Resilience of athletes with physical disabilities : a cross-sectional study

This study focused on evaluating the resilience of 208 athletes with a physical disability and on testing the Wagnild and Young Resilience Scale. The mean resilience scores, considered to represent moderate resilience, were similar for men (X = 132.4 ± 30.9) and women (X = 131.4 ± 35.7). Participants with spinal cord injuries and myelomeningocele were observed to have achieved higher resilience scores, while those with cerebral palsy obtained the lowest and those with amputations or polio obtained intermediate scores (F = 3, p = .019). The participants in this research study displayed a significantly lower mean resilience (X = 132.13 ± 32.25) than those reported in other studies with the general population. A factor analysis showed multidimensional causes, with seven factors accounting for 61.27% of the total variation. Moreover, the research tool/questionnaire showed a good internal consistency (α = .88). The moderate resilience scores indicate that there is potential for developing these athletes' resilience.El objetivo de este estudio fue evaluar la resiliencia de 208 atletas con discapacidades físicas y examinar la Escala de Resiliencia de Wagnild e Young. Las puntuaciones medias de la resiliencia fueron similares para los hombres (X = 132.4 ± 30.9) y mujeres (X = 131.4 ± 35.7), considerado como resiliencia moderada. Se observó que los participantes con lesión de la médula espinal y mielomeningocele mostraron mejores resultados en resiliencia, mientras que aquellos con parálisis cerebral presentaran los peores y los amputados y con la polio tenían puntuaciones intermedias (F = 3, p = .019). Los participantes en este estudio tenían una media de resiliencia (X = 132.13 ± 32.25) significativamente menor que la reportada en otros estudios que evaluaban la población general. El análisis factorial se mostró multidimensional, con siete factores responsables por 61.27% de la varianza total. Además, el instrumento mostró buena consistencia interna (α = .88). La moderada resiliencia encontrada en este estudio indica que existe un potencial para desarrollo de la resiliencia en estos atletasO objetivo deste estudo foi avaliar a resiliência de 208 atletas com deficiência física e testar a Escala de Resiliência de Wagnild e Young. A média dos escores de resiliência foram similares para homens (X = 132.4 ± 30.9) e mulheres (X = 131.4 ± 35.7), considerados como resiliência moderada. Foi observado que os participantes com lesão medular e mielomeningocele mostraram melhores escores de resiliência, enquanto aqueles com paralisia cerebral apresentaram os piores e os amputados e com poliomielite tiveram escores intermediários (F = 3, p = .019). Os participantes deste estudo apresentaram uma média de resiliência (X = 132.13 ± 32.25) significativamente menor que os relatados em outros estudos avaliando a população em geral. A análise fatorial mostrou-se multidimensional, com sete fatores responsáveis por 61.27% da variância total. Além disso, o instrumento demonstrou boa consistência interna (α = .88). Os escores de resiliência moderados indicam que existe um potencial para desenvolvimento da resiliência nesses atletas

Assessment of a brief fatigue inventory in patients with hematologic malignancies

Indexación: Web of Science, Scielo.Background: Fatigue is one of the most common and distressing symptoms experienced by cancer patients. Aim: To validate the Brief Fatigue Inventory in people treated for hematological neoplasms. Material and Methods: In a cross-sectional study, the Brief Fatigue Inventory was answered by 122 patients aged 40 +/- 14 years (50% women) treated for hematological neoplasms at an intensive hematological unit of a public hospital between July 2010 and July 2013. Socio-demographic and clinical parameters were obtained from their clinical records. Results: Fatigue was present in nearly all patients (99.2%) in minor (50%), moderate (36.9%) or severe (12.3%) levels. The average fatigue score was 4.5 +/- 1.9). The Brief Fatigue Inventory had a good internal consistency (Cronbach's alpha = 0.973) and proved to be one-dimensional (84.3% of the explained variance). Women reported that fatigue interfered more with enjoyment of life than men (p = 0.036). Conclusions: The Brief Fatigue Inventory is a reliable instrument that can be used in clinical practice. It allows a quick assessment of the level of fatigue. People treated for hematologic cancer have a high prevalence of fatigue.http://ref.scielo.org/v5xw3

Association between participation in community groups and being more physically active among older adults from Florianópolis, Brazil

