008年12月-2009年2月采用艾森克个性问卷(Eysenck personal Question-naire,EPQ)和症状自评量表(The symptomch ecklist90,SCL-90)调查了北京市某5家三级甲等医院147名护士的个性特征和心理健康状况。结果护士的内外向、神经质、精神质得分高于全国常模,其中内外向与全国常模比较,差异具有统计学意义;护士在躯体化、强迫、焦虑、敌对、恐怖、精神病性6个因子和总分上的得分高于全国常模,其中在躯体化和精神病性因子与常模比较,差异具有统计学意义;护士心理健康的各因子和总分与个性特征中的神经质和精神质维度呈正相关,与内外向维度呈负相关。结论护士的个性特征有较高的外倾向;护士的心理健康状况低于一般人群,突出表现在躯体化和精神病性两方面;护士的心理健康水平受其个性特征的影响。