Aplicação da classificação internacional de funcionalidade, incapacidade e saúde (CIF) em saúde do trabalhador

Objetivo: Identificar a utilização da Classificação internacional de funcionalidade, incapacidade e saúde na área de saúde do trabalhador, buscando sua aplicação na avaliação da capacidade funcional de trabalhadores, em exames admissionais, periódicos e demissionais, e também na realização de perícias judiciais trabalhistas. Metodologia: Foi realizada uma revisão da literatura utilizando-se os unitermos “Classificação Internacional de Funcionalidade, Incapacidade e Saúde” e “trabalho” nas bases de dados SciELO, Lilacs e Biblioteca Virtual em Saúde (BVS) os unitermos “International Classification of Functioning, Disability and Health” and “workers” na PubMed. Foram selecionados artigos publicados entre 2005 e 2016.  Resultados: Foram incluídas 16 referências, nos idiomas português e inglês, que abordaram a utilização da CIF na área de saúde do trabalhador, independente do tipo de aplicação. Considerações Finais: A busca pela operacionalização e simplificação da Classificação internacional de funcionalidade, incapacidade e saúde permanece como um foco importante dos estudos que objetivam a sua utilização na avaliação da funcionalidade e das incapacidades dos trabalhadores, sendo a saúde do trabalhador uma das áreas promissoras de aplicação da CIF

Dor miofascial crônica e alimentação: Uma relação a ser considerada pelo cirurgião-dentista?

Objetivo: comparar o consumo energético, de macronutrientes e fibras por mulheres portadoras de dor miofascial crônica e não portadoras, atendidas durante o ano de 2006, em uma Clínica de Fisioterapia da cidade de Araraquara - SP. Métodos: Os grupos – controle e dor miofascial – foram definidos pelo Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares - Eixos I e II, sendo compostos por 36 e 37 indivíduos, respectivamente. As participantes foram entrevistadas para o preenchimento do recordatório alimentar de 24 horas de dois dias. A análise da ingestão de energia, macronutrientes e fibras foi realizada com auxílio do programa Virtual Nutri e os grupos foram comparados pelo teste t Student. Para o grupo com dor miofascial, foi realizado estudo de Correlação de Pearson entre os domínios propostos pelo Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares – intensidade média da dor, depressão, sintomas inespecíficos incluindo itens de dor e limitação da função mandibular – e o consumo de energia, macronutrientes e fibras. O nível de significância adotado foi de 5%. Resultados: Houve diferença estatisticamente significante entre os grupos no consumo de proteínas e lipídios, sendo este menor no grupo de mulheres portadoras de dor miofascial crônica. O consumo energético e de fibras esteve no limite de significância. Observou-se correlação não significativa entre os domínios do Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares e o consumo de energia, macronutrientes e fibras. Conclusão: O consumo de proteínas e lipídios foi diferente entre portadores e não portadores de dor miofascial crônica.ABSTRACT: Abstract: Objective: to compare the energetic consumption, of macronutrients and fibers, of chronic myofascial pain carries and non-carries women, attended during the year of 2006, in the Physiotherapy Clinic of Araraquara - SP city. Methods: Control Groups and myofascial pain were defined by the Research Diagnostic Criteria for Temporomandibular Disorders – Axis I and II, being composed by 36 and 37 individuals respectively. The food consumption of the participants were analysed by the 24 hours recall. The analysis of energy, macronutrients and fibers ingestion was realized with the support of the Virtual Nutri program and the groups were compared by the t Student test. For the group of myofascial pain carriers, it was realized the Pearson correlation’s study among the domains proposed by the Research Diagnostic Criteria for Temporomandibular Disorders (pain intensity, depression, nonspecific physical symptoms including items of pain, limitations of jaw functioning) and the consumption of energy, macronutrients and fibers. The level of significance was 5%. Results: There was significant difference between groups regarding the consumption of proteins and lipids, being observed a lower consumption in the group of carriers of the chronic myofascial pain women. The energetic and fibers consumption was in the limit of the significance. It was observed a non-significant correlation between the domains of the Research Diagnostic Criteria for Temporomandibular Disorders and the consumption of energy, macronutrients and fibers. Conclusion: The consumption of proteins and lipids were different between carries and non-carries of the chronic myofascial pain