OBJECTIVE: In Brazil, older adults frequently participate in community groups. However, the influence of this participation on physical activity levels has not been fully investigated. It is known that both regular physical activity and social support are beneficial for health. The aim of this study is to evaluate the association between participation in community groups and physical activity among older adults from Florianópolis, Brazil. METHODS: The sample consisted of 1062 adults with a mean age of 71.9 (±7.6) years. Among these individuals, 293 subjects participated in community groups and 769 did not. A questionnaire to collect sociodemographic data and the long version of the International Physical Activity Questionnaire were used for the assessment. RESULTS: The prevalence of active older adults was 66.6% among participants in community groups and 58.4% among non-participants. Participation in these groups was significantly associated with being more physically active in the transportation and domestic domains, but with being less physically active in the leisure-time domain. Some changes in these associations were observed when the sample was stratified by age, gender, body mass index, and health status. With respect to total physical activity, participation in community groups was associated with being more physically active in only two strata (subjects younger than 70 years and women). CONCLUSION: The results of this study indicate that older adults who participate in community groups are characterized by a greater probability of being more physically active. However, longitudinal studies are needed to determine whether participation in community groups facilitates the adoption of physically active behavior

Incidencia y riesgo de caídas en pacientes tratados por neoplasias hematológicas en Unidad Hematología Intensiva

Objetivo: determinar a incidência e a taxa de risco de quedas em pacientes adultos tratados por neoplasias hematológicas na Unidade de Hematologia Intensiva de um hospital de referência. Método: corresponde a um estudo observacional retrospectivo. Foram avaliados 101 pacientes. A ocorrência de quedas foi obtida a partir do registro da unidade e as variáveis preditivas do modelo Hendrich II foram coletadas: sexo, presença de tontura ou vertigem, confusão mental, problemas de eliminação, depressão, uso de benzodiazepínicos, uso de anticonvulsivantes e o teste Get up and Go. Resultados: dois eventos de quedas foram relatados em 101 pacientes (incidência de 1,98% em um período de 1,5 ano). Usando o ponto de corte cinco do Modelo Hendrich II, identificou-se que 30 pacientes (29,7%) apresentaram risco de queda no primeiro dia de hospitalização, 41 (40,6%) ao meio e 38 (37,6%) no momento da alta hospitalar. Conclusões: pacientes tratados por neoplasias hematológicas apresentaram baixa incidência e alto risco de quedas durante a hospitalização.Objetivo: determinar la incidencia y la tasa de riesgo de caídas en pacientes adultos tratados por neoplasias hematológicas en la Unidad de Hematología Intensiva de un hospital de referencia. Método: corresponde a un estudio observacional retrospectivo. Se evaluaron 101 pacientes. La ocurrencia de caídas se obtuvo del registro de la unidad y las variables predictivas del modelo Hendrich II fueron recopiladas: sexo, presencia de mareos o vértigo, confusión mental, problemas de eliminación, depresión, uso de benzodiacepina, uso de anticonvulsionantes y la prueba Get up and Go. Resultados: dos eventos de caídas fueron reportados en 101 pacientes (incidencia de 1,98% en un período de 1,5 años). Utilizando el punto de corte 5 del Modelo Hendrich II, fue identificado que 30 pacientes (29,7%) tenían riesgo de caída al ingreso hospitalario, 41 (40,6%) en la mitad y 38 (37,6%) al egreso hospitalario. Conclusiones: los pacientes tratados por neoplasias hematológicas presentaron una incidencia baja y un alto riesgo de caídas durante la hospitalización.Objective: to determine the incidence and rate of risk of falls in adult patients treated for hematologic malignancies in the Intensive Hematology Unit of a reference hospital. Method: this is a retrospective observational study. A total of 101 patients were evaluated. The occurrence of falls was obtained from records of the unit and the predictive variables of the Hendrich II model were collected, namely: sex, presence of dizziness or vertigo, mental confusion, elimination problems, depression, use of benzodiazepines, use of anticonvulsants, and the Get up and Go test. Results: two fall events were reported in 101 patients (incidence of 1.98% over a 1.5- year period). Based on the cut-off point 5 of the Hendrich II Model, 30 patients (29.7%) were at risk of fall at the moment of hospital admission, 41 (40.6%) in the middle of the hospitalization period, and 38 (37.6%) at the moment of hospital discharge. Conclusions: patients treated for hematological malignancies presented low incidence and high risk of falls during hospitalization

