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Introduction: The recent transformations undergone by Brazilian labor court, especially with the introduction of electronic process of law (processo judicial eletrônico [PJe]), had a significant influence on how people work. Objectives: This study aimed to evaluate the occurrence of musculoskeletal symptoms and work ability in public sector employees working in a specialized labor court body. Methods: A cross-sectional study was conducted with 449 workers, who provided demographic and occupational information and completed the Nordic Musculoskeletal Questionnaire (NMQ) and the Work Ability Index (WAI). Results: Symptoms occurred more frequently in wrists/hands (62.4%), shoulders (62.1%), and neck (60.4%) in the past 12 months, and in the neck (29.8%), shoulders (29.4%), and wrists/hands (29.2%) in the past 7 days. The mean WAI score was 38.7 (6.4), and 31.4% of participants had poor or moderate work ability. WAI scores were poorer when participants had previous problems, and the number of body segments involved in complaints was greater among those with inadequate work ability. Conclusions: Higher frequency of musculoskeletal symptoms in wrists/hands, shoulders, and neck may be related to using PJe for work and is associated with poorer work ability scores, highlighting the importance of preventive interventions for work-related musculoskeletal disorders.

Objective: to presenting the linguistic validation of the Diabetic Foot Ulcer Scale Short-Form (DFS-SF) among patients with ulcer diabetic foot (DFU) to Brazilian Portuguese and evaluate its content, practicability and acceptability.Methods and casuistry: a cross-sectional, methodological research, was conducted among 30 outpatients in follow-up for DF, assessed regarding QoL, sociodemographic and clinical data. International recommendations provided bythe Mapi Research Trust on adaptation procedures were followed: the stages of Forward translation, Backward translation and the Cognitive interview were carried out. The Content Validity Index was calculated and a pre-test were gathered to produce a pre-final version. Practicability and acceptability were also assessed. Results: the semantic, idiomatic, cultural and conceptual equivalences between the linguistic validated and the original version were obtained.The DFS-SF was practical, well accepted and easy to understand. Conclusion: the linguistic validation process of the Brazilian version of the DFS-SF has been completed in accordance with internationally recommended standards.The instrument was easy to apply, to understand and presented short time for administration.

Objectives To verify the content validity of questions of an insulin adherence questionnaire based on the Theory Planned Behavior in outpatients with type 2 diabetes mellitus. Methods The instrument was derived from a tool created to evaluate psychosocial determinants of adherence to oral antidiabetics medications in the Brazilian context, and was submitted for evaluation by a committee of experts and members of the target population. The item-level content validity index, the scale-level content validity index averaging calculation method, and the modified kappa coefficient were used to evaluate agreement among specialists. The comprehensibility of the instrument by members of the target population was qualitatively analyzed. Results The item-level content validity index was found to be lower than desired in 6 of the 20 items analyzed. Of these, one item was modified and 5 were excluded after the comprehensibility evaluation by members of the target population; one item from the perceived control scale was excluded. Content validation resulted in an instrument with 14 items, distributed in the domains intention (4 items), attitude (3 items), perceived norm (4 items), and perceived control (4 items) scales. Conclusions The findings support good evidence of the content validity of the instrument for use among people with type 2 diabetes mellitus receiving insulin therapy.

The purpose of this paper is to provide measurement properties evaluation and factor analysis of the Brazilian version of the diabetic foot ulcer scale-short form (DFS-SF). This methodological study evaluated the measurement properties of the DFS-SF by ceiling and floor effect reliability, responsiveness, and structural construct validity. The study included 290 people with diabetic foot under regular follow-up in a specialised outpatient clinic in inland Sao Paulo. Reliability was assessed by internal consistency using Cronbach's alpha and composite reliability. Ceiling and floor effects were assessed by the percentage of participants who scored the 15% worst (floor) and 15% best (ceiling) possible scale results. Validity was tested by correlating the instrument values with the domains of the Brazilian version of the Short Form Health Survey (SF-36). Responsiveness (n = 34) was accessed through the wound area obtained by photography and evaluated by the Image J Features program and the DFS-SF score at two moments, with a 4-week interval between them. The instrument had good evidence of reliability, shown by adequate internal consistency (Cronbach's alpha in domains >0.70) and compound reliability (0.84 > CC > 0.92); and of convergent validity, by significant positive correlations of moderate to strong magnitude with SF-36. Structural construct validity was examined by applying the DFS-SF confirmatory factor analysis, which indicated that the Brazilian version of the instrument is properly fitted to the original dimensional structure. The ceiling and floor effect analysis showed no ceiling or floor effects. Responsiveness was observed in the wound area, but not in the DFS-SF scores in the times. The Brazilian version of the DFS-SF presented evidence of validity and reliability, suggesting that this instrument is a valid tool for assessing the quality of life of people with diabetic foot in the Brazilian population.

Study Design: Study Design: This mixed-methods study. Objective: To describe action plans related to the behavior of adherence to oral antidiabetic medications produced by people with type 2 diabetes mellitus and identify the challenges and coping strategies for the establishment of this behavior. Methods: The study followed-up 44 people with type 2 diabetes mellitus who used oral antidiabetic medications from southeast Brazil. Adults were invited to build action and coping plans based on the Implementation Intention Theory. The plans were quantitative and qualitatively analyzed. Results: Action plans included three major themes: (1) binding oral antidiabetic medication to time markers or the sleep/wake cycle; (2) in specific environments; (3) associated with daily life activities. The motivation for coping with the perceived barriers focused on placing the pills in visible places, asking for help from family members, establishing a routine and feeding properly. Conclusions: The most effective way to manage satisfactory oral antidiabetic medication adherence seems to be recognizing the perceived barriers by patients. The implementation of specific and individualized action and coping plans to overcome perceived barriers was the stark difference.

