Programa de pós-graduação em Ciências da Reabilitação
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Master Thesis Young Children's Participation and Environment Measure (YCPEM): tradução e adaptação transcultural para o uso no Brasil(2019-10-29) Silva Filho, João Antônio da; Hull, Egmar Longo; ; ; Cazeiro, Ana Paula Martins; ; Lindquist, Ana Raquel Rodrigues;Introduction: The International Classification of Functioning, Disability and Health (ICF), published in 2001 by the World Health Organization (WHO), describes participation as the involvement of the individual in a real life situation. Being involved and participative in activities at home, at school and in the community is an important part of childhood and wellbeing indicator, as it improves health and quality of life, and is linked to social development outcomes and is a important rehabilitation objective. The Young Children's Participation and Environment Measure (YC-PEM) is a tool that assesses the frequency, involvement and impact of the environment on the participation of children between zero and five years of age, with and without disabilities, in home, daycare / pre-school environments. - school and community. Because it is a tool developed according to the ICF model, which has been extensively used in different contexts, the availability of translation and cross-cultural adaptation of this tool will be very useful to support future Brazilian validation. Objective: To translate and culturally adapt YC-PEM for use in Brazil. Method: The process was authorized by the authors of the original instrument. This is a methodological and multicenter study composed of 6 steps: (1) Translation from English - North American to Portuguese - Brazil; (2) Synthesis of translations; (3) Expert Committee Review; (4) Cognitive interview with parents / guardians; (5) back translation; (6) Consolidation of the final version. Results: Some terms, after the initial translation, had to be adapted to bring them closer to the cultural reality of the country. In step 2, all discrepancies found were carefully analyzed and the terms considered most common in Brazil were chosen. In steps 3 and 4, the item descriptions were replaced by better comprehension items and the examples were included in the questions, as well as a supplementary instruction material for self-application of the tool. In step 5 the final version was back-translated and sent to CanChild for evaluation and final approval (step 6). Conclusion: YC-PEM was translated into Brazilian Portuguese and cross-culturally adapted for this country and the final product, YC-PEM Brazil (Measurement of Participation and Environment - Small Children), was considered satisfactory. YC-PEM Brazil is expected to be able to help parents, guardians, and rehabilitation professionals identify the participation levels and environment characteristics of children aged zero to five, thus enabling the planning and implementation of rehabilitation interventions focused on these factors of great relevance to Brazilian children.Master Thesis Avaliação da validade convergente e reprodutibilidade do core set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) para a saúde física de idosos comunitários(2019-08-29) Monteiro, Isabel Oliveira; Câmara, Saionara Maria Aires da; ; ; Dantas, Diego de Sousa; ; Ruaro, João Afonso;Introduction: The International Classification of Functioning, Disability and Health (ICF) is presented as a classification strategy that may be useful for the identification of multidimensional aspects related to the physical health of the elderly. Due to the extension of the ICF, the Core Sets are presented as strategies that facilitate its application. A Core Set of the ICF was proposed to classify the physical health of the elderly, but it is necessary to know its validity in relation to measures recognized for this purpose, as well as its reproducibility. Objective: To evaluate the convergent validity of the core set for the physical health of the elderly in relation to validated measures for the evaluation of this domain, as well as its reproducibility. Methods: This is a validity study, composed of a population of elderly residents in the city of Santa Cruz, Rio Grande do Norte, Brazil. A total of 101 elderly individuals over 60 years old, of both sexes, without cognitive alterations were included. We evaluated palmar grip strength, physical performance in the Short Physical Performance Battery (SPPB) and physical activity level by International Physical Activity Questionnaire (IPAQ) long version. The Core Set of the ICF was also applied, which is composed of 30 categories (14 body functions, 4 body structures, 9 activity and participation, and 3 environmental factors), from which the each component. To evaluate the reproducibility, the Intraclass Correlation Coefficient (ICC) was used between two measurements performed in a range of 5-8 days. The association between the core set results and the other research instruments was evaluated using the Kruskal-Wallis, Mann-Whitney and Spearman correlation tests. In all the steps were considered 5% alpha and 95% CI. Results: It was observed that elderly individuals with higher levels of physical activity in IPAQ had lower impairment index in the components body functions (p = 0.012) and in the performance (p = 0.002) and capacity (p = 0.005) constructs of the component activity and participation. For SPPB, it was observed that better results are related to lower impairment index in the body functions (p <0.001), body structures (p = 0.006), activity and participation (p <0.001), and lower use of aid devices and medications (p <0.001). A higher palmar grip strength was related to a lower impairment index in the body functions (p = 0.001), body structures (p = 0.004) and activity and participation (p <0.001), and the categories that treated of medication use (p = 0.002) and of aid devices (p = 0.004). The ICC analysis indicated good reproducibility for most components evaluated, with a minimum of 0.59 for the category of access