Quality of Life of Chilean Breast Cancer Survivors: Multicentric Study

Introduction: As breast cancer survivorship rates increase, so does the necessity to improve survivors’ health-related quality of life (HRQoL). Objective: To analyze HRQoL among Chilean breast cancer survivors, in general and considering geographic location. In addition, to correlate HRQoL with age, education level and body mass index (BMI). Method: Cross-sectional observational study which included 125 female breast cancer survivors from three public hospitals in three Chilean Macroregions: Central, North Central, and South. The EORTC Questionnaires, QLQ-C30 and QLQ-BR23, and sociodemographic and clinical records were applied. Results: The mean age was 56.1 (±11.9) years with a HRQoL summary score of 67.6 (21.9). HRQoL was reduced mainly in emotional functioning, pain, and insomnia. Fatigue, dyspnea, appetite loss, constipation, financial difficulties, breast and arm symptoms were also reported. The women from the South Macroregion Hospital presented the worst HRQoL scores for most of the domains [general health, functioning (physical, emotional, cognitive and social), fatigue, and nausea], p<0.001. The summary score of HRQoL was correlated to age (Spearman´s rho=0.202, p=0.033), BMI (rho=-0.341, p<0.001), and education level (rho=0.310, p=0.001). Conclusion: Women from three Macroregions showed differences in HRQoL. The latter correlated to age, BMI, and education level. Considering the high presence of symptoms, it is necessary to improve survivorship care plans, providing access to rehabilitation in the continuum of care

Factors that influence adherence to home-based pelvic floor muscle exercises in adult women with urinary incontinence