A insuficiência cardíaca é uma doença crônica, de elevada prevalência no Brasil e no mundo, e apresenta importante impacto na realização de atividades de vida diária e na qualidade de vida. Desta forma, este trabalho tem como objetivo avaliar o autocuidado em pacientes com insuficiência cardíaca e testar a sua relação com a aptidão cardiorrespiratória. Trata-se de um estudo descritivo-exploratório, de corte transversal. Foram incluídos pacientes com insuficiência cardíaca das classes funcionais I, II e III da New York Heart Association, com idade entre 18 e 65 anos. Foram coletados dados sociodemográficos e clínicos; avaliado o autocuidado por meio do European Heart Failure Self-Care Behaviour Scale e a aptidão cardiorrespiratória pelo Veterans Specific Activity Questionnaire. Os dados foram analisados de forma descritiva, por meio de testes de correlação e comparação. Identificamos que os pacientes são em sua maioria eram do sexo masculino (63,1%), brancos (46,4%), casados (54,7%), aposentados (30,9%), tinham fração de ejeção reduzida (70%) e pertenciam a classe funcional 2 (50%). Os resultados deste estudo oferecerão subsídios para o desenvolvimento de intervenções voltadas à implementação de comportamentos de autocuidado por parte dos pacientes com IC.

Objetivo: identificar as barreiras ou problemas enfrentados pelos enfermeiros para realizar a monitorizacao cardiaca de acordo com as recomendacoes atuais e apontar as intervencoes realizadas para solucao dos problemas identificados. Metodo: Foi relaizada uma revisao integrativa da literatura. Para a selecao dos estudos, utilizou-se as bases de dados PubMed, Scopus e Web of Science. Resultados: foram incluidos 20 artigos, sendo as principais barreiras para a realizacao da monitorizacao cardiaca adequada o desconhecimento sobre recomendacoes para a correta monitorizacao eletrocardiografica e a dificuldade de interpretacao do ritmo cardiaco. Estrategias de educacao continuada e personalizacao dos parâmetros dos monitores tem demonstrado serem eficazes para que as boas praticas na monitorizacao cardiaca sejam implementadas nas instituicoes hospitalares.

As doenças cardiovasculares (DCV) são a principal causa de morbimortalidade no país e no mundo, com destaque para a doença arterial coronária (DAC). O sedentarismo é relevante fator de risco para a progressão da doença e a prática regular de atividade física (AF) faz parte das ações para prevenção e reabilitação da DAC. Esse estudo teve como objetivo validar o conteúdo de um instrumento para oferecimento de uma intervenção para promoção de caminhada na DAC; e pré testá-lo junto à população alvo. Para a validação, o comitê de especialistas foi composto por 5 experts que avaliaram o instrumento quanto à clareza, pertinência e abrangência. Foi utilizado o Índice de Validade de Conteúdo (IVC), que mensura a proporção ou porcentagem de experts em concordância acerca dos aspectos e itens do instrumento. De acordo com os especialistas, 9 itens apresentaram IVC≥0,8 e 6 itens apresentaram IVC

The relationship between salt intake and cardiovascular diseases is a contemporary scientific controversy, which has been attributed to the limits of the measures of salt intake used in the studies. Thus, this article sought to systematically review the literature on the methods used to estimate salt intake in different study designs. Of the 124 articles, 60.5% used only biochemical measures, 26.6% only self-report measures and 12.9% reported the combined use of both methods. The 24-hour urinary sodium excretion was the predominant biochemical method (79.1%) and the Food Frequency Questionnaire was the predominant self-report measure (36.4%). Interventional studies used mostly 24-hour urinary sodium excretion; while longitudinal studies used self-report measures. The question guiding the study and its design, as well as constraints related to costs, sample size and feasibility seems to influence the choice of the type of measurement.

Sao bem estabelecidos na literatura os beneficios decorrentes da pratica de atividade fisica (AF) regular para pacientes com doenca arterial coronaria (DAC), como a reducao dos niveis sericos de colesterol, controle da pressao arterial e peso corporal, melhora do humor e da saude mental, entre outros. Avaliar a relacao entre AF de lazer, aptidao cardiorrespiratoria, o desempenho das enzimas cardiacas e o desfecho obtido por meio do cateterismo cardiaco em pacientes com DAC, internados na Unidade Coronariana. Estudo exploratorio transversal em que a AF foi avaliada por meio do Godin-Shephard Leisure-Time Physical Activity Questionnaire, Questionario de Atividade Fisica Habitual de Baecke; e a aptidao cardiorrespiratoria pelo Veterans Specific Activity Questionnaire. A troponina I, enzima CKMB e resultados do cateterismo cardiaco foram obtidos por meio do prontuario. O estudo foi aprovado sob o CAAE no 58449216.8.0000.5404. Foram realizadas analises descritivas, de correlacao e associacao para avaliar a relacao entre a AF, a aptidao cardiorrespiratoria e os desfechos clinicos. A amostra (n=68) foi composta por homens, com idade entre 50 e 60 anos, brancos, que viviam acompanhados, ativos, com baixas renda e escolaridade; com diagnostico de infarto agudo do miocardio sem supra desnivelamento de segmento ST, com precordialgia, hipertensao arterial e dislipidemia, pouco ativos quanto a AF de lazer. A presenca de sintomas evidenciou pior aptidao cardiorrespiratoria entre aqueles com historico de infarto previo. Pacientes com diabetes mellitus apresentaram menor aptidao cardiorrespiratoria, maior elevacao da CKMB e mais arterias coronarias comprometidas. Quanto a coronariografia, aqueles com menos arterias comprometidas apresentaram maior escore de AF e maiores medias de idade e escolaridade. Foram constatadas correlacoes positivas entre AF e escolaridade; entre a aptidao cardiorrespiratoria e a escolaridade e a renda; e correlacao negativa entre a aptidao cardiorrespiratoria e a idade; e entre AF e a idade.

