Kajian Naratif: Efektivitas Pemanfaatan Minichal Sebagai Pengukur Kualitas Hidup Pasien Hipertensi

Hipertensi merupakan istilah tekanan darah tinggi. Apabila tidak terkontrol dan berlangsung dalam waktu yang lama dapat menyebabkan timbulnya komplikasi yang memengaruhi kualitas hidup penderita. Salah satu instrument yang tersedia dengan tujuan untuk menilai kualitas hidup pasien hipertensi secara spesifik yaitu MINICHAL. Tujuannya untuk mengetahui efektivitas pemanfaatan instrument MINICHAL sebagai pengukur kualitas hidup pasien hipertensi dengan metode kajian naratif menggunakan artikel terpublikasi dari penelusuran pustaka melalui GoogleScholar, NCBI dan ScienceDirect. Terdapat 15 literatur yang menunjukkan penggunaan MINICHAL versi Brasil berpotensi mengukur dengan sensitif dan responsif terhadap hipertensi yang memburuk. MINICHAL juga menilai perbedaan kualitas hidup berdasarkan semua gejala yang dianalisis. MINICHAL efektif dalam menilai kualitas hidup pasien hipertensi secara sensitif terutama terhadap hipertensi yang mengalami pemburukan

Desempenho psicométrico da versão brasileira do Mini-cuestionario de calidad de vida en la hipertensión arterial (MINICHAL)

This study aimed to evaluate the feasibility, acceptability, ceiling and floor effects, reliability, and convergent construct validity of the Brazilian version of the Mini Cuestionario de Calidad de Vida en la Hipertensión Arterial (MINICHAL). The study included 200 hypertensive outpatients in a university hospital and a primary healthcare unit. The MINICHAL was applied in 3.0 (± 1.0) minutes with 100% of the items answered. A "ceiling effect" was observed in both dimensions and in the total score, as well as evidence of measurement stability (ICC=0.74). The convergent validity was confirmed by significant positive correlations between similar dimensions of the MINICHAL and the SF-36, and significant negative correlations with the Minnesota Living with Heart Failure Questionnaire - MLHFQ, however, correlations between dissimilar constructs were also observed. It was concluded that the Brazilian version of the MINICHAL presents evidence of reliability and validity when applied to hypertensive outpatientsEste estudio tuvo como objetivo evaluar la practicidad, la aceptabilidad, los efectos techo y suelo, la confiabilidad y la validez de constructo convergente de la versión brasileña del Minicuestionario de Calidad de Vida de la Hipertensión Arterial - MINICHAL. Participaron del estudio 200 pacientes hipertensos en seguimiento en ambulatorio, en hospital universitario y en Unidad Básica de Salud. El MINICHAL fue aplicado en 3,0 (±1,0) minutos, con 100% de los ítems respondidos. Fue observado "efecto techo" en ambas dimensiones y puntaje total, así como evidencias de estabilidad de la medida (CCI=0,74). La validez convergente fue confirmada por correlaciones significativas positivas entre dimensiones similares del MINICHAL y del SF-36, y por correlaciones significativas negativas con el Minnesota Living with Heart Failure Questionnaire - MLHFQ, a pesar de que correlaciones entre constructos no similares hubiesen sido observadas. Se concluye que la versión brasileña del MINICHAL presenta evidencia de confiabilidad y validez cuando aplicada en hipertensos en seguimiento en ambulatorio.Este estudo teve como objetivo avaliar a praticabilidade, a aceitabilidade, os efeitos teto e chão, a confiabilidade e a validade de constructo convergente da versão brasileira do mini - cuestionario de calidad de vida en la hipertensión arterial - Minichal. Participaram do estudo 200 pacientes hipertensos, em seguimento ambulatorial, em hospital universitário e unidade básica de saúde. O Minichal foi aplicado em 3,0 (±1,0) minutos, com 100% dos itens respondidos. Foi observado efeito teto em ambas as dimensões e escore total, bem como evidências de estabilidade da medida (ICC=0,74). A validade convergente foi confirmada por correlações significativas positivas entre dimensões similares do Minichal e do SF-36, e por correlações significativas negativas com o Minnesota Living with Heart Failure Questionnaire - MLHFQ, embora correlações entre constructos dissimilares tenham sido observadas. Conclui-se que a versão brasileira do Minichal apresenta evidência de confiabilidade e validade, quando aplicada em hipertensos, em seguimento ambulatorial

Health-related quality of life impact of a triple combination of olmesartan medoxomil, amlodipine besylate and hydrochlorotiazide in subjects with hypertension

