Qualidade de vida de pessoas com úlcera venosa: associação dos aspectos sociodemográficos, de saúde, assistência e clínicos da lesão

Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

Qualidade de vida medida pelo "WHOQOL-bref": estudo comparativo de pacientes em hemodiálise e pós-transplante renal

Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005

Autoestima e qualidade de vida de pessoas com úlcera venosa atendidas na atenção primária

Venous ulcers (VU) is a chronic injury of the lower extremities and because of its high incidence and recurrence implies long and complex treatments, damaging the quality of life (QOL) and self-esteem (SE) of the people. This study aimed to analyze the association between self-esteem with the quality of life of people with venous ulcers treated in primary care. Cross sectional analytical study with a quantitative approach conducted with 44 people met with VU at 13 primary care units 2 and Mixed units in Natal/RN. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte (UFRN), CAAE: 07556312.0.0000.5537. Held data collection from February to April 2014 and used three instruments: a structured form covering sociodemographic, health care and clinical variables, the Rosenberg Self-Esteem Scale and the SF-36. The collected data were entered into a database and processed on computerized software for descriptive and inferential analyzes. The results showed a predominance of people with UV females (65,9%), with more than 60 years (59,1%), married or in a stable relationship (52,3%), low education (86,4%) without occupation (68,2%) and less than one minimum wage income (81,8%). Regarding assistance characteristics was observed that most patients performed the dressing with appropriate material (72,7%), professional or trained caregiver (61,4%) did not use compression therapy (81,8%), treating the injury for more than 6 months (77,3%), lack of guidelines for the use of compression therapy, elevation of legs, and regular exercise (77,3%) and consulting the angiologist last year (52,3% ). Regarding clinical features of the lesion was found that most of the recurrent lesions are (77,3%), over one year of current lesion (52,3%) medium to large lesions (54,8%), without signs of infection (61,3%) and pain (79,5%). The mean SE of respondents was 9,3 (± 5,1). The relations between the SE and the sociodemographic variables, health care and clinics showed that individuals without a partner (a) (p = 0,01), who did not wear compression therapy (p = 0,04), with more 6 months of treatment (p = 0,01) and larger lesions (p = 0,01) had a lower SE. The mean domain and the dimensions of the SF-36 were lower emphasizing the functional capacity 36.5 (± 27,6) and the physical aspects of 15.3 (± 30,6). There were significant correlations between AE people with VU and the domains and dimensions of the SF-36: physical functioning (r = -0,432), general health (r = -0,415), vitality (r = -0,573), aspects social (r = -0,517), mental health (r = -0,612) and mental health dimensions (r = -0,612) and physical health (r = -0,473). Based on these results it is concluded by rejecting the null hypothesis and accept the alternative proposed in the study in which it was found that there is a negative correlation between the SE and the QOL of people with venous ulcers

Análise da adesão ao tratamento e da qualidade de vida de pessoas com úlcera venosa

The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ

Vida sem-porquê em Mestre Eckhart : desprendimento e cotidiano

Diese Masterthese beschäftigt sich mit der Erforschung der Frage nach dem Begriff Leben ohne Warum basierend auf den Werken des Meisters Eckhart, genauer gesagt, auf den Deutschen Predigten , auf Das Buch der göttlichen Tröstung , Von dem edlen Menschen , Die Reden der Unterweisung und Von Abgeschiedenheit . Bei der Theorie der Abgeschiedenheit versucht man die Idee des Lebens ohne warum zu verstehen und zu zeigen, die Gott und der Mensch ent-decken kann. So wird erstmals eine Reflexion darüber beschrieben, was Abgeschiedenheit ist, und zwar mittels dreier Dimensionen: Ontik, Ontologisch und Mystik. Die Ontik der absoluten Armut fordert eine Analyse der Ontologie aller Ontik und das bedeutet nach Eckhart das Gotteswesen in seiner Gottheit, die unbegreifbar für den Menschen ist. Unterdessen bringt die Analyse des Wesens Gottes des Menschenlebens wieder die Einheit zwischen dem Ontischen und dem Ontologischen in der Welt. Die mystische Dimension begründet diese Einheit als Absolutum ohne Warum . Aber die Möglichkeit des Sprechens und des Denkens über die Abgeschiedenheit führt zum erfüllten Leben. Es gibt keine endgültige Predigt, keine wundersame Methode, keinen bekannten Weg oder keine leistungsfähige Strategie dafür nur in der Vollendung des Lebens ist es möglich, die subtile Äusserung von Gott, die uns entgeht, zu empfinden. Um diese Erfüllung zu erklären und die Lebensbedeutung als ohne Warum zu verstehen, untersucht diese Masterthese unter vier Perspektiven: arché und telos des Lebens, die Zeit unter dem Begriff des nun, das verbum und das ego sum qui sum, was das Leben als ohne Warum beweist und die Beharrlichkeit in der täglich von der Welt verstandenen Transzendenz. Es ist schwierig die Tiefe des Leben-ohne-Warum-Begriffs von Meister Eckhart auszudrücken, weil seine ganze Bemühung darin besteht, die Kräfte dieser Ent-deckung vor einer begrenzten Bestimmung zu schützen. Und in dieser Hinsicht öffnet er einen neuen Horizont für den Grund des Lebens. Es gibt keine Routine und Determination bei Meister Eckhart. Alles, was ist, spiegelt das Außerordentliche, seine dringende Absicht ist die Widerherstellung der Einheit mit dem Gegenwärtigen, mit dem Wesentlichen, mit dem Leben im Alltag ohne Warum