ObjectiveTo assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population.DesignPopulation-based cross-sectional survey.SettingSalt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake).ParticipantsAdults and older people (n 517) aged 20–80 years, living in Artur Nogueira, São Paulo, Brazil.ResultsMean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10·5 and 11·0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68·2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11·7 v. 9·6 g salt/d; PConclusionsSalt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference.

A ulceracao nas extremidades e a complicacao mais frequente em pessoas com diabetes mellitus (DM) e representa um grave problema de saude. Ha evidencias de que a qualidade de vida relacionada a saude (QVRS), por sua vez, se agrava conforme os pacientes apresentam maiores complicacoes nos pes. A QVRS desses pacientes pode ser avaliada por meio de instrumentos de medida, os quais sao escassos na populacao brasileira. Disponibilizar a versao brasileira do instrumento Diabetic foot ulcer scale- short form (DFS-SF), um instrumento que avalia a QV de pessoas com pe diabetico e avaliar a sua validade de conteudo. Estudo metodologico, composto pelas etapas: 1) validacao linguistica: composta por traducao, retrotraducao, avaliacao pelo comite de especialistas e pre-testagem junto aos pacientes-alvos; e 2) avaliacao da validade de conteudo, praticabilidade e aceitabilidade. O estudo foi realizado em um Ambulatorio de Pe Diabetico do interior do estado de Sao Paulo. Foi utilizado um instrumento previamente testado de caracterizacao sociodemografica e a versao brasileira do DFS-SF. O estudo foi aprovado sob o CAAE no 66816717.1.0000.5404. A amostra (n=30) foi composta por homens (76,7%), com 57,4 anos, brancos (86,7%); a maioria (56,7%) possuia mais de oito anos de estudo e era aposentada (56,7%). A maior parte (53,3%) apresentava diagnostico de DM ha mais de 19 anos; Classificacao de Wagner 2 (46,7%); ulcera neuropatica (76,7%) e relataram ter ulcera no pe por mais de 3 meses (73,3%). As equivalencias semântica, idiomatica, cultural e conceitual entre a versao traduzida e a versao original foram obtidas. O DFS-SF foi bem aceito e de facil entendimento. A versao brasileira do DFS-SF parece ser compreensivel e de facil aplicacao. Outros estudos estao sendo desenvolvidos para avaliar sua estrutura fatorial, confiabilidade e validade interna e permitir sua utilizacao na pratica clinica.

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring. OBJETIVO: comparar la calidad de vida relacionada a la salud (CVRS) - general y específica de pacientes con enfermedad coronaria entre los grupos Intervención y Control después de la implementación de las estrategias de Planificación de Acción y de Enfrentamiento de Obstáculos para adherencia a medicamentos y verificar la relación entre adherencia y CVRS. MÉTODO: se trata de estudio controlado y aleatorio. RESULTADOS: la muestra (n=115) fue del tipo aleatorio en los grupos GI (n=59) y GC (n=56). Fueron obtenidas medidas de adherencia a medicamentos y de CVRS general y específica, en la fase inicial del estudio y después de dos meses de seguimiento. CONCLUSIÓN: los hallazgos evidenciaron que la combinación de estrategias de intervención - Planificación de Acción y de Enfrentamiento de Obstáculos para adherencia a medicamentos no influenció la CVRS de pacientes con enfermedad coronaria en seguimiento en ambulatorio. OBJETIVO: comparar a qualidade de vida relacionada à saúde - geral e específica - de pacientes coronariopatas entre os grupos Intervenção e Controle, após a implementação das estratégias de Planejamento de Ação e de Enfrentamento de Obstáculos para adesão medicamentosa e verificar a relação entre adesão e qualidade de vida, relacionada à saúde. MÉTODO: trata-se de estudo controlado e randomizado. RESULTADOS: a amostra (n=115) foi aleatorizada nos grupos Intervenção (n=59) e Controle (n=56). Foram obtidas medidas de adesão medicamentosa e de qualidade de vida relacionada à saúde geral e específica, na fase inicial do estudo e após dois meses de seguimento. CONCLUSÃO: os achados evidenciaram que a combinação de estratégias de intervenção - Planejamento de Ação e de Enfrentamento de Obstáculos para adesão medicamentosa não influenciou a qualidade de vida relacionada à saúde de pacientes coronariopatas em seguimento ambulatorial.

Objectives To culturally adapt the instrument “Evidence-Based Practice Questionnaire” (EBPQ) to the Portuguese language and assess its psychometric qualities. Methods The steps of cultural adaptation of measurement instruments were followed. Reliability was verified through internal consistency, stability by test-retest, and construct validity by the contrasted groups approach. Results High Cronbach’s alpha (0.91 to 0.68) and satisfactory Intraclass Correlation Coefficient (0.90) were obtained in all domains. In assessing construct validity, significant differences were found between groups of nurses with different backgrounds. Conclusion The steps of cultural adaptation of measurement instruments have been successfully completed. The Brazilian version obtained presents reliable psychometric properties for its use in this population.

