Evidências de validade da versão brasileira do Exercise Motivation Inventory-2 em contexto de academia e personal training

Este estudo teve como objetivos verificar a validade fatorial e a validade interna da versão brasileira do Exercise Motivation Inventory-2 (EMI-2) e comparar os principais motivos para prática de exercício tendo em conta os contextos de academia e personal training. Um total de 588 praticantes de exercício da cidade de Pelotas/RS/Brasil (405 de academia e 183 de personal training) preencheram o EMI-2, o qual é constituído por 51 itens, agrupados em 14 motivos (fatores) para prática de exercício físico. A validade fatorial do EMI-2 foi testada através da realização de análises fatoriais confirmatórias e a validade interna através do alfa de Cronbach. Para a verificar o efeito do contexto nos motivos foi utilizada a MANOVA e calculado o tamanho do efeito. Os resultados obtidos dão suporte à estrutura original do EMI-2 com 14 fatores, nesta amostra. Verificou-se um efeito multivariado significativo do contexto sobre os motivos de prática [Wilks’ λ = 0.912, F (14, 573.000) = 3.9, p < 0.001, η² = 0.088]. Os motivos de “Prazer”, “Força e resistência”, “Desafio”, “Socialização”, “Competição” e “Reconhecimento Social” foram significativamente superiores no contexto de academia e os motivos de “Agilidade” e “Prevenção de Doenças” foram significativamente superiores no contexto de personal training.

Factorial validity of the Maslach Burnout Inventory (MBI-HSS) among Spanish professionals

OBJECTIVE: To assess the factorial validity and internal consistency of the Maslach Burnout Inventory (MBI-HSS). METHODS: In a sample consisting of 705 Spanish professionals from diverse occupational sectors (health, education, police and so one), seven plausible factorial models hypothesized were compared using LISREL 8. RESULTS: The four-factor oblique solution and the three-factor oblique solution showed the best and similar fit. Deletion of Item 12 and Item 16, taking into consideration the suggestions in the manual, improved the goodness of fit for both models. The four-factor oblique model suggests that, in addition to Emotional Exhaustion (EE) and Depersonalization (DP), Personal Accomplishment (PA) consists of two components labeled here Self-Competence (Items 4, 7, 17, and 21) and the Existential Component (Items 9, 12, 18, and 19). However, the alpha coefficient was relatively low for the Self-Competence component, suggesting that it is more suitable to estimate the syndrome as a threedimensional construct. The Cronbach's alpha was satisfactory for PA (alpha =.71) and EE (alpha =.85), and moderate for DP (alpha =.58). CONCLUSIONS: The results show that the MBI-HSS offers factorial validity and its scales present internal consistency to evaluate the quality of working life for Spanish professionals.

Conhecimentos sobre VIH sida nos clientes de um hospital de Lakes State, Sudão do Sul

Enquadramento: O VIH/Sida exige uma ação direcionada na vertente da prevenção, cujo suporte integra a transmissão de conhecimentos promotores da adoção e manutenção de comportamentos seguros, em conformidade com as características sociais e culturais dos indivíduos. Objetivos: Validar, para a população do Sudão do Sul, a Escala de Conhecimentos sobre VIH/Sida, The HIV Knowledge Questionnaire: HIV-KQ-45, de Carey et al. (1997); analisar de que forma as variáveis sociodemográficas influenciam os conhecimentos sobre VIH/Sida, dos cidadãos de Mapuordit Sudão do Sul; verificar se a frequência de formação sobre VIH/Sida influencia o seu nível de conhecimentos. Metodologia: Estudo quantitativo, descritivo-analítico e transversal, com 232 clientes do Mary Immaculate de Mapuordit Hospital. Foi utilizado um Questionário de caracterização sociodemográfica e do contexto de formação sobre o VIH/Sida, e o HIV Knowledge Questionnaire (HVI-K-Q) de Carey, Morrison-Beedy e Johnson (1997). Resultados: Amostra é maioritariamente masculina (74.6%), com uma média de idade 22,83 (±5.793 anos). A análise fatorial confirmatória do HIV-K-Q permitiu apurar 5 fatores, cujos valores médios mais significativos foram nos fatores preconceitos/medos (média=80.60%), conhecimentos sobre os comportamentos de risco (média=76.58%) e vias de transmissão (média=70.36%). Os sudaneses pontuaram maioritariamente com razoáveis conhecimentos sobre a Sida (média=68.08%). As mulheres, os participantes mais velhos, com companheiro(a), mais escolarizados, profissionalmente ativos, a distar do hospital =<20 Km, deslocando-se num veículo não motorizado e com diagnóstico de VIH relataram mais conhecimentos sobre a Sida. Os participantes com informação sobre a prevenção do VIH/Sida e frequência em workshop na área demonstraram melhores conhecimentos. Revelaram-se preditivas dos conhecimentos acerca da doença as habilitações literárias (β=0.32) e o diagnóstico de VIH/Sida (β=0.14) revelou-se preditor dos conhecimentos sobre os comportamentos de risco. Conclusão: As casuísticas significativas do VIH/Sida justificam considerar as habilitações literárias e a presença de diagnóstico VIH/Sida como variáveis a avaliar previamente ao planeamento estratégico das ações de educação para a prevenção do VIH/Sida no Sudão do Sul. Palavras-chave: Conhecimentos; VIH/Sida; Sudão do Sul.