Background A post-hoc analysis was performed on the data from a 54 weeks phase III study (ClinicalTrials.gov identifier: NCT00923091) to measure changes in the health-related quality of life (HRQoL) of 2,690 patients aged ≥18 with moderate-to-severe hypertension who received one of six doses of olmesartan/amlodipine/hydrochlorothiazide (OLM/AML/HCTZ), using the MINICHAL and EQ-5D instruments. Methods Descriptive statistics were used to assess blood pressure and HRQoL scores over the study period. Analysis of covariance (ANCOVA) was used to identify those factors that could possibly have influenced HRQoL. Linear regression was used to assess the relationship between changes in blood pressure and HRQoL scores. Results Patients’ baseline MINICHAL mood and somatic domains scores were 5.5 and 2.6. Over the study period HRQoL improved as both MINICHAL scores decreased by 31-33%. Patients’ baseline EQ-5D index and VAS scores were 0.9 and 73.4 respectively, increasing by 6% and 12% over the study period. Patients’ QALY gain over the 54 weeks study period was estimated to be 0.029 QALYs. The ANCOVA showed that changes in patients’ HRQoL was likely to have been influenced by patients’ achievement of blood pressure control, the amount of concomitant medication and patients’ last used dosage strength of antihypertensive. Linear regression showed that blood pressure improvement may have been associated with improved HRQoL. Conclusions This study showed that OLM/AML/HCTZ reduced blood pressure and significantly increased blood pressure control whilst improving patients’ HRQoL. Achieving blood pressure control, amount of concomitant medication and dosage strength of antihypertensive impacted on patients’ HRQoL

Measuring Instruments In Cardiology Adapted Into Portuguese Language Of Brazil: A Systematic Review

Revisão sistemática com o objetivo de identificar e caracterizar instrumentos de medida desenvolvidos no contexto da cardiologia que foram adaptados para a língua portuguesa do Brasil. Buscas sistematizadas foram realizadas em seis bases de dados. Extraíram-se informações referentes ao processo de adaptação cultural e as propriedades de medida. Para avaliação da qualidade metodológica dos estudos, foram utilizados critérios com base em diretrizes internacionais para adaptação cultural de instrumentos. Dentre os 114 artigos levantados, 14 foram considerados elegíveis para a revisão. Desses, a maioria avaliava qualidade de vida (35,7%) e conhecimento/aprendizagem em saúde (28,6%). A maioria dos estudos contemplou todas as etapas do processo de adaptação recomendadas pela literatura. Com relação às propriedades de medida, a consistência interna, verificada por meio do alfa de Cronbach, foi a propriedade relatada na maioria dos estudos, bem como as validades de constructo e critério. Com este estudo, espera-se disponibilizar para a comunidade científica uma avaliação criteriosa dos questionários adaptados disponíveis no contexto da cardiologia.
Esta revisión sistemática tuvo como objetivo: identificar y caracterizar los instrumentos de medición desarrollados en el contexto de la cardiología que fueron adaptados a la lengua portuguesa de Brasil. Se llevaron a cabo búsquedas sistemáticas en seis bases de datos. Se extrajeron los datos sobre el proceso de adaptación cultural y las propiedades de medición. Para evaluar la calidad metodológica de los estudios, fueron utilizados criterios basados en las directrices internacionales para la adaptación cultural de instrumentos. Entre los 114 artículos encontrados, 14 fueron elegibles para su revisión. De los 14, la mayoría evaluaba la calidad de vida (35,7%) y los procesos de conocimiento / aprendizaje en salud (28,6%). La mayoría de los estudios incluyeron todas las etapas del proceso de adaptación recomendadas por la literatura. En relación a la medición de las propiedades, la consistencia interna, verificada por el alfa de Cronbach, fue la propiedad reportada en la mayoría de los estudios, así como la validez de constructo y la validez de criterio. Con este estudio, se espera brindar a la comunidad científica una cuidadosa evaluación de los cuestionarios adaptados disponibles en el contexto de la cardiología. 
This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach’s alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology.