Objetivo: atualizar o conhecimento sobre a manutencao da permeabilidade dos Dispositivos de Acesso Vascular Central (DAVC) em paciente com câncer. Conteudo: os pacientes que fazem uso de quimioterapicos muitas vezes necessitam de DAVC seguros e de longa permanencia; a obstrucao ocorre em 36% dos pacientes com DAVC inseridos no periodo de 2 anos, que pode ser classificada como mecânica, por precipitacao de medicamento/minerais e pela formacao de coagulos. A equipe de enfermagem e responsavel por realizar os cuidados para manter a permeabilidade desses dispositivos atraves do Flushing e Locking . O uso de heparina demonstrou baixa evidencia quando comparado ao Soro Fisiologico (SF), em relacao a diminuicao da obstrucao. Conclusao: o uso de SF na manutencao dos DAVC mostra-se seguro, eficaz e com menor custo financeiro. ABSTRACT Objective: to update the knowledge on the maintenance of permeability of Central Vascular Access Devices (CVAD) in cancer patients. Content: Patients on chemotherapy often require safe, long-term CKD. Obstruction occurs in 36% of patients with CVAD inserted in a 2-year period, which can be classified as mechanical due to drug / mineral precipitation and clot formation. The nursing staff is responsible for taking care to maintain the permeability of these devices through Flushing and Locking. The use of heparin showed low evidence when compared to saline (SF), regarding the reduction of obstruction. Conclusion: the use of DES to maintain CVAD is safe, effective and has a lower financial cost. RESUMEN Objetivo : actualizar los conocimientos sobre el mantenimiento de la permeabilidad del dispositivo de acceso vascular central (DAVC) en pacientes con cancer. Contenido: los pacientes que usan quimioterapicos a menudo necesitan DAVC seguros y de larga permanencia. La obstruccion ocurre en el 36% de los pacientes con DAVC insertados en el periodo de 2 anos y puede ocorir por precipitacion de medicamento / minerales y por la formacion de coagulos. El equipo de enfermeria es responsable de realizar los cuidados para mantener la permeabilidad de estos dispositivos a traves del Flushing y Locking. El uso de heparina demostro una baja evidencia en comparacion con el Suero Fisiologico (SF), en relacion con la disminucion de la obstruccion. Conclusion: el uso de SF en el mantenimiento de los DAVC se muestra seguros, eficaz y con menor costo financiero.

AIM: this paper reports the results of a nursing-administered theory-based intervention, the "Moving Heart Program", based on the implementation intention theory and pointed at improving physical activity adherence among coronary heart disease outpatients in Brazil. METHODS: this experimental study applied assessments at baseline, 1 and 2 months after baseline. The Consolidated Standards of Reporting Trials statement was followed. Participants were randomly assigned to intervention, comprising action and coping plans on how to deal with anticipated barriers (n=69), or a standard-care control group (n=67). RESULTS: participants submitted to the intervention showed significant higher levels of physical activity 2 months after baseline and were significantly more active than the control group. CONCLUSIONS: the results indicate that the intervention is feasible for patients with coronary heart disease and can be a useful tool to facilitate intended lifestyle changes. This study brings relevant contributions to the Nursing field and other health-related areas, once the intervention presents low cost to health services and can be applied in cardiac rehabilitation programs, showing significant benefits to participants. OBJETIVO: en este estudio, se presentan los resultados de una intervención de enfermería - "El Programa Corazón en Movimiento", basada en las premisas teóricas del "implementation intention" para mejorar la actividad física entre pacientes con enfermedad coronaria en Brasil. MÉTODOS: este estudio experimental aplicó las evaluaciones al inicio del estudio, 1 y 2 meses después. La declaración Consolidated Standards of Reporting Trials fue seguida. Los participantes fueron asignados al azar al Grupo Intervención, que comprende los planes de acción y de hacer frente a la manera de lidiar con los obstáculos (n=69); o al Grupo Control (n=67). RESULTADOS: los participantes sometidos a la intervención mostraron niveles significativamente más altos de actividad física después de 2 meses y eran más activos que los del grupo control. CONCLUSIÓN: la intervención es viable para pacientes con enfermedad coronaria y es una herramienta útil para facilitar los cambios de estilo de vida. Este estudio aporta contribuciones relevantes en el campo de enfermería y de otras áreas relacionadas a la salud, una vez que la intervención tiene costo bajo para los servicios de salud y se puede aplicar en los programas de rehabilitación cardíaca, y muestra beneficios significativos para los participantes. OBJETIVO: este estudo reporta os resultados de uma intervenção denominada "Programa Coração em Movimento", baseada nos pressupostos teóricos da "implementação da intenção", para incrementar o nível de atividade física entre pacientes coronariopatas, em seguimento ambulatorial, no Brasil. MÉTODOS: neste estudo experimental foram avaliados os pacientes numa abordagem inicial, um e dois meses após. A declaração CONSORT foi seguida. Os participantes foram aleatoriamente alocados nos grupos intervenção (GI) e controle (GC). O GI (n=69) foi submetido ao planejamento de ação e de enfrentamento de obstáculos e o GC (n=67) recebeu tratamento de rotina. RESULTADOS: os participantes submetidos à intervenção apresentaram níveis significativamente mais elevados de atividade física dois meses após a abordagem inicial e foram mais ativos do que aqueles no GC. CONCLUSÕES: os resultados indicam que a intervenção é possível ser aplicada em pacientes coronariopatas e pode ser uma ferramenta útil para facilitar mudanças no estilo de vida. Este estudo traz contribuições relevantes para a área de enfermagem e outras áreas afins, uma vez que essa intervenção apresenta baixo custo aos serviços de saúde e pode ser aplicada em programas de reabilitação cardíaca, com evidências de benefícios significativos aos participantes.