Motivations which influence volunteers' satisfaction

In this paper we attempt to find out which motivations influence volunteers satisfaction. So, in a first moment, we categorize satisfaction through a factor analysis and then use linear regression models to find out the relations previously mentioned. Furthermore we analyse the existence of correlations between some demographic attributes and the other variables. In this research the population under study includes volunteers that work in the health area, more precisely volunteers that work in hospital and have direct contact with patients and their families. We obtained a total of 327 questionnaires and after excluding incomplete answers we get 304 questionnaires which embody a response rate of 36%. The outcomes of our analysis reveal that we can categorize satisfaction into intrinsic and extrinsic categories and show that motivations related to belonging and protection and career recognition are the ones influencing extrinsic satisfaction; motivations associated to development and learning and altruism are the ones with higher effect in intrinsic satisfaction. There are some negative correlations between age and extrinsic satisfaction, between years of participation and extrinsic satisfaction, between education and the motivation related to belonging and protection and between age and the motivation related to career recognition. There is only one positive correlation between hours per week and intrinsic satisfaction. The results offer new insights for research about volunteers’ motivations, motive fulfillment and volunteer satisfaction. Furthermore the outcomes advocate that to ensure satisfied volunteers, their motivations must be identified in a timely and appropriate moment, meaning that should happened as early as possible.

Dietary patterns and risk of oral cancer: a case-control study in São Paulo, Brazil

OBJECTIVE: To analyze the association between dietary patterns and oral cancer. METHODS: The study, part of a Latin American multicenter hospital-based case-control study, was conducted in São Paulo, Southeastern Brazil, between November 1998 and March 2002 and included 366 incident cases of oral cancer and 469 controls, frequency-matched with cases by sex and age. Dietary data were collected using a food frequency questionnaire. The risk associated with the intake of food groups defined a posteriori, through factor analysis (called factors), was assessed. The first factor, labeled "prudent," was characterized by the intake of vegetables, fruit, cheese, and poultry. The second factor, "traditional," consisted of the intake of rice, pasta, pulses, and meat. The third factor, "snacks," was characterized as the intake of bread, butter, salami, cheese, cakes, and desserts. The fourth, "monotonous," was inversely associated with the intake of fruit, vegetables and most other food items. Factor scores for each component retained were calculated for cases and controls. After categorization of factor scores into tertiles according to the distribution of controls, odds ratios and 95% confidence intervals were calculated using unconditional multiple logistic regression. RESULTS: "Traditional" factor showed an inverse association with cancer (OR=0.51; 95% CI: 0.32; 0.81, p-value for trend 0.14), whereas "monotonous" was positively associated with the outcome (OR=1.78; 95% CI: 1.78; 2.85, p-value for trend <0.001). CONCLUSIONS: The study data suggest that the traditional Brazilian diet, consisting of rice and beans plus moderate amounts of meat, may confer protection against oral cancer, independently of any other risk factors such as alcohol intake and smoking.

Paranoia in the General Population : a revised version of the General Paranoia Scale for adolescents

The aim of the current study was to validate the General Paranoia Scale for Portuguese Adolescents population (GPS-A). This scale assesses the paranoid ideation in non-clinical population. Results from a confirmatory factor analysis of the scale on 1218 youths confirmed an alternative model to the one-dimensional model proposed by Fenigstein and Vanable (1992) comprising three different dimensions (Mistrust thoughts, persecutory ideas and depreciation). This alternative model presented a good fit: χ2 (162)= 727.200, p = .000; CFI = .925; RMSEA = .054, P(rmsea ≤0.05) = .000; PCFI = .788; AIC = 863.200. All items presented adequate factor loadings (λij ≥0.5) and individual reliability ((λij)2 ≥0.25). Further data analysis on the scale revealed that the GPS-A is an adequate assessment tool for adolescents, with good psychometric characteristics and high internal consistency.