WHO disability grade does not influence physical activity in Brazilian leprosy patients

Disability caused by leprosy may be associated with stigma. The aim of this work is to describe the degree of disability, quality of life and level of physical activity of individuals with leprosy and to identify possible correlations between these factors. Ninety-seven patients from two referral centres were studied. A complete medical history was taken and the World Health Organization degree of physical disability classification (WHO-DG), the International Physical Activity Questionnaire (IPAQ) and the Medical Outcome Study 36-item Short-form health Survey (SF36) were applied. The mean age of patients was 51 +/- 14.9 years old; participants were predominantly men, married, unemployed, had concluded treatment and had had lepromatous leprosy. The WHO-DG and the level of physical activity (P-value = 0.36) were not correlated. The WHO-DG showed that 72.2% of patients had disabilities, 37-1% of whom performed vigorous physical activities. No significant association was observed between the WHO-DG and the domains of the QoL SF-36 except for functional capacity (P-value = 0.02); the physical capacity is generally 'very good' when individuals have no disabilities and 'bad' with severe disabilities. In conclusion, the WHO-DG of leprosy patients does not affect the level of physical activities or quality of life except functional capacity. There is no significant association between physical activities and quality of life in these individuals.

Efeitos do ultrassom terapêutico sobre parâmetros morfométricos e clínicos e método de extração de metaloproteinases em sujeitos com úlceras venosas

Venous wounds cause physical, psychological and financial problems that impact the quality of life of patients. Treatment alternatives are investigated in order to reduce healthcare costs and improve quality of life of people affected by this problem. Physical resources, such as therapeutic ultrasound (US), are being considered in the treatment of ulcers as a potential healing agent. This study aimed to investigate the application of US as a treatment for venous ulcers. Subjects were divided into two groups: US group, where treatment consisted of 5 sessions of pulsed US (3 MHz, 1W/cm²) associated with compression and kinesiotherapy; and sham group, where individuals went through the same procedures, but with sham US therapy. Subjects were evaluated for wound size by planimetry and digital photography, visual analogue scale for pain, quality of life by the questionnaires SF- 36 and VEINES-QoL/Sym and enzymatic activity of metalloproteinases 2 and 9 by zymography. It was observed mean reduction in wound area of 41.58±53.8% for the US group and 63.47±37.2% for the placebo group, maintenance of quality of life scores in the US group and significant improvement (p<0.05) in the placebo group by VEINES questionnaire. It was observed decreased perception of pain in the placebo group. Sample feasibility for analysis of the protein activity of metalloproteinases 2 and 9 by zymography collected by swab method was also confirmed. Our data did not give us evidence to support the theory that the US accelerates healing of venous ulcers in a short-term analysis. However, we observed that standard care associated with compression therapy and kinesiotherapy were able to significantly shorten the progression of chronic venous ulcers

Estudo das propriedades psicométricas da escala WHOQOLold em idosos da região Nordeste