The mechanisms by which dietary sodium modulates cardiovascular risk are not fully understood. This study investigated whether sodium intake is related to carotid structure and hemodynamics and to plasma matrix metalloproteinase (MMP) activity in hypertensive adults. One hundred thirty-four participants were cross-sectionally evaluated by clinical history, anthropometry, carotid ultrasound, and analysis of hemodynamic, inflammatory, and metabolic variables. Daily sodium intake (DSI) was estimated by 24-h recall, discretionary sodium, and a FFQ. In 42 patients, plasma MMP-2 and MMP-9 activities were also analyzed. The mean DSI was 5.52 ± 0.29 g/d. Univariate analysis showed that DSI correlated with common carotid artery systolic and diastolic diameter (r = 0.36 and 0.34; both P < 0.001), peak and mean circumferential tension (r = 0.44 and 0.39; both P < 0.001), Young's Elastic Modulus (r = 0.40; P < 0.001), intima-media thickness (r = 0.19; P < 0.05), and internal carotid artery resistive index (r = 0.20; P < 0.05). Multivariate analyses revealed that only artery diameter, circumferential wall tension, and Young's Elastic Modulus were independently associated with DSI. Conversely, plasma MMP-9 activity was associated with DSI (r = 0.53; P < 0.001) as well as with common carotid systolic diameter (r = 0.33; P < 0.05) and Young's Elastic Modulus (r = 0.38; P < 0.01). In conclusion, sodium intake is associated with carotid alterations in hypertensive adults independently of systemic hemodynamic variables. The present findings also suggest that increased MMP-9 activity might play a role in sodium-induced vascular remodeling.

Upper arm circumference (UAC) measurement is necessary for the proper sizing of cuffs and is recommended for accurate blood pressure (BP) assessment. The aim of this report is to identify and quantify the relationships between UAC and the usual anthropometric measurements of body fat distribution and cardiac structure in hypertensive subjects. We evaluated 339 patients (202 women and 137 men) by medical history, physical examination, anthropometry, metabolic and inflammatory parameters, and echocardiography. Partial correlation analyses adjusted for age and body mass index revealed that anthropometric variables were significantly associated with echocardiographic parameters exclusively in women. In this regard, UAC correlated with interventricular septum thickness, posterior wall thickness, and relative wall thickness >or=0.45, while waist circumference was related to left cardiac chamber diameter. Multivariate analyses including age, body mass index, systolic BP, homeostasis model assessment index, and use of antihypertensive medications demonstrated that UAC was an independent predictor of left ventricular wall thickness and concentric hypertrophy in women. Further linear regression analyses revealed that waist circumference was an independent predictor of left ventricular end-diastolic and left atrial diameters in this gender. Overall, these findings suggest that UAC determination might serve not only as a routine approach preceding BP evaluation but also as a simple and feasible predictor of adverse LV remodeling in hypertensive women.

This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach’s alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology. Esta revisión sistemática tuvo como objetivo: identificar y caracterizar los instrumentos de medición desarrollados en el contexto de la cardiología que fueron adaptados a la lengua portuguesa de Brasil. Se llevaron a cabo búsquedas sistemáticas en seis bases de datos. Se extrajeron los datos sobre el proceso de adaptación cultural y las propiedades de medición. Para evaluar la calidad metodológica de los estudios, fueron utilizados criterios basados en las directrices internacionales para la adaptación cultural de instrumentos. Entre los 114 artículos encontrados, 14 fueron elegibles para su revisión. De los 14, la mayoría evaluaba la calidad de vida (35,7%) y los procesos de conocimiento / aprendizaje en salud (28,6%). La mayoría de los estudios incluyeron todas las etapas del proceso de adaptación recomendadas por la literatura. En relación a la medición de las propiedades, la consistencia interna, verificada por el alfa de Cronbach, fue la propiedad reportada en la mayoría de los estudios, así como la validez de constructo y la validez de criterio. Con este estudio, se espera brindar a la comunidad científica una cuidadosa evaluación de los cuestionarios adaptados disponibles en el contexto de la cardiología. Revisão sistemática com o objetivo de identificar e caracterizar instrumentos de medida desenvolvidos no contexto da cardiologia que foram adaptados para a língua portuguesa do Brasil. Buscas sistematizadas foram realizadas em seis bases de dados. Extraíram-se informações referentes ao processo de adaptação cultural e as propriedades de medida. Para avaliação da qualidade metodológica dos estudos, foram utilizados critérios com base em diretrizes internacionais para adaptação cultural de instrumentos. Dentre os 114 artigos levantados, 14 foram considerados elegíveis para a revisão. Desses, a maioria avaliava qualidade de vida (35,7%) e conhecimento/aprendizagem em saúde (28,6%). A maioria dos estudos contemplou todas as etapas do processo de adaptação recomendadas pela literatura. Com relação às propriedades de medida, a consistência interna, verificada por meio do alfa de Cronbach, foi a propriedade relatada na maioria dos estudos, bem como as validades de constructo e critério. Com este estudo, espera-se disponibilizar para a comunidade científica uma avaliação criteriosa dos questionários adaptados disponíveis no contexto da cardiologia.

