Elaboração de questionário para avaliação cognitiva em pacientes com anemia falciforme
Data
2024-06-05
Autores
Reis, Maria José de Farias Ramos 
Orientadores
Figueiredo, Maria Stella
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A Doença Falciforme (DF) é a denominação do conjunto de anemias hereditárias mais prevalente em todo o mundo. É uma doença autossômica recessiva e os portadores da mutação, dependendo do genótipo, têm diversas complicações desde o nascimento até o final da vida, além da anemia hemolítica. As complicações podem ser agudas ou crônicas, fazendo com que estes pacientes possam apresentar diversas comorbidades. O Acidente Vascular Cerebral (AVC) e o Infarto Cerebral Silencioso (ICS) são comorbidades frequentes e importantes de serem avaliadas por poderem resultar em declínio cognitivo. Diversos países desenvolveram questionários de rastreio cognitivo validados, porém não existe um teste de rastreio de declínio cognitivo em portadores de anemia falciforme (AF) em língua portuguesa. Objetivo: desenvolver questionário para avaliação de funções cognitivas em portadores de AF. Metodologia: Pesquisa fundamentada pelo método descritivo com natureza observacional, abordagem dupla, tanto qualitativa quanto quantitativa. Foram recrutados 41 pacientes com AF, divididos em dois grupos: grupo controle/G1 – com AVC; grupo caso/G2 – sem AVC. Análise estatística: Foram utilizadas as seguintes ferramentas para análise dos dados: tabela de contingência, teste de Mann Withney, ANOVA de duas vias sem repetição para a avaliação socioeconômica e Teste Alfa de Cronbach para o questionário cognitivo, onde resultados próximos a 1,00 correspondem a alta confiabilidade do questionário. Resultado: Observou-se que os dois grupos obtiveram resultados semelhantes quanto a idade, sexo, etnia e base alimentar. No questionário sobre funções cognitivas, a aplicação da ferramenta Alpha mostrou que o G1 obteve valor de 0,90 e o G2 de 0,14, com diferença significante. Conclusão: Conclui-se que o objetivo do trabalho em produzir um questionário piloto foi alcançado. O resultado observado em G1 mostra que o questionário foi confiável na identificação de indivíduos com declínio cognitivo. O G2 teve resultado próximo a zero, ou seja, os pacientes deste grupo não apresentaram declínio cognitivo. Considerando que a frequência de ICS é considerável nestes pacientes, era esperado um resultado mais próximo a um nível intermediário, não tão baixo. Tal fato pode ser devido ao número amostral bastante reduzido e/ou ao baixo número de pacientes com ICS avaliados em G2. Novos estudos relativos à construção de novo questionário, com produção de novos construtos, análise mais assertiva das pontuações em relação à psicometria e avaliação de fatores interferentes nas respostas ao questionário deverão ser feitos para a elaboração de um questionário definitivo.
Sickle Cell Disease (SCD) is the name for the most prevalent set of hereditary anemias worldwide. It is an autosomal recessive disease and carriers of the mutation, depending on the genotype, have several complications from birth to the end of life, in addition to hemolytic anemia. Complications can be acute or chronic, meaning that these patients may have several comorbidities. Cerebral Vascular Accident (CVA) and Silent Cerebral Infarction (SCI) are frequent and important comorbidities to be evaluated as they can result in cognitive decline. Several countries have developed validated cognitive screening questionnaires, but there is no screening test for cognitive decline in patients with SCD in Portuguese. Objective: to develop a questionnaire to assess cognitive functions in people with sickle cell anemia (SCA). Methodology: Research based on the descriptive method with an observational nature, dual approach, both qualitative and quantitative. 41 patients with SCA were recruited, divided into two groups: control group/G1 – with stroke; case group/G2 – without stroke. Statistical analysis: Outside, the following tools were used for data analysis: contingency table, Mann Withney test, two-way ANOVA without repetition for the socioeconomic assessment and Cronbach's Alpha test for the cognitive questionnaire, where results close to 1.00 correspond to high reliability of the questionnaire. Result: It was observed that the two groups obtained similar results regarding age, sex, ethnicity, and dietary basis. In the questionnaire on cognitive functions, the application of the Alpha tool showed that G1 obtained a value of 0.90 and G2 of 0.14, with a significant difference. Conclusion: It is concluded that the objective of the work to produce a pilot questionnaire was achieved. The result observed in G1 shows that the questionnaire was reliable in identifying individuals with cognitive decline. G2 had a result close to zero, that is, patients in this group did not show cognitive decline. Considering that the frequency of SCI is considerable in these patients, a result closer to an intermediate level, not so low, was expected. This fact may be due to the very small sample size and/or the low number of patients with SCI evaluated in G2. New studies related to the construction of a new questionnaire, with the production of new constructs, more assertive analysis of scores in relation to psychometrics and evaluation of factors interfering in responses to the questionnaire must be carried out in order to prepare a definitive questionnaire.
Sickle Cell Disease (SCD) is the name for the most prevalent set of hereditary anemias worldwide. It is an autosomal recessive disease and carriers of the mutation, depending on the genotype, have several complications from birth to the end of life, in addition to hemolytic anemia. Complications can be acute or chronic, meaning that these patients may have several comorbidities. Cerebral Vascular Accident (CVA) and Silent Cerebral Infarction (SCI) are frequent and important comorbidities to be evaluated as they can result in cognitive decline. Several countries have developed validated cognitive screening questionnaires, but there is no screening test for cognitive decline in patients with SCD in Portuguese. Objective: to develop a questionnaire to assess cognitive functions in people with sickle cell anemia (SCA). Methodology: Research based on the descriptive method with an observational nature, dual approach, both qualitative and quantitative. 41 patients with SCA were recruited, divided into two groups: control group/G1 – with stroke; case group/G2 – without stroke. Statistical analysis: Outside, the following tools were used for data analysis: contingency table, Mann Withney test, two-way ANOVA without repetition for the socioeconomic assessment and Cronbach's Alpha test for the cognitive questionnaire, where results close to 1.00 correspond to high reliability of the questionnaire. Result: It was observed that the two groups obtained similar results regarding age, sex, ethnicity, and dietary basis. In the questionnaire on cognitive functions, the application of the Alpha tool showed that G1 obtained a value of 0.90 and G2 of 0.14, with a significant difference. Conclusion: It is concluded that the objective of the work to produce a pilot questionnaire was achieved. The result observed in G1 shows that the questionnaire was reliable in identifying individuals with cognitive decline. G2 had a result close to zero, that is, patients in this group did not show cognitive decline. Considering that the frequency of SCI is considerable in these patients, a result closer to an intermediate level, not so low, was expected. This fact may be due to the very small sample size and/or the low number of patients with SCI evaluated in G2. New studies related to the construction of a new questionnaire, with the production of new constructs, more assertive analysis of scores in relation to psychometrics and evaluation of factors interfering in responses to the questionnaire must be carried out in order to prepare a definitive questionnaire.
Descrição
Citação
REIS, Maria José de Farias Ramos. Elaboração de questionário para avaliação cognitiva em pacientes com anemia falciforme. 2024. 57 f. Dissertação (Mestrado em Hematologia) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2024.