The population aging process increases the number of elderly people worldwide. In Brazil, a country of continental size, this process began in the 40s and happens with specific features in each of the different region s realities. This way, this thesis aimed to evaluate the psychometric properties of a elderly s quality of life (QOL) scale, the WHOQOL-old, in a population of the Northeast of Brazil. We sought to investigate the congruence between the content covered by the scale and the ones deemed as relevant by the participants. It aimed also study the validity evidences of the instrument s internal structure. To achieve the research objectives we adopted the design of multiple methods. The research was organized in two studies. For data collection, both studies used a sociodemographic questionnaire to obtain a profile of the participants and the Mini Mental State Exam (MMSE), used as exclusion criterion. A number of 18 elderly residents of the cities of Natal-RN and Campina Grande-PB, mean age of 73.3 years (SD = 5.9) took part od the study, They were organized into three focal groups (FG) in witch they discussed about the concept of QOL, what enhance and what hinders QOL. For Study II, a quantitative approach, 335 elderly from Campina Grande responded scale WHOQOL-old. They are between 65 and 99 years (M = 74.17, SD = 6.5). The FG data were analyzed by categorical thematic content. For the data analysis of the WHOQOL-old scale were used exploratory factor analysis and calculation of the Akaike and Bayesian information criteria. The results of both studies were triangulated. According to the discussions in the FG, health and social participation have central roles in quality of life. Social participation is related to all the other QOL s influences raised. The participants indicated the relevance of religiosity and were divided about the importance of sexual activity. Exploratory factor analysis (EFA) extracted a model of six factors. Two items (OLD_3 and OLD_9), not loaded on any factor and were excluded. The other items had factor loadings > 0.3. The response categories were reduced from five to three. After the scale changes, the empirical model showed better fit (-2loglikelihood = 8993.90, BIC and AIC = 9183.90 = 9546.24) than the theoretical model (-2loglikelihood = 18390.88, AIC = 18678.88 and BIC = 19228.11). Despite the best information criterion values, the RMESA remained above the ideal (0.06). We conclude that the WHOQOL-old presents psychometric parameters below the ideal when used with the Northeast population, but the improvements made the scale s use acceptable. The WHOQOL-old uses observable variables that matches with the participants' perceptions on quality of life. However, new strategies must be tested for a better sacale refinement

Correlação entre a qualidade de vida, classe funcional e idade em portadores de marca-passo cardíaco

OBJETIVO: Avaliar se existe correlação entre qualidade de vida e classe funcional em pacientes no pós-implante de marca-passo cardíaco, e sua relação com idade. MÉTODOS: Investigados 107 pacientes de ambos os sexos (49,5% do sexo feminino e 50,5% do sexo masculino), tempo médio de implante 6,36º ±2,99 meses e média de idade 69,3º ±12,6 anos. Para avaliação da classe funcional, foi utilizada escala proposta por Goldman e para qualidade de vida, questionário AQUAREL associado ao SF-36. Realizada análise estatística pela correlação de Spearman, com significância de 5%. RESULTADOS: Foram observadas correlações negativas entre qualidade de vida e classe funcional: AQUAREL nos três domínios, desconforto no peito (r=-0,197, P=0,042), dispneia (r=-0,508, P =0,000), arritmia (r=-0,271, P=0,005) e, no SF-36 nos oito domínios. em relação à idade, correlação negativa com Capacidade Funcional do SF-36 (r=-0,338, P=0,000) e não se observou correlação com AQUAREL. Entre idade e classe funcional observou-se correlação positiva (r=0,237, P=0,014). CONCLUSÃO: Neste estudo, encontrou-se correlação negativa entre qualidade de vida e classe funcional, evidenciando nesta amostra que os pacientes pertencentes a melhor classe funcional apresentaram melhor qualidade de vida. Conforme maior idade, pior a qualidade de vida em Capacidade Funcional e em classe funcional. Sugere-se, que idade e classe funcional influenciam qualidade de vida e as escalas de classificação funcional podem constituir um dos instrumentos que integram a avaliação e refletem a qualidade de vida em portadores de marca-passo.

Qualidade de vida e saúde física e mental de médicos: uma autoavaliação por egressos da Faculdade de Medicina de Botucatu - UNESP

OBJETIVO: O presente artigo teve como objetivo analisar resultados de autoavaliações em termos de qualidade de vida (QV), saúde física (SF) e saúde mental (SM) realizadas por ex-alunos do curso de medicina de uma universidade pública brasileira, associando-se tais indicadores a dados demográficos e diversas dimensões da atuação profissional. MÉTODOS: estudo de corte transversal que teve como população-alvo todos os egressos da Faculdade de Medicina de Botucatu (UNESP) no período de 1968 a 2005, utilizando-se um questionário autoaplicável, respondido por correio ou internet. RESULTADOS: Dos 2.864 questionários enviados, 1.224 (45%) foram respondidos. Tanto a QV como SF e SM foram avaliadas como boa ou muito boa por 67,8%, 78,8% e 84,5% dos participantes, respectivamente. Nos modelos finais de regressão logística, associaram-se a avaliação favorável de QV: ter boa SF e SM, frequentar congressos regulamente, ter tempo suficiente de lazer e estar satisfeito com a profissão. SF boa ou muito boa associou-se independentemente com QV e SM positivas, faixa de renda mais alta, prática regular de atividades físicas e nunca ter fumado. SM favorável permaneceu associada com satisfação profissional, tempo para lazer, e boa avaliação da QV e da SF. CONCLUSÕES: Entre os médicos egressos da UNESP, SF e SM foram aspectos indissociáveis e também relacionados à QV. Bons hábitos, como praticar atividades físicas, ter tempo para lazer e não fumar foram associados à melhor avaliação da saúde em geral e devem ser incentivados. A satisfação profissional teve um peso importante no bem-estar emocional relatado pelos participantes.