Validity and reliability of the portuguese version of Mandibular Function Impairment Questionnaire

he aim of this study is to evaluate the validity and reliability of the Mandibular Function Impairment Questionnaire (MFIQ) (Portuguese version). Face and content validity of the Portuguese version were performed. To assess reproducibility of the data gathered with MFIQ, it was applied to 62 individuals who completed the questionnaire on two occasions. Validity and reliability of the data gathered with MFIQ were evaluated in a sample of 249 patients. Construct-related validity was assessed through factorial validity (by means of a confirmatory factor analysis), and convergent and discriminant validities were assessed, respectively, by the average variance extracted (AVE), composite reliability (CC) and bivariate correlations between factors. The internal consistency was estimated by the standardised Cronbachs alpha coefficient (a) and reproducibility by the intra-class correlation coefficient (ICC). All the items of MFIQ showed content validity. Reproducibility was excellent in both the functional capacity dimension (D1) (ICCD1 = 0.895, 95% CI = 0.832 to 0.935) and the feeding dimension (D2) (ICCD2 = 0.825, 95% CI = 0.726 to 0.891). Items 1, 2, 6 and 7 of D1 had factor weights below the desired cut-off (0.5), and overall fit of the original bifactorial structure of the MFIQ was poor [(confirmatory fit index) CFI = 0.850, (goodness of fit index) GFI = 0.781, (root mean square error of approximation) RMSEA = 0.118]. Thus, these items were excluded, and the new, reduced version of the MFIQ showed good fit (CFI = 0.933, GFI = 0.879, RMSEA = 0.099). The convergent validity was adequate (AVE = 0.5, CC = 0.7) for both factors. However, their discriminant validity was low (AVED1 = 0.51 and AVED2 = 0.66 < ?2D1D2 = 0.70). The internal consistency was excellent (aD1 = 0.874; aD2 = 0.918). The Portuguese version of the reduced MFIQ produced data with good validity and reliability

Validation of a measuring instrument for the perception of oral health in women

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/ General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (threefactor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the threedimensional and the unifactorial structures

Disfunções temporomandibulares: estudo epidemiológico no município de Araraquara (SP)

