Navegando por Palavras-chave "estado funcional"

Agora exibindo 1 - 2 de 2
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Estudo da capacidade funcional de idosos com neoplasias mieloides e leucemias agudas
    (Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Carbonell, Ana Lucia Ippolito [UNIFESP]; Chauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The human aging has been accompanied by higher incidence and prevalence of myeloid neoplasms (MN). Hematologists use age, performance status (PS) and comorbidities indices to characterize the elderly patient. Improvement in the functional assessment can be achieved applying geriatric scales assessing functional status (FS). Objectives: To evaluate the functionality of elderly outpatients with MNs with scales utilized by hematologists and geriatricians. Thus, to study the impact of age, sex, comorbidities, and hemoglobin level in the functionality of such patients. Methods: Karnofsky (KPS), Eastern Cooperative Oncology Group (ECOG), the basic (ADL) and instrumental (IADL) activities of daily living scales were applied to assess the functionality of elderly outpatients with MN. The patients’ assessment was made by a hematologist and a geriatrician. The comorbidity index for hematopoietic cell transplantation (HCT–CI) was used to stratify the patients’ comorbidities. Statistical study applied the intraclass correlation, the alpha Cronbach’ coefficient, the Fisher tests, the t Student test and ANOVA. We fitted a mixed logistic regression model to evaluate the impact of age, sex, hemoglobin and comorbidities in performance and functional status of this group of elderly patients. Results: A total of 82 elderly patients (mean age of 72.8 years, varying from 60 to 90 years) were evaluated. Their hematological diagnosis included: essential thrombocythemia (ET; n=6); polycythemia vera (PV; n=15); chronic myeloid leukemia (CML; n=9); myelofibrosis (MF; n=25); myelodysplastic syndromes (MDS; n=17) and acute myeloid leukemia (AML; n=10). Eighty percent of the patients had good PS but only 50% of this group of individuals was independent in daily activities. All patients with poor PS were dependent in ADLs and/or IADLs. The mixed logistic regression models showed that age, sex, Hb and HCT–CI affected FS. However, only Hb and HCT–CI impacted on PS. Conclusions: The aggregation of the ADL and IADL to KPS and ECOG increases the sensibility and specificity of functional assessment of elderly patients with NM. The Hb level and comorbidity index affected both performance and functional status. However, the age and the sex only impacted on functional status.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Qualidade de vida de crianças e adolescentes de São Paulo: confiabilidade e validade da versão brasileira do questionário genérico Pediatric Quality of Life InventoryTM versão 4.0
    (Sociedade Brasileira de Pediatria, 2008-08-01) Klatchoian, Denise Ascenção [UNIFESP]; Len, Claudio Arnaldo [UNIFESP]; Terreri, Maria Teresa Ramos Ascensão [UNIFESP]; Silva, Marina [UNIFESP]; Itamoto, Caroline [UNIFESP]; Ciconelli, Rozana Mesquita [UNIFESP]; Varni, James W.; Hilário, Maria Odete Esteves [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); College of Medicine Department of Pediatrics; Texas A & M University College of Architecture Department of Landscape Architecture and Urban Planning
    OBJECTIVES: To evaluate the reliability and validity of the Brazilian version of the Pediatric Quality of Life InventoryTM (PedsQL TM 4.0) Generic Core Scales and measure the quality of life of healthy children and adolescents and patients with rheumatic diseases. METHODS: We followed the translation methodology proposed by the developer of the original English version of the PedsQL TM 4.0. The instrument was administered by interviews in two groups: 240 apparently healthy children and adolescents from São Paulo (SP, Brazil) and 105 patients with chronic rheumatic diseases, matched by age, as well as to their respective parents or caregivers. The parent proxy-report was administered to the children's parents or caregivers separately on the same day. RESULTS: Cronbach's alpha values were between 0.6 and 0.9 for all dimensions, demonstrating adequate internal consistency. Patients with rheumatic diseases reported significantly lower PedsQL TM scores on all dimensions when compared to the healthy control group (p < 0.0001). Construct validity of the Brazilian Portuguese version of the PedsQL TM 4.0 was also confirmed. Parent proxy-report of patients with rheumatic diseases highly correlated with child self-report for physical functioning (r = 0.77, p < 0.001) and school functioning (r = 0.73, p < 0.001). Lower correlations were observed for emotional and social functioning (r = 0.40 and 0.59, respectively, p < 0.001). CONCLUSIONS: The tool demonstrated reliability, validity and the administration was fast and easy. Quality of life of patients with rheumatic diseases was significantly lower than the healthy control group, supporting the necessity of a comprehensive approach to rheumatic disease management, focused on the psychosocial dimensions.