This experimental study was aimed at assessing the potential effect of a theory-driven intervention—implementation intentions—on reducing salt intake among hypertensive Brazilian women. Ninety-eight participants were randomly assigned to participate in an implementation intentions intervention aimed at promoting lower salt intake through decreased addition of salt and salty spices to meals (intervention group,n=49; group,n=49). Endpoints were assessed at baseline and at the 2-month follow-up. Primary endpoints were a self-reporting measure of salt intake given by salt addition to meals (discretionary salt + salty spices = total added salt) and the 24 h urinary-sodium excretion. Secondary endpoints included intention, self-efficacy, and habit related to adding salt to meals. Patients in the intervention group showed a significant reduction in salt intake as assessed by 24 h urinary-sodium excretion. A significant reduction in the measure of habit was observed for both groups. No differences were observed for intention and self-efficacy. The results of this pilot study suggest the efficacy of planning strategies to help hypertensive women reduce their salt intake.

Aim To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease. Background Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations. Design Randomized controlled trial. Methods Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010–May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up. Findings When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5·3), but no statistically significant change was observed in the other two outcome measures. Conclusion This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

OBJECTIVE: to evaluate the relationship between the behaviors of salt consumption and socio-demographic and clinical variables. METHOD: sodium consumption was evaluated using the methods: self-reporting (considering 3 different behaviors related to salt consumption), 24- hr dietary recall, discretionary salt, food frequency questionnaire, estimation of total sodium intake and 24-hr urinary excretion of sodium (n=108). RESULTS: elevated salt intake according to the different measurements of consumption of the nutrient was associated with the variables: male sex, low level of schooling and monthly income, being Caucasian, and being professionally inactive; and with the clinical variables: elevated Body Mass Index, tensional levels, ventricular hypertrophy and the number of medications used. CONCLUSION: the data obtained shows a heterogenous association between the different behaviors related to salt consumption and the socio-demographic and clinical variables. This data can be used to optimize the directing of educational activities with a view to reducing salt consumption among hypertensives. OBJETIVO: evaluar la relación entre los comportamientos de consumo de sal y variables sociodemográficas y clínicas. MÉTODO: el consumo de sodio fue evaluado según los métodos: de autorrelato (objetivando 3 diferentes comportamientos relacionados al consumo de sal), recordatorio de 24h, sal per cápita, cuestionario de frecuencia alimentaria, estimativa de consumo total de sodio y excreción urinaria de sodio (n=108). RESULTADOS: el consumo elevado de sal según las diferentes medidas de consumo del nutriente fue asociado a las variables: sexo masculino, bajo nivel de escolaridad y de renta mensual, color blanco, inactividad profesional y a las variables clínicas: Índice de Masa Corporal elevada, niveles de tensión, indicadores de hipertrofia ventricular y número de medicaciones utilizadas. CONCLUSIÓN: los datos obtenidos muestran una asociación heterogénea entre los diferentes comportamientos relacionados al consumo de sal y a las variables sociodemográficas y clínicas. Estos datos pueden ser utilizados para optimizar la orientación de las actividades educativas objetivando la reducción del consumo de sal entre hipertensos. OBJETIVO: avaliar a relação entre os comportamentos de consumo de sal e variáveis sociodemográficas e clínicas. MÉTODO: o consumo de sódio foi avaliado segundo os métodos: de autorrelato (visando 3 diferentes comportamentos relacionados ao consumo de sal), recordatório de 24h, sal per capita, questionário de frequência alimentar, estimativa de consumo total de sódio e excreção urinária de sódio (n=108). RESULTADOS: o consumo elevado de sal, segundo as diferentes medidas de consumo do nutriente foi associado às variáveis: sexo masculino, baixo nível de escolaridade e de renda mensal, cor branca, inatividade profissional e às variáveis clínicas: índice de massa corpórea elevada, níveis tensionais, indicadores de hipertrofia ventricular e número de medicações utilizadas. CONCLUSÃO: os dados obtidos mostram uma associação heterogênea entre os diferentes comportamentos relacionados ao consumo de sal e às variáveis sociodemográficas e clínicas. Esses dados podem ser utilizados para otimizar o direcionamento das atividades educativas, visando a redução do consumo de sal entre hipertensos.