Assessment of Quality of Life and Psychologic Aspects in Patients with Gestational Trophoblastic Disease

OBJECTIVE: To assess quality of life (QoL) and psychological aspects in patients with gestational trophoblastic disease (GTD).METHODS: This cross-sectional self-report study was conducted among 54 women. Validated questionnaires assessed QoL (WHO-QOL-bref), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (State-Trait Anxiety Inventory [STAI]).RESULTS: Most patients rated overall QoL as good (44.44%) anti were satisfied with their health status (42.59%). Mean QoL domain score was lowest for psychologic health (53.86 +/- 21.46) and highest for social relationships (65.74 +/- 22.41). BDI mean was 15.81 +/- 11.15, indicating dysphoria. STAI means were 46 +/- 6.46 for trait-anxiety and 43.72 +/- 4.23 for state-anxiety, both evidencing medium-high anxiety. Among employed patients, environment domain mean was the highest (p = 0.024). Presence of children resulted in lowest means for physical health (p = 0.041) and environment (p = 0.045). Patients desiring children showed significantly higher means for physical health (p = 0.004), psychological health (p = 0.021) and environment (p = 0.003). Chemotherapy had no significant influence on QoL (p > 0.05).CONCLUSION: This study evidenced psychological impact on GTD patients, suggesting specialized care centers should provide psychological interventions during treatment and follow-up of GTD patients, highlighting the importance of a multidisciplinary approach. (J Reprod Med 2009;54:239-244)

Quality of life in women with vulvar cancer submitted to surgical treatment: a comparative study

Objectives: To investigate the occurrence and severity of lymphoedema of the lower extremities (LLE), quality of life (QoL), and urinary and sexual dysfunction in women with vulvar cancer submitted to surgical treatment.Study design: Twenty-eight patients with vulvar cancer submitted to vulvectomy and inguinofemoral lymphadenectomy and 28 healthy, age-matched women (control group) were evaluated. The occurrence and severity of LLE were determined by Miller's Clinical Evaluation. QoL, urinary function and sexual function were assessed by the EORTC QLQ-C30, SF-ICIQ and FSFI questionnaires, respectively. The differences between groups and correlations were assessed using Student's r-test, Chi-squared test, Mann-Whitney U-test and Spearman's rho test.Results: The groups were similar in terms of marital status, educational status, menopausal status, hormone therapy and height. The occurrence and severity of LLE were higher in women with vulvar cancer compared with the control group (p < 0.001 and p = 0.003, respectively). A significant association was found between the severity of LLE and advanced age (p = 0.04), and the severity of LLE and higher body mass index (BMI; p = 0.04) in patients with vulvar cancer. In the patients with vulvar cancer, there was a significant correlation between the severity of LLE and worse QoL in the following domains: physical, cognitive, emotional, social, fatigue, pain, sleep and financial questions (p < 0.05). There was no difference in urinary function between the two groups (p = 0.113). Age and number of deliveries were the only variables associated with the occurrence of urinary incontinence (p = 0.01). Urinary incontinence was present in women with a mean age of 74.9 +/- 4.6 years and a mean of 7.3 +/- 1.3 normal deliveries. There was no difference between the groups in terms of the sexual function. Multivariate analysis showed an association between sexual function and age (p = 0.01), and sexual function and being in a stable relationship (p = 0.02).Conclusion: Patients submitted to vulvectomy or inguinofemoral lymphadenectomy for vulvar cancer are at higher risk of developing LLE compared with healthy, age-matched women. This has a negative effect on QoL, but does not interfere with urinary or sexual function. (C) 2012 Elsevier B.V. All rights reserved.