Pelvic floor muscle exercises (PFMX) are strongly recommended for the treatment of urinary incontinence (UI). Adherence to home-based PFMX is an important factor in treatment effectiveness. Self-efficacy has been shown to be a predictor of adherence to exercises. The aim of this thesis was to evaluate the factors that influence adherence to home-based PFMX in adult women with UI. More specifically, we aimed to: develop and validate a self-efficacy scale for PFMX; evaluate the effect of an intervention to improve self-efficacy and adherence to PFMX; evaluate adherence predictors; and compare sexual function before and after treatment. Methods: This trial randomised 86 women into either control or intervention groups (dropout = 16.3%). Both groups participated in three physical therapy sessions for UI treatment based on PFMX and health education and performed PFMX at home. The additional intervention consisted of enhancing self-efficacy through a structured discussion on achievements and goal setting (mastery experience), a 9-minute video with testimonials (vicarious experience), and a magnet as a reminder. The rationale of the thesis considered socio-cognitive theory (BANDURA, 1997). The instruments used consisted of: a diary and questionnaire for adherence; a diary and International Consultation on Incontinence Questionnaire (ICIQ-SF); female Sexual Quotient; and the Modified Oxford grading scale for pelvic floor muscle strength. Results: The Self-Efficacy Scale was developed and validated regarding content, dimensionality, and internal consistency (&#945;=0.923). In the final hierarchical regression model considering allocated group, socio-structural factors (age, ICIQ-SF, and education), outcome expectation, and self-efficacy, only the last was a significant predictor of adherence (R2=0.232). Another regression model, of variables measured at final evaluation (group, ICIQ-SF change from baseline, social support, and mood state), revealed that only good mood state and self-efficacy were significantly associated with adherence (R2=0.303). Mood states such as anxiety, depression and irritability may act as barrier to the exercises. There was no additional effect of the proposed intervention to improve self-efficacy and adherence to PFMX. The intervention group felt UI was less bothersome at the 1-month evaluation compared with the control group (p=0.035). Adherence level at 3 months was high for both groups: 55.8% of the experimental group and 44.2% of the control group reported doing PFMX every day. Within-group analysis showed that both groups significantly had improved UI symptoms and pelvic floor muscle strength and endurance. The sexually active incontinent women showed improvement in their sexual function after the treatment (p<0.001). Conclusions: Socio-cognitive variables, more specifically self-efficacy, and emotional control play an important role in adherence to home-based PFMX. The non-supervised treatment strategy for UI proposed might be useful for women who live far from specialised treatment centres.Os exercícios dos músculos do assoalho pélvico (EMAP) são amplamente recomendados para o tratamento da incontinência urinária (IU). A aderência aos EMAP realizados em domicílio é um importante aspecto para o sucesso do tratamento. Objetivo: avaliar os fatores que influenciam a aderência aos EMAP domiciliares para tratamento de IU em mulheres adultas. Além disso, pretendeu-se desenvolver e validar uma escala de autoeficácia para EMAP; verificar o efeito de uma intervenção para melhorar a autoeficácia e a aderência para os EMAP; avaliar os preditores da aderência e comparar a função sexual antes e depois do tratamento. Métodos: ensaio clínico que randomizou 86 mulheres em grupo controle ou intervenção (drop out=16,3%). Ambos participaram de três sessões de fisioterapia para tratamento de IU baseados em EMAP e educação em saúde. A intervenção adicional consistiu em estimular a autoeficácia por meio de uma discussão estruturada sobre melhoras e objetivos (experiência de domínio), vídeo de 9 minutos com depoimentos (experiência vicária) e um ímã com lembrete. Considerou-se a teoria social cognitiva. Os instrumentos utilizados incluíram diário e questionário para aderência; escala de auto-eficácia; International Consultation on Incontinence Questionnaire (ICIQ-SF); Quociente Sexual Feminino e escala de Oxford modificada para força dos MAP. Resultados: a escala de autoeficácia foi desenvolvida e validada quanto a conteúdo, dimensionalidade e consistência interna (&#945;=0,923). No modelo de regressão hierárquica, considerando-se aspectos como grupo (controle ou intervenção), fatores socioestruturais (idade, ICIQ-SF e escolaridade), expectativa de resultados e autoeficácia, apenas esta última foi preditora da aderência aos EMAP domiciliares (R2=0,232). Outro modelo de regressão efetuado com as variáveis obtidas na avaliação final (grupo, variação no ICIQ-SF, suporte social e estado de humor) revelou que estado de humor e autoeficácia estavam significativamente associados a aderência (R2=0,303). Estados de humor como ansiedade, depressão e irritabilidade podem atuar como barreira para os exercícios. Os resultados do ensaio clínico demonstraram que não houve efeito adicional da intervenção para aumentar a autoeficácia na aderência aos EMAP. O grupo intervenção referiu que a IU afetava menos a vida diária na reavaliação de um mês comparado ao controle (p=0,035). A aderência em três meses foi alta em ambos os grupos, visto que 55,8% do grupo experimental e 44,2% do grupo controle realizavam EMAP todos os dias. A análise dentre grupos demonstrou que ambos melhoraram significativamente os sintomas de IU e a força dos EMAP. As mulheres incontinentes sexualmente ativas mostraram melhora na função sexual após o tratamento (p<0,001). Conclusões: as variáveis sociocognitivas, mais especificamente a autoeficácia, e o controle emocional exercem um papel importante na aderência aos EMAP domiciliares. A intervenção não supervisionada para tratar IU proposta nesta tese poderá ser útil para mulheres que vivem distante de centros especializados de tratamento.Coordenação de Aperfeiçoamento de Pessoal de Nível Superio