The Characterisation and Treatment of Resistant Hypertension

Hypertension is a highly prevalent condition and, as a risk factor for vascular disease in particular, a leading contributory cause of death worldwide. Recent consensus guidelines suggest that moderate and severe (grade II and III) hypertension should be treated rapidly to achieve targets though, prior to the inception of this thesis, the evidence for the safety and efficacy of this approach, together with the physiological consequences of rapid hypertension treatment in moderate and severe disease, was limited. This thesis explores the clinical consequences of an 18-week treatment programme for individuals with grade II and III hypertension, using guideline- recommended pharmacological treatment, delivered over an accelerated timeframe. The blood pressure response to treatment is reported, together with the tolerance and safety of the protocol, as defined by the protocol completion rate, frequency of medication side effects and clinically significant adverse events. The programme also provided an opportunity to study health-rated quality of life in patients with moderate and severe hypertension and the effect of rapid treatment on health-related quality of life. This allowed for the first validation (according to modern standards) of an English language disease-specific instrument for measuring health-related quality of life in hypertension, following translation of the original MINICHAL disease-specific instrument from the original Spanish. In addition, the clinical treatment programme provided an opportunity to study the microvascular response to rapid treatment of moderate and severe hypertension, particularly with relevance to the rarefaction of hypertension and its reversal with treatment. Moreover, the morphological and functional myocardial consequences of treatment were determined, using cardiac MR imaging. Accordingly, this thesis presents evidence supporting the rapid treatment of moderate and severe hypertension, providing an opportunity for this to be studied in future investigations, with the aim of exploring whether this approach is prognostically advantageous for patients

Prospective Clinical Registry to Evaluate Clinical Outcomes of Hypertension Patients in a Multidisciplinary Clinic

Introduction: clinical registries are necessary to define public policies for treatment and prevention, by providing highly accurate and interoperable data. Objective: to describe the implementation of a prospective, computerised, interoperable and multidisciplinary clinical registry to evaluate the clinical practice and outcomes of hypertensive patients. Methods: prospective observational study designed as a clinical registry carried out in a multidisciplinary hypertension clinic, in Brazil. A multi-professional team attends the patients. The database included patients with primary hypertension, above 18 years of age. Patients who had undergone surgery, a stroke, myocardial infarction, or renal failure were excluded. Variables were defined in accordance with national and international variables to allow interoperability. Results: the RE-HYPER registry was implemented by following the steps: (1) Data standardisation. The dataset included all applicable standardised data elements published by the American Heart Association / American College of Cardiology, and Brazilian national datasets standards; (2) Development of an initial data collection and clinical research workflow; (3) Development of electronic case reports (CRF) using REDCap (Research Electronic Data Capture) and in accordance with the HIPAA (Health Insurance Portability and Accountability Act) privacy rule; (4) Pilot testing and validation of the data collection and clinical research workflows and CRFs, and (5) Development of automated data quality report using REDCap. Discussion: Due to the magnitude of this disease in the world, this study becomes relevant to clinical practice. Conclusion:  The study showed reproducible standards and solutions that can be applied in the implementation of health records, allowing data integration between health and research services

Teknologi Pendidikan dalam Meningkatkan Kualitas Hidup dan Kepatuhan pada Penderita Hipertensi

This study aims to determine the effectiveness of educational technology in improving the quality of life and compliance in hypertensive patients. The research method is quasi-experimental, with a research design before and after educational interventions. The results showed that the majority of respondents aged >50 years were ten people (83.3%), female sex was eight people (66.7%), with high school education status were six people (50%), respondents had a history of hypertension numbering ten people (83.3 %), and the maximum BMI value is 25.1-27 of 7 people (58.3%). In conclusion, educational interventions with flipcharts can improve quality of life scores and enhance adherence to hypertension treatment, with attentive listening and dialogue built within health facilities and in community spaces that can facilitate decision-making about strategies to promote life improvements.   Keywords: Hypertension, Quality of Life, Educational Technolog

Psychometric performance of the brazilian version of the Mini-cuestionario de calidad de vida en la hipertensión arterial (MINICHAL)