OBJECTIVE: to validate the content of persuasive messages for promoting walking among patients with coronary heart disease (CHD). The messages were constructed to strengthen or change patients' attitudes to walking. METHOD: the selection of persuasive arguments was based on behavioral beliefs (determinants of attitude) related to walking. The messages were constructed based in the Elaboration Likelihood Model and were submitted to content validation. RESULTS: the data was analyzed with the content validity index and by the importance which the patients attributed to the messages' persuasive arguments. Positive behavioral beliefs (i.e. positive and negative reinforcement) and self-efficacy were the appeals which the patients considered important. The messages with validation evidence will be tested in an intervention study for the promotion of the practice of physical activity among patients with CHD. OBJETIVO: validar el contenido de mensajes persuasivos para promover la caminata entre pacientes con enfermedad arterial coronaria (DAC). Los mensajes fueron construidos objetivando al fortalecimiento/cambio de la actitud del paciente con relación a la caminata. MÉTODO: la selección de los argumentos persuasivos fue basada en las creencias comportamentales (determinantes de la actitud) relacionadas a la caminata. Los mensajes fueron construidos con base en el Modelo de Probabilidad de Elaboración y sometidos a la validez de contenido. RESULTADOS: los datos fueron analizados por medio del índice de validez de contenido y por la importancia atribuida por los pacientes a los argumentos persuasivos de los mensajes. Las creencias comportamentales positivas (ejemplo: refuerzo positivo y negativo) y la autoeficacia fueron los reclamos considerados importantes por los pacientes. Los mensajes con evidencias de validación serán testadas en estudio de intervención para promoción de la práctica de actividad física entre pacientes con DAC. OBJETIVO: validar o conteúdo de mensagens persuasivas para promover a caminhada entre pacientes com doença arterial coronária (DAC). As mensagens foram construídas com vistas ao fortalecimento/mudança da atitude do paciente em relação à caminhada. MÉTODO: a seleção dos argumentos persuasivos foi baseada nas crenças comportamentais (determinantes da atitude), relacionadas à caminhada. As mensagens foram construídas com base no Modelo de Probabilidade de Elaboração e submetidas à validade de conteúdo. RESULTADOS: os dados foram analisados por meio do índice de validade de conteúdo e pela importância atribuída pelos pacientes aos argumentos persuasivos das mensagens. As crenças comportamentais positivas (i.e. reforço positivo e negativo) e a autoeficácia foram os apelos considerados importantes pelos pacientes. As mensagens com evidências de validação serão testadas em estudo de intervenção para promoção da prática de atividade física entre pacientes com DAC.

OBJECTIVE: to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS: the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS: specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION: this study's findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD. OBJETIVO: analisar os planos de ação e de enfrentamento de obstáculos, relacionados ao comportamento de adesão à terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adoção desse comportamento. MÉTODO: os participantes (n=59) foram convidados a elaborar planos de ação (action planning) e de enfrentamento de obstáculos (coping planning) para o comportamento de adesão aos medicamentos cardioprotetores e de alívio dos sintomas. RESULTADOS: foram evidenciados planos de ação específicos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigília/sono. Os obstáculos mais frequentemente relatados foram o esquecimento e a ausência de rotina nas atividades de vida diária. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais específicos. CONCLUSÃO: os achados deste estudo subsidiam a aplicação da implementação da intenção para otimizar a adesão de coronariopatas à terapia medicamentosa. OBJETIVO: analizar los planes de acción y de enfrentamiento de obstáculos relacionados al comportamiento de adhesión a la terapia medicamentosa, elaborados por pacientes con coronariopatía en seguimiento de ambulatorio e identificar las barreras percibidas para adopción de este comportamiento. MÉTODO: los participantes (n=59) fueron invitados a elaborar planes de acción (action planning) y de enfrentamiento de obstáculos (coping planning) para el comportamiento de adhesión a los medicamentos cardio-protectores y de alivio de los síntomas. RESULTADOS: fueron evidenciados planes de acción específicos para la tomada de los medicamentos que asociaron el comportamiento a marcadores temporales y al ciclo vigilia sueño. Los obstáculos más frecuentemente relatados fueron el olvido y la ausencia de rutina en las actividades de vida diaria. Los planes de enfrentamiento elaborados para superar el olvido fueron los más específicos. CONCLUSIÓN: los hallazgos de este estudio subvencionan la aplicación de la implementación de la intención para optimizar la adhesión de pacientes con coronariopatía a la terapia medicamentosa.

Objetivo: apresentar a estrutura conceitual baseada no modelo PRECEDE, para guiar a pesquisa e a pratica clinica do enfermeiro, na abordagem do paciente cardiopata ao longo de seu seguimento clinico. Metodo: as bases conceituais, assim como os desenhos metodologicos de pesquisa, implicados na estrutura conceitual, sao abordados. A seguir, a contextualizacao da estrutura proposta e ilustrada no seguimento clinico de pacientes hipertensos, com incorporacao das etapas de planejamento de intervencoes, segundo o protocolo intervention mapping. Resultados: constatase que a utilizacao dessa estrutura conceitual permitiu guiar, de modo coerente e racional, as etapas diagnosticas relacionadas ao consumo excessivo de sal entre os hipertensos, bem como norteou o desenvolvimento e avaliacao de intervencoes especificas para mudanca desse comportamento alimentar. Conclusao: a utilizacao da estrutura conceitual proposta permite compreensao mais ampla dos comportamentos em saude, implicados no desenvolvimento e progressao dos fatores de risco cardiovascular, assim como revela-se um caminho interessante para a proposicao de intervencoes de enfermagem, com maior chance de sucesso. O emprego dessa estrutura, de modo ampliado, pode constituir um meio factivel para melhorar a saude cardiovascular dos pacientes atendidos pelo Sistema Unico de Saude.

This cross-sectional study, based in implementation intention theory, describes action plans developed by women with hypertension (n=49) to add no more than 4g of salt per day to food and to reduce consumption of salty foods, as well as describing the barriers perceived and the coping strategies adopted for putting the action plans into practice. The plans were categorized according to similarities and were submitted to frequency analysis. The majority of the action and coping plans had to do with the effectuation of the behavior involving adding up to 4g of salt per day per person to food. The action strategies were aimed at quantifying the salt added, and the main obstacles were related to the reduced palatability of the food made with less salt. The coping plans have to do with preparing foods separately and to using natural seasonings instead of salt. This data can help the nurse to design activities for clinical education, with a view to reducing salt consumption among patients who prepare their own food.