Qualidade de vida no transtorno obsessivo-compulsivo: uma revisão

CONTEXTO: O transtorno obsessivo-compulsivo (TOC) foi considerado pela Organização Mundial da Saúde como a 10ª causa de anos vividos com incapacidade, mas pesquisas sobre qualidade de vida (QV) nesse transtorno ainda são relativamente raras. OBJETIVOS: O objetivo deste trabalho foi fazer uma revisão convencional da literatura a respeito de estudos sobre qualidade de vida no TOC, publicados em português e inglês. MÉTODOS: A busca de artigos foi feita pelos sistemas MEDLINE, PsicoInfo e LILACS, cobrindo o período de 1980 a 2007, utilizando-se como palavras-chave: qualidade de vida, transtorno obsessivo-compulsivo, prejuízo funcional e incapacidade. RESULTADOS: Estudos populacionais apresentam indicadores indiretos de comprometimento na QV em pessoas com TOC, como mais desemprego, menor renda e menor índice de união conjugal estável, além de taxas relativamente altas de ideação e tentativas de suicídio. Estudos clínicos encontraram mais comprometimento na QV no TOC em comparação com algumas doenças clínicas crônicas, outros transtornos de ansiedade, quadros depressivos e mesmo esquizofrenia, em alguns aspectos. CONCLUSÃO: O impacto negativo do TOC sobre a QV de seus portadores pode ser grande, afetando vários domínios da vida e repercutindo também nos familiares. A reabilitação psicossocial deve ser vista como parte integrante essencial do tratamento e é preciso aumentar a conscientização da população sobre o problema, assim como o acesso a tratamentos adequados, para minimizar tal impacto, por vezes devastador.

Quality of life and stimulus perception in patients' rehabilitated with complete denture

The objective of this study was to evaluate and correlate quality of life (QoL), and stimulus perception of complete denture users, before and after the insertion of new prostheses. We selected 60 patients using bimaxillary complete conventional dentures who needed to replace their prostheses. During anamnesis, we collected demographic data and applied the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) questionnaire and stimulus perception questionnaire (PERCEPTION). Before installation of new prostheses, the patients responded to OHIP-EDENT questionnaire, and on the day of installation, they responded to PERCEPTION questionnaire. At the patients 3-month follow-up, we re-administered the OHIP-EDENT and PERCEPTION questionnaires. The Wilcoxon and MacNemar tests were used to compare patient responses between the time points analysed. Most of the OHIP-EDENT items showed a highly significant impact of the new prostheses on oral health (P = 0.003). The PERCEPTION questionnaire data indicated that the patients experienced significant improvements (P < 0.05) in terms of their sensations with the new prostheses. Cross-lagged data analysis did not show any causality between the OHIP-EDENT and PERCEPTION questionnaires (ZPF test, P = 0.772). We concluded that the treatment was effective with respect to the patients QoL and their adaptation to the new prostheses.

Qualidade de vida em pacientes com doença ateroclerótica coronariana grave e estável

FUNDAMENTO: Existem poucas informações sobre fatores agravantes da qualidade de vida em pacientes com doença arterial coronariana (DAC), antes da intervenção coronária percutânea (ICP). OBJETIVO: Associar variáveis clínicas com escores de qualidade de vida (EQV) em pacientes com DAC estável, antes da ICP e com desfechos desfavoráveis, 12 meses após o procedimento. MÉTODOS: Trata-se de estudo longitudinal incluindo 78 pacientes (43 homens e 35 mulheres), antes da ICP eletiva. As associações entre EQV (questionário SF-36) e idade, sexo, peso, índice de massa corpórea, diabete melito (DM), hipertensão arterial, dislipidemia, tabagismo atual, evento cardiovascular ou ICP prévios, controle da glicemia e da pressão arterial foram analisadas por meio de regressão logística multivariada. Também se analisaram as associações entre esses atributos clínicos e os desfechos desfavoráveis (morte por qualquer causa, insuficiência cardíaca ou infarto não fatal). O nível de significância foi p < 0,05. RESULTADOS: As medianas dos EQV estiveram abaixo de 70 percentuais em todos os domínios. Sexo feminino, idade < 60 anos, evento cardiovascular ou ICP prévios, IMC > 25 kg/m², DM e pressão arterial elevada foram associados a maior prejuízo de, pelo menos, um dos EQV. Sexo feminino (OR: 7,19; IC95%: 1,55 - 33,36; p = 0,012), evento cardiovascular prévio (OR: 3,97; IC95%: 1,01 - 15,66; p = 0,049) e insucesso na ICP (OR: 10,60; IC95%: 1,83 - 61,46; p = 0,008) foram associados com risco aumentado de desfecho combinado. CONCLUSÃO: Na presença de DAC, mulheres e pacientes com comorbidades têm maior prejuízo da qualidade de vida. Os desfechos desfavoráveis após 12 meses da ICP estão associados com o sexo feminino, evento prévio ou insucesso do procedimento.