to health services and a maximum of 0.95 for the category of medication use. Conclusion: The results show that the core set is valid in relation to the manual grip strength, lower limbs performance and physical activity level, and reproducible, indicating that the data obtained through this tool can be used with confidence by clinicians and researchers.Master Thesis Adaptação transcultural e validação para o uso no Brasil da Medida da Participação e do Ambiente - Crianças e Jovens (PEM-CY)(2019-01-31) Galvão, Elida Rayanne Viana Pinheiro; Hull, Egmar Longo; ; ; Sousa, Klayton Galante; ; Campos, Ana Carolina de;Introduction: Participation is defined by the International Classification of Functioning, Disability and Health (ICF) as the individual's involvement in everyday situations, being determined by intrinsic factors and the environment. Objectives: To carry out the cross-cultural adaptation of the Measure of Participation and the Environment - Children and Youth (PEM-CY) to Brazilian Portuguese; and to analyze their psychometric properties in a sample of children and youth with and without disabilities, aged 5-17 years. Methods: This is a methodological study developed in two stages. The first one comprised the process of cross-cultural adaptation, which was divided and executed in five stages, following the methodology widely used and recommended by Beaton and Collaborators. The stages were divided into: (I) Initial adaptation to Brazilian Portuguese; (II) Synthesis of the versions; (III) Back-translation; (IV) Committee of experts; (V) Parent understanding and back-translation for final approval. The second stage was characterized by the application of the questionnaire to 101 parents and/or caregivers of children and youth with and without disabilities from 3 Brazilian states, in order to attest their psychometric properties, as well as to identify supposed differences in participation and characteristics of the environment at home, at school and in the community between the two groups. Results: Linguistic and grammatical modifications were made to facilitate fluency, interpretation and comprehension in reading the instrument, as well as to make the expressions more equivalent to the language in the first stage of the study, giving rise to the definitive version of PEM-CY Brazil, which was approved by the authors of the original version and is commercially available on CanChild's official website. In the second stage, of the 101 children and youth recruited, 62 had a disability and 39 presented a typical development; 45.5% were female and 54.5% were male, with a mean age of 9.36 years (+/- 3.47). The internal consistency of the instrument varied from good to excellent when considering all the participation items and the environment, respectively, at home (α = 0.873 and α = 0.760), at school (α = 0.877 and α = 0.948) and in the community (α = 0.889 and α = 0.855). There were significant differences between groups in terms of the number of activities performed in the three scenarios, indicating that children with disabilities participated in fewer activities at home (p = 0.000), at school (p = 0.001) and in the community (p = 0.000 ). Children with disabilities were less involved than their non-disabled peers in school setting activities (p = 0.034). In relation to the environment, the disabled group perceived higher barriers at home (p = 0.001) and fewer aids in the home (p = 0.000), school (p = 0.002) and community (p = 0.011) settings than the non-disabled group. Conclusion: After the transcultural adaptation process, the Brazilian version of PEM-CY can be considered a valid and reliable instrument to measure participation in activities at home, at school and in the community, as well as the characteristics of the environment. At the same time, the instrument made it possible to identify differences between children and youth with and without disabilities in relation to participation and the environment.Master Thesis Identificação de categorias da classificação internacional de funcionalidade, incapacidade e saúde para avaliação da funcionalidade de puérperas na perspectiva de fisioterapeutas brasileiros(2019-06-27) Bulhões, Élida Raquel Freitas Neri; Dantas, Diego de Sousa; ; ; Ferraiz, Nadja Vanessa de Almeida; ; Sousa, Vanessa Patricia Soares de;Background: The puerperium comprises a unique and variable period in the life of all women who become mothers, starting after delivery until the organism returns to pregravid conditions. In addition, psychological and social changes are also present at this time. However, there is still a gap in the literature regarding the use of a specific and comprehensive instrument that addresses the full complexity of health and health-related states for postpartum women. Both the content and structure of the International Classification of Functioning, Disability and Health (CIF) allow us to broaden the understanding and optimize the planning of physiotherapeutic interventions designed to maintain the functionality of these patients. Objective: to identify categories of the International Classification of Functioning, Disability and Health (CIF) to evaluate the functionality of puerperae from the perception of Brazilian physiotherapists and to carry out content validation. Methods: a study developed from the Delphi methodology in three electronic rounds, including Brazilian physiotherapists with expertise in women's health. The process involved the capture of biopsychosocial aspects in the physiotherapeutic treatment of puerperae, identification of categories of the CIF and validation of content. Two independent researchers analyzed the categories, with concordance assessed by the Kappa coefficient. The Content Validity Index was calculated by category and in total, with cut-off point set at 0.80. Descriptive statistics served to characterize the sample. Results: The panel consisted of 45 participants, with a median age of 33 years, predominantly women (93.7%), doctoral (42.2%) and over 10 years of experience (40%). We identified 