The aim of this study was to report the development and the analysis of content validity and reliability of the Psychosocial Determinants of Physical Activity among Coronary Heart Disease Patients Questionnaire, based on an extension of the Theory of Planned Behavior. In the content validity step, three experts evaluated the instrument which was, afterwards, pre-tested with five subjects in order to obtain a conceptually appropriate and easily understood instrument. Fifty-one patients participated in the evaluation of internal consistency of the reviewed instrument. Cronbach's alpha coefficients above 0.75 were observed for the constructs: Intention, Attitude, Subjective Norm, Self-efficacy and Habit. The new instrument demonstrated acceptable evidence of content validity and reliability.

Este estudo teve como objetivo apresentar o desenvolvimento, a análise de conteúdo e da confiabilidade do Questionário para identificação dos fatores psicossociais determinantes do comportamento de atividade física em coronariopatas, baseado na extensão da Teoria do Comportamento Planejado. O instrumento foi submetido à validade de conteúdo, com realização de sua avaliação por três juízes e pré-teste com cinco sujeitos, até mostrar-se conceitualmente adequado e compreensível aos sujeitos entrevistados. Foi aplicado em 51 sujeitos para a avaliação preliminar da consistência interna, por meio da determinação do coeficiente alfa de Crombach. Foram observados coeficientes alfa de Crombach >0,75 para os constructos Intenção, Atitude, Norma Subjetiva, Autoeficácia e Hábito. O instrumento desenvolvido mostrou evidências de validade de conteúdo e de confiabilidade. The aim of this study was to report the development and the analysis of content validity and reliability of the Psychosocial Determinants of Physical Activity among Coronary Heart Disease Patients Questionnaire, based on an extension of the Theory of Planned Behavior. In the content validity step, three experts evaluated the instrument which was, afterwards, pre-tested with five subjects in order to obtain a conceptually appropriate and easily understood instrument. Fifty-one patients participated in the evaluation of internal consistency of the reviewed instrument. Cronbach's alpha coefficients above 0.75 were observed for the constructs: Intention, Attitude, Subjective Norm, Self-efficacy and Habit. The new instrument demonstrated acceptable evidence of content validity and reliability. Este estudio tuvo como objetivo presentar el desarrollo, el análisis de contenido y de confiabilidad del Cuestionario para la identificación de los factores psicosociales determinantes del comportamiento de actividad física en pacientes afectados de coronariopatías, basado en la extensión de la Teoría del Comportamiento Planificado. Se sometió la validez del contenido del instrumento a la evaluación por parte de tres jueces y pre test con cinco sujetos, hasta mostrarse conceptualmente adecuado y comprensible para los sujetos entrevistados. Fue aplicado en 51 sujetos para la evaluación preliminar de consistencia interna, a través de la determinación del coeficiente Alfa de Cronbach. Fueron observados coeficientes Alfa de Cronbach >0,75 para los constructos Intención, Actitud, Norma Subjetiva, Autoeficacia y Hábito. El instrumento desarrollado evidenció la validez de su contenido, así como su confiabilidad.

This study aimed to present the content validity and reliability analyses of an instrument to study the determinant factors of salt consumption among hypertensive subjects, based on an extension of the Theory of Planned Behavior. Content validity was assessed by 3 experts and a pre-test was carried out with 5 subjects. The final tool, comprising 3 different behaviors related to salt consumption and corresponding psychosocial variables, was applied to 32 subjects for internal consistency and temporal stability (15-day interval) analysis. Cronbach's alpha coefficients > 0.70 and significant intra-class correlation coefficients were observed for most variables, indicating the temporal stability of the measured concepts. The developed instrument exhibited evidence of both content validity and reliability. Este estudio tuvo como objetivo presentar el análisis de validez de contenido y de confiabilidad de un instrumento para estudiar los factores determinantes del consumo de sodio entre hipertensos, basado en la extensión de la Teoría del Comportamiento Planificado. El instrumento fue sometido a validez de contenido por 3 jueces y a una prueba piloto con 5 sujetos. El instrumento final, compuesto por 3 comportamientos relacionados al consumo de la sal y por las variables psicosociales correspondientes, fue aplicado a 32 sujetos para evaluación de la consistencia interna y de la estabilidad temporal (intervalo de 15 días). Fueron observados coeficientes alfa de Cronbach>0,70 para la mayoría de las variables y coeficientes de correlación entra clases significativas, que apuntaron la estabilidad temporal de los conceptos mensurados. El instrumento desarrollado mostró evidencias de validez de contenido y de confiabilidad. Este estudo teve como objetivo apresentar a análise da validade de conteúdo e da confiabilidade de um instrumento para estudo dos fatores determinantes do consumo de sódio entre hipertensos, baseado na extensão da Teoria do Comportamento Planejado. O instrumento foi submetido à validade de conteúdo por 3 juízes e pré-teste com 5 sujeitos. O instrumento final, composto por 3 comportamentos relacionados ao consumo de sal e pelas variáveis psicossociais correspondentes, foi aplicado a 32 sujeitos para avaliação da consistência interna e da estabilidade temporal (intervalo de 15 dias). Foram observados coeficientes alfa de Cronbach>0,70 para a maioria das variáveis e coeficientes de correlação intraclasse significativos, apontando para a estabilidade temporal dos conceitos mensurados. O instrumento desenvolvido mostrou evidências de validade de conteúdo e de confiabilidade.