This study aimed to evaluate the feasibility, acceptability, ceiling and floor effects, reliability, and convergent construct validity of the Brazilian version of the Mini Cuestionario de Calidad de Vida en la Hipertensión Arterial (MINICHAL). The study included 200 hypertensive outpatients in a university hospital and a primary healthcare unit. The MINICHAL was applied in 3.0 (± 1.0) minutes with 100% of the items answered. A "ceiling effect" was observed in both dimensions and in the total score, as well as evidence of measurement stability (ICC=0.74). The convergent validity was confirmed by significant positive correlations between similar dimensions of the MINICHAL and the SF-36, and significant negative correlations with the Minnesota Living with Heart Failure Questionnaire - MLHFQ, however, correlations between dissimilar constructs were also observed. It was concluded that the Brazilian version of the MINICHAL presents evidence of reliability and validity when applied to hypertensive outpatientsEste estudio tuvo como objetivo evaluar la practicidad, la aceptabilidad, los efectos techo y suelo, la confiabilidad y la validez de constructo convergente de la versión brasileña del Minicuestionario de Calidad de Vida de la Hipertensión Arterial - MINICHAL. Participaron del estudio 200 pacientes hipertensos en seguimiento en ambulatorio, en hospital universitario y en Unidad Básica de Salud. El MINICHAL fue aplicado en 3,0 (±1,0) minutos, con 100% de los ítems respondidos. Fue observado "efecto techo" en ambas dimensiones y puntaje total, así como evidencias de estabilidad de la medida (CCI=0,74). La validez convergente fue confirmada por correlaciones significativas positivas entre dimensiones similares del MINICHAL y del SF-36, y por correlaciones significativas negativas con el Minnesota Living with Heart Failure Questionnaire - MLHFQ, a pesar de que correlaciones entre constructos no similares hubiesen sido observadas. Se concluye que la versión brasileña del MINICHAL presenta evidencia de confiabilidad y validez cuando aplicada en hipertensos en seguimiento en ambulatorio.Este estudo teve como objetivo avaliar a praticabilidade, a aceitabilidade, os efeitos teto e chão, a confiabilidade e a validade de constructo convergente da versão brasileira do mini - cuestionario de calidad de vida en la hipertensión arterial - Minichal. Participaram do estudo 200 pacientes hipertensos, em seguimento ambulatorial, em hospital universitário e unidade básica de saúde. O Minichal foi aplicado em 3,0 (±1,0) minutos, com 100% dos itens respondidos. Foi observado efeito teto em ambas as dimensões e escore total, bem como evidências de estabilidade da medida (ICC=0,74). A validade convergente foi confirmada por correlações significativas positivas entre dimensões similares do Minichal e do SF-36, e por correlações significativas negativas com o Minnesota Living with Heart Failure Questionnaire - MLHFQ, embora correlações entre constructos dissimilares tenham sido observadas. Conclui-se que a versão brasileira do Minichal apresenta evidência de confiabilidade e validade, quando aplicada em hipertensos, em seguimento ambulatorial

Calidad de vida en personas con hipertensión arterial en el municipio de San Gil

La presente investigación tiene como objetivo determinar la calidad de vida de las personas con hipertensión arterial en el municipio de San Gil (S.) en términos de estado de ánimo y manifestaciones somáticas. Fue un estudio de tipo descriptivo, se entrevistaron 104 personas con hipertensión arterial inscritas en 3 Instituciones Prestadoras de Salud (IPS) del municipio. Para realizar el estudio se utilizó una ficha de datos socio demográficos y el cuestionario E“MINICHAL†para determinar la calidad de vida de las personas con hipertensión arterial. De los 104 participantes, 75% (78) fueron mujeres, la edad estuvo entre 37 y 93 años con una media de 69 años. La procedencia: San Gil, 43,3% (45), estado civil: casados, 51% (53) y seguridad social: subsidiado, 58,7% (61). En cuanto a la hipertensión arterial: la sistólica estuvo entre 100 y 160 mm Hg y la diastólica entre 60 y 90 mm Hg. El medicamento más administrado fue el ácido acetilsalicílico (ASA). En cuanto al estado de ánimo sedestaca que la mayoría manifestaron realizar actividades sociales 79,8% (83) pero sienten que la vida es una lucha continua (90,3%) y en cuanto las manifestaciones somáticas, la mayoría indicó no presentar dolor en el pecho (68,3%) (71), sin embargo las personas han notado sequedad en la boca (63,5%) (66). Finalmente, la calidad de vida anotó que las medias de la dimensión de estado de ánimo (6,855± 3,755 DE) se aproximan a los valores mejores de calidad de vida, también las manifestaciones somáticas (4,26 ± 3,07 DE) se aproximan más a los valores mejores de calidad de vida, lo que evidencia que la calidad de vida de las personas con hipertensión arterial fue relativamente buena

Psychometric performance of the brazilian version of the Mini-cuestionario de calidad de vida en la hipertension arterial (MINICHAL)

This study aimed to evaluate the feasibility, acceptability, ceiling and floor effects, reliability, and convergent construct validity of the Brazilian version of the Mini Cuestionario de Calidad de Vida en la Hipertension Arterial (MINICHAL). The study included 200 hypertensive outpatients in a university hospital and a primary healthcare unit. The MINICHAL was applied in 3.0 (+/- 1.0) minutes with 100% of the items answered. A "ceiling effect" was observed in both dimensions and in the total score, as well as evidence of measurement stability (ICC=0.74). The convergent validity was confirmed by significant positive correlations between similar dimensions of the MINICHAL and the SF-36, and significant negative correlations with the Minnesota Living with Heart Failure Questionnaire - MLHFQ, however, correlations between dissimilar constructs were also observed. It was concluded that the Brazilian version of the MINICHAL presents evidence of reliability and validity when applied to hypertensive outpatients.194855864Fundo de Apoio ao Ensino, a Pesquisa e a Extensa (FAEPEX), Campinas, SP, Brazil [52899-10]Fundo de Apoio ao Ensino, a Pesquisa e a Extensa (FAEPEX), Campinas, SP, Brazil [52899-10