1,261 significant contents, associated to 258 categories of the CIF and Personal Factors. Initially, 74 categories obtained a sufficiently high consensus for judgment in the second round of Delphi, which were reduced to 66 specific categories validated by 89% of experts at the end of the third round, 11 of body functions, 14 for body structures, 14 activity and participation, 18 environmental factors and 9 personal factors. Conclusion: a total of 66 categories were identified based on the perception of physiotherapists regarding the functionality of puerperal women. These findings are unprecedented worldwide and may strengthen the implementation of the biopsychosocial health care model of this population.Master Thesis Vinculando conteúdo dos questionários de qualidade de vida para crianças com doença pulmonar obstrutiva crônica com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde(2018-08-03) Gomes, Danielle Cristina; ; ; Hull, Egmar Longo; ; Ribeiro, Luciana Castaneda;Purpose: To identify the principal health-related quality of life (HRQoL) questionnaires specific for Chronic Obstructive Pulmonary Disease in children, translated and validated for Brazilian children; and to examine how the reflected content in these tools are represented in the categories that compose the International Classification of Functioning, Disability and Health (ICF). Methods: This is a methodological study developed in two stages. The first stage comprehended a literature review for identification and selection of the questionnaires and the second consisted of linking the contents to ICF. For such purpose was followed the widely used Cieza and colleagues methodology, with the identification of meaningful concepts of questionnaires items and linking to correspondent categories on ICF, by two independent reviewers. Results: In the cystic fibrosis questionnaire (Cystic Fibrosis Questionnaire - CFQparents6-13 and CFQ6-11; and versions of DISABKIDS ® - Cystic Fibrosis), 130 significant concepts were identified from 112 questions. Forty-seven different categories of ICF were linked to the concepts, most of which were 21 (44.7%) related to the "body function" component, 20 (42.6%) "activity and participation" and 6 (12.8% ) to "environmental factors". Thirteen concepts (10%) could not be linked because they represent personal factors (fp) or are not covered (nc) by the ICF. In the asthma questionnaires (Pediatric Asthma Quality of Life - Pediatric Quality of Life Asthma Module - PedsQLAsthma), from 77, we identified 114 significant concepts. Thirty-five different categories of ICF were linked to the concepts, most of them 16 (45.7%) related to the "body function" domain, 13 (37.1%) "activity and participation" and 6 (17.1% ) to "environmental factors". Two concepts (1.7%) could not be linked because they represent personal factors (fp) or are not covered (nc) by the ICF. Conclusion: Four instruments were identified and analyzed (Pediatric Asthma Quality of Life (PAQLQ; Pediatric Quality of Life Asthma Module - PedsQL-Asthma; CysticFibrosisQuestionnaire-Revised - CFQ-R and DISABKIDS ® - Cystic Fibrosis Module - DISABKIDS ® - CFM). In the CFQ and DISABKIDS versions, the linked categories represented predominantly body functions, except for CFQ6-11, where the activity and participation component was the most depicted. Environment factors were poorly described, and there were no categories related to body structures in any of the instruments. PedsQL-Asthma allowed a greater comprehensiveness of the components of the ICF, addressing three of the six components that compose it, however, its content presented a greater focus on the body's function component and did not address important categories of "activity and participation" and "environmental factors" linked to quality of life. PAQLQ, in addition to presenting most of its content linked to the body's function component, did not cover categories of environmental factors, making it impossible to identify the impact of this component on the HRQOL of children with asthma.Master Thesis Avaliação da funcionalidade em mulheres com incontinência urinária(2018-03-02) Dantas, Thaissa Hamana de Macedo; Ribeiro, Luciana Castaneda; ; ; ; Bezerra, Clarissa Loureiro Campêlo; ; Correia, Grasiela Nascimento;Purpose: To understand the relationship between urinary incontinence in women and functioning by analyzing the content of specific questionnaires to assess the quality of life of women with this health condition and its relation to the International Classification of Functioning, Disability and Health (ICF); as well as evaluating the functioning and disability of women with urinary incontinence through an instrument based on Classification. Methods: The analysis of the contents of the quality of life questionnaires and the ICF was performed using the methodology proposed by Cieza et al. To assess the disability of women with urinary incontinence, a cross-sectional study was conducted using the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Results: The product of the studies is presented in two scientific articles. The link between the content of the quality of life scales and the ICF showed that the instruments have, mostly, a structure still based on the biomedical model, with a great focus on clinical aspects. The cross-sectional study revealed, through the analysis of the means of WHODAS 2.0, that women with urinary incontinence have greater disability regarding the domains of cognition and mobility, in addition to the total score. Qualitative analysis of disability revealed 42.5% of these women had moderate to severe disability. Conclusion: The results presented serve as a starting point for the discussion of urinary incontinence in the light of functioning, assisting clinicians that assists incontinent women to review their practices and outline new strategies for attention to this public, transposing the biomedical model of approach to the health-disease process and using the biopsychosocial approach, as recommended by the World Health Organization.