Patrocínio: influência na atitude relativamente à marca e intenção de compra: caso Nike e selecção portuguesa de futebol

Devido à enorme importância que tem sido atribuída ao desporto nas últimas décadas, os marketers abraçam agora totalmente o facto de uma campanha integrada de patrocínio desportivo poder atingir um imensurável número de benefícios. Na verdade, apesar das empresas se comprometerem hoje com muitas outras áreas como a cultura, caridade e domínios humanitários, o desporto continua a ser o campo mais requisitado no que ao patrocínio se refere. Para muitas organizações o patrocínio desportivo é, de facto, o elemento-chave de uma comunicação integrada de marketing. Devido então a todo este enfase dado ao desporto, decidimos verificar se a relação de patrocínio entre a marca Nike e a Selecção Portuguesa de Futebol (SPF) influencia a atitude relativamente à marca e a intenção de compra dos seus produtos, o que constitui o objectivo desta investigação. Assim, tendo como ponto de partida a questão: exercerá a relação de patrocínio entre a Nike e a SPF alguma influência na atitude relativamente à marca e sua intenção de compra? E, por meio de uma revisão da literatura referente a este tema, desenvolvemos um modelo conceptual, o qual é baseado no criado por Martensen et al (2007) e integra quatro principais conceitos: envolvimento, atitudes, intenção de compra e congruência entre a marca e o evento. O presente estudo emprega um design exploratório envolvendo uma colecta de dados quantitativos, através da aplicação de um questionário online. De modo a confirmarmos o modelo proposto, duas técnicas estatísticas foram utilizadas: análise factorial e análise de equações estruturais (AEE). As conclusões desta investigação podem fornecer directivas para a compreensão de como uma relação de patrocínio pode criar ou melhorar a atitude relativamente a uma marca e sua intenção de compra. Como principal resultado, podemos destacar a existência de uma influência positiva da relação de patrocínio na atitude relativamente à marca.

Interactions between physical and psychosocial demands of work associated to low back pain

OBJECTIVE: To examine the interaction between physical and psychosocial demands of work associated to low back pain. METHODS: Cross-sectional study carried out in a stratified proportional random sample of 577 plastic industry workers in the metropolitan area of the city of Salvador, Northeast Brazil in 2002. An anonymous standard questionnaire was administered in the workplace by trained interviewers. Physical demands at work were self-rated on a 6-point numeric scale, with anchors at each end of the scale. Factor analysis was carried out on 11 physical demand variables to identify underlying factors. Psychosocial work demands were measured by demand, control and social support questions. Multivariate analysis was performed using the likelihood ratio test. RESULTS: The factor analysis identified two physical work demand factors: material handling (factor 1) and repetitiveness (factor 2). The multiple logistic regression analysis showed that factor 1 was positively associated with low back pain (OR=2.35, 95% CI 1.50;3.66). No interaction was found between physical and psychosocial work demands but both were independently associated to low back pain. CONCLUSIONS: The study found independent effects of physical and psychosocial work demands on low back pain prevalence and emphasizes the importance of physical demands especially of material handling involving trunk bending forward and trunk rotation regardless of age, gender, and body fitness.

The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability

Purpose – Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability. Design/methodology/approach – A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done. Findings – Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed. Originality/value – This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Development and validation of a psychometric scale for assessing PA chest image quality: a pilot study

Purpose - To develop and validate a psychometric scale for assessing image quality perception for chest X-ray images. Methods - Bandura's theory was used to guide scale development. A review of the literature was undertaken to identify items/factors which could be used to evaluate image quality using a perceptual approach. A draft scale was then created (22 items) and presented to a focus group (student and qualified radiographers). Within the focus group the draft scale was discussed and modified. A series of seven postero-anterior chest images were generated using a phantom with a range of image qualities. Image quality perception was confirmed for the seven images using signal-to-noise ratio (SNR 17.2–36.5). Participants (student and qualified radiographers and radiology trainees) were then invited to independently score each of the seven images using the draft image quality perception scale. Cronbach alpha was used to test interval reliability. Results - Fifty three participants used the scale to grade image quality perception on each of the seven images. Aggregated mean scale score increased with increasing SNR from 42.1 to 87.7 (r = 0.98, P < 0.001). For each of the 22 individual scale items there was clear differentiation of low, mid and high quality images. A Cronbach alpha coefficient of >0.7 was obtained across each of the seven images. Conclusion - This study represents the first development of a chest image quality perception scale based on Bandura's theory. There was excellent correlation between the image quality perception scores derived using the scale and the SNR. Further research will involve a more detailed item and factor analysis.