O objetivo deste trabalho foi estimar a distribuição de mulheres residentes no município de Araraquara-SP segundo o grau de severidade de DTM e a contribuição das variáveis percepção de saúde bucal, limitação funcional mandibular e fatores sócio-demográficos no grau de severidade. Diante da importância de se avaliar a qualidade da informação obtida em estudos epidemiológicos antes da interpretação dos dados realizou-se estudos de validação dos instrumentos de medida. Dessa forma, este trabalho foi dividido em quatro capítulos. O primeiro apresenta a adaptação transcultural e a validação do Questionário de Limitação Funcional Mandibular (MFIQ) para o português. O segundo é o estudo de verificação das qualidades psicométricas do Índice Anamnésico de Fonseca (IAF) e o terceiro apresenta as estimativas de confiabilidade, validade e invariância fatorial da versão em português do Geriatric/General Oral Health Assessment Index (GOHAI). O quarto capítulo apresenta a estimativa da distribuição da severidade de DTM nas mulheres do município de Araraquara e a contribuição da percepção de saúde bucal, limitação funcional mandibular e dos fatores sócio-demográficos na severidade de DTM. A Validade de Face e de Conteúdo do MFIQ foi avaliada por equipe multidisciplinar. Após definição da versão em português o MFQI foi aplicado a 249 indivíduos. Realizou-se análise fatorial confirmatória. Calculou-se a validade convergente, a validade discriminante, a consistência interna e a reprodutibilidade. Todos os itens apresentaram validade de conteúdo significativa. A reprodutibilidade foi ótima (ICC=0,825-0,895). A estrutura do MFIQ foi bifatorial e foram excluídos os itens 1, 2, 6 e 7 (CFI: 0,933, GFI: 0,879, RMSEA: 0,099). Verificou-se...The aim of this study were to estimate the distribution of women in the municipality of Araraquara (SP), according to the severity of temporomandibular dysfunction (TMD) and the contribution of the variables oral health perception, mandibular functional limitation and sociodemographic factors on the degree severity. In view of the importance of evaluating the quantity of information obtained in epidemiologic studies before data interpretation, validation studies of the measuring instruments were conducted. Therefore, this study was divided into four chapters. The first present the transcultural adaptation and validation of the Mandibular Functional Limitation Questionnaire (MFIQ) into Portuguese. The second was the study to verify the psychometric qualities of the Fonseca Anamnesic Index (FAI) and the third presents the estimates of reliabiility, validity and factor invariance of the portuguese translation of the Geriatric/General Oral Health Assessment Index (GOHAI). The fourth chapter presents the estimate of the distribution of TMD severity in the municipality of Araraquara (SP) and the contribution of oral health perception, mandibular functional limitation and sociodemographic factors to the severity of TMD. The Face Validity and Content of MFIQ was evaluated by a multidisciplinary team. After definition of the Portuguese version, the MFQI was applied to 249 individuals. Confirmatory factor analysis was performed. The convergent and discriminatory validity, internal consistencey and reproducibility were calculated. All items presented significant validity of content. Reproducibility was excellent (ICC=0.825-0.895). The MFIQ structure was bifactorial and items 1, 2, 6 and 7 were excluded... (Complete abstract click electronic access below

Impacto da dor miofascial no hábito alimentar

O objetivo deste trabalho foi estudar a relação entre a alimentação e a dor miofascial crônica, além da influência dos fatores psicológicos e psicossociais nesta relação. Para tanto, o mesmo foi dividido em quatro capítulos, sendo o primeiro uma revisão bibliográfica sobre a presença de disfunções temporomandibulares e sua possível implicação na alimentação e nutrição dos portadores. No segundo capítulo estuda-se a confiabilidade da versão em português do Critério de Diagnóstico na Pesquisa para Desordens Temporomandibulares (RDC/TMD) – Eixo II. O terceiro capítulo busca caracterizar os aspectos psicológicos e psicossociais apontados por um grupo de mulheres com dor miofascial crônica (n=37), atendidas em uma Clínica de Fisioterapia do município de Araraquara, SP. Utilizou-se o Eixo II do RDC/TMD e realizou-se estudo de correlação entre os domínios do instrumento. O quarto capítulo comparou a alimentação de mulheres com dor miofascial (n=37) e sem dor miofascial (n=36), com relação ao consumo energético, de macronutrientes (carboidratos, proteínas e lipídios) e fibras e verificou a relação entre os domínios do Eixo II do RDC/TMD e o consumo energético, de macronutrientes e fibras no grupo de mulheres com dor miofascialThe aim of the research described herein was to investigate the connection between chronic myofascial pain and eating behavior, as well as the effects of psychological and psychosocial factors on this relation. This dissertation has four chapters, the first consisting of a bibliographic review of the occurrence of temporomandibular disorder and its possible implications regarding the eating and nutrition of sufferers. In the second chapter, the reliability of the Portuguese language edition of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II questionnaire is discussed. The third chapter is an attempt to address the psychological and psychosocial issues identified by a group of women with chronic myofascial pain (n=37) treated at a Physiotherapy Clinic in the city of Araraquara, SP, Brazil. Employing the RDC/TMD Axis II questionnaire, a study is made of correlation between the various Axis II domains. The four chapter compares the food eaten by women with (n=37) and without (n=36) myofascial pain, with respect to the consumption of energy, macronutrients (carbohydrates, proteins and lipids) and fiber. The existence of a correlation between the several domains of Axis II and the intake of energy, macronutrients and fiber by the group of women with myofascial pain was tested

Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women