Explicit discrimination and health: development and psychometric properties of an assessment instrument

OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.

As competências dos técnicos de radiologia: um contributo para a sua identificação e definição

Mestrado em Intervenção Sócio-Organizacional em Saúde - Ramo de especialização: Políticas de Administração e Gestão de Serviços de Saúde

Depressive symptoms in institutionalized older adults

OBJECTIVE To estimate the prevalence of depressive symptoms among institutionalized elderly individuals and to analyze factors associated with this condition. METHODS This was a cross-sectional study involving 462 individuals aged 60 or older, residents in long stay institutions in four Brazilian municipalities. The dependent variable was assessed using the 15-item Geriatric Depression Scale. Poisson’s regression was used to evaluate associations with co-variables. We investigated which variables were most relevant in terms of presence of depressive symptoms within the studied context through factor analysis. RESULTS Prevalence of depressive symptoms was 48.7%. The variables associated with depressive symptoms were: regular/bad/very bad self-rated health; comorbidities; hospitalizations; and lack of friends in the institution. Five components accounted for 49.2% of total variance of the sample: functioning, social support, sensory deficiency, institutionalization and health conditions. In the factor analysis, functionality and social support were the components which explained a large part of observed variance. CONCLUSIONS A high prevalence of depressive symptoms, with significant variation in distribution, was observed. Such results emphasize the importance of health conditions and functioning for institutionalized older individuals developing depression. They also point to the importance of providing opportunities for interaction among institutionalized individuals.

Cross-cultural validity of the demand-control questionnaire: Swedish and Brazilian workers

OBJECTIVE To evaluate the cross-cultural validity of the Demand-Control Questionnaire, comparing the original Swedish questionnaire with the Brazilian version. METHODS We compared data from 362 Swedish and 399 Brazilian health workers. Confirmatory and exploratory factor analyses were performed to test structural validity, using the robust weighted least squares mean and variance-adjusted (WLSMV) estimator. Construct validity, using hypotheses testing, was evaluated through the inspection of the mean score distribution of the scale dimensions according to sociodemographic and social support at work variables. RESULTS The confirmatory and exploratory factor analyses supported the instrument in three dimensions (for Swedish and Brazilians): psychological demands, skill discretion and decision authority. The best-fit model was achieved by including an error correlation between work fast and work intensely (psychological demands) and removing the item repetitive work (skill discretion). Hypotheses testing showed that workers with university degree had higher scores on skill discretion and decision authority and those with high levels of Social Support at Work had lower scores on psychological demands and higher scores on decision authority. CONCLUSIONS The results supported the equivalent dimensional structures across the two culturally different work contexts. Skill discretion and decision authority formed two distinct dimensions and the item repetitive work should be removed.

Screening for frailty in older adults using a self-reported instrument

OBJECTIVE To validate a screening instrument using self-reported assessment of frailty syndrome in older adults.METHODS This cross-sectional study used data from the Saúde, Bem-estar e Envelhecimento study conducted in Sao Paulo, SP, Southeastern Brazil. The sample consisted of 433 older adult individuals (≥ 75 years) assessed in 2009. The self-reported instrument can be applied to older adults or their proxy respondents and consists of dichotomous questions directly related to each component of the frailty phenotype, which is considered the gold standard model: unintentional weight loss, fatigue, low physical activity, decreased physical strength, and decreased walking speed. The same classification proposed in the phenotype was utilized: not frail (no component identified); pre-frail (presence of one or two components), and frail (presence of three or more components). Because this is a screening instrument, “process of frailty” was included as a category (pre-frail and frail). Cronbach’s α was used in psychometric analysis to evaluate the reliability and validity of the criterion, the sensitivity, the specificity, as well as positive and negative predictive values. Factor analysis was used to assess the suitability of the proposed number of components.RESULTS Decreased walking speed and decreased physical strength showed good internal consistency (α = 0.77 and 0.72, respectively); however, low physical activity was less satisfactory (α = 0.63). The sensitivity and specificity for identifying pre-frail individuals were 89.7% and 24.3%, respectively, while those for identifying frail individuals were 63.2% and 71.6%, respectively. In addition, 89.7% of the individuals from both the evaluations were identified in the “process of frailty” category.CONCLUSIONS The self-reported assessment of frailty can identify the syndrome among older adults and can be used as a screening tool. Its advantages include simplicity, rapidity, low cost, and ability to be used by different professionals.