Sexuality during pregnancy: a human movement sciences look

It is a causal comparative research which objective was to evaluate how pregnant women live and perceive their sexuality enlightened by Human Movement Sciences. Also, more specifically, to measure test-retest reliability of the Questionário de Sexualidade na Gestação (QSXG) and to compare the answers of sexuality.s variables between two study designs - longitudinal prospective and retrospective. Material and methods: the QSXG was applied in cross-sectional and longitudinal ways. In the cross-sectional approach 80 pregnant women (20 from the first trimester, 31 from the second and 29 from the third) from 15 brazilian states with mean age of 27 (± 4,31) years old answered the questionnaire twice in an interval of one week between the answers. And in the longitudinal approach 14 pregnant women from Florianópolis (SC), mean age of 28,1 (± 5,1) years old answered once in each period of pregnancy (prospective design); eleven of them answered the retrospective questionnaire one week after the last prospective questionnaire. To evaluate the reliability of the instrument and to compare prospective and retrospective designs Pearson correlation test and Kappa coeficient were used; to compare sedentary and physically active women the independent T test was done; and to evaluate changes in the sexuality ANOVA for repeated measures, Friedman, Wilcoxon and Cohcran.s Q tests were done. It was adopted p<.05. Results: (a) cross-sectional approach: a good reproductibility was observed of the quantitative (0,599 &#8804;&#61472;r &#8804;&#61472;1) and categorical (0,499 &#8804;&#61472;k &#8804;&#61472;1) measures from test-retest. Only 30% of them practiced some physical activity during the appraised period. The physically active women, on average felt more sexually satisfied (T=-2,1, p=0,04), they considered sex more important in that period of their lives (T=-2,4, p=0,018), they liked more to practice sex (T=-2,1, p=0,037) and they had higher frequency of orgasms (T=-3,3, p=0,001) than the sedentary participants. (b) Longitudinal approach: a decrease, remarkable in the first and third gestational trimesters, in the frequencies or intensities of sexuality.s variables was observed: sexual frequency, sexual practices, sexual positions, sexual desire, sexual excitment, vaginal lubrication, orgasm, importance atributted to sexual activity and sexual satisfaction. In a methodological view for most of the quantitave items in the gestational trimesters a good agreement was obtained between prospective and retrospective designs anwers. However, before pregnancy less agreement was observed. A version of the questionnaire was created with questions considered secure to apply retrospectively. Conclusions: The QSXG which evaluates behavioral, physiological and symbolic aspects of sexuality is a reliable instrument regarding test-retest and an able to measure adaptations of women sexuality during pregnancy. The relevance of this study is beyond theoretical field once it discusses the own method used to construct this knowledge. It has been suggested to Human Movement Sciences to address the sexuality subject in their researches considering it is an important aspect of health and, how demonstrated in this study, it is related to human movement as physical activity.Trata-se de um estudo causal comparativo com o objetivo de avaliar de que forma as gestantes vivem e percebem a sexualidade, à luz das Ciências do Movimento Humano. E, mais especificamente, mensurar a confiabilidade via teste e re-teste do Questionário de Sexualidade na Gestação (QSXG) e comparar as respostas de variáveis da sexualidade entre dois desenhos de estudo - longitudinal prospectivo e retrospectivo. Materiais e métodos: o QSXG foi aplicado de forma transversal e longitudinal. No estudo transversal 80 gestantes (20 do primeiro, 31 do segundo e 29 do terceiro trimestre), oriundas de 15 estados brasileiros, média de idade 27 (± 4,31) anos, responderam duas vezes o questionário num intervalo de uma semana. E no estudo longitudinal 14 gestantes de Florianópolis (SC), média de idade 28,1 (± 5,1) anos, responderam ao QSXG uma vez em cada trimestre da gestação (desenho prospectivo); onze destas responderam o questionário retrospectivo uma semana após a última resposta do prospectivo. Para avaliar a confiabilidade do instrumento e comparar os desenhos prospectivo e retrospectivo utilizaram-se os testes de correlação de Pearson e coeficiente Kappa; para comparar mulheres sedentárias e ativas o teste T independente; e para avaliar as alterações da sexualidade os testes ANOVA medidas repetidas, Friedman, Wilcoxon e Cohcran.s Q. Adotou-se um p<0,05. Resultados: (a) Estudo transversal: houve uma boa reprodutibilidade das medidas quantitativas (0,599 &#8804;&#61472;r &#8804;&#61472;1) e categóricas (0,499 &#8804;&#61472;k &#8804;&#61472;1) do QSXG no teste e re-teste. Apenas 30% das gestantes praticavam atividade física durante o período avaliado; as mulheres ativas fisicamente, em média, sentiam-se mais satisfeitas sexualmente (T=-2,1, p=0,04), consideravam o sexo mais importante (T=-2,4, p=0,018), gostavam mais da atividade sexual (T=-2,1, p=0,037) e tinham orgasmos com mais freqüência (T=-3,3, p=0,001) que as gestantes sedentárias. (b) Estudo longitudinal: observou-se uma diminuição, mais marcante nos primeiro e terceiro trimestres gestacionais, na freqüência ou intensidade das variáveis: freqüência sexual, práticas sexuais, posições sexuais, desejo sexual, excitação sexual, lubrificação vaginal, orgasmo, importância atribuída à atividade sexual e satisfação sexual. Do ponto de vista metodológico, houve um bom grau de concordância entre as respostas dos desenhos prospectivo e retrospectivo para a maioria dos itens quantitativos nos trimestres gestacionais; porém, para o período antes da gestação houve menos concordância. Criou-se uma versão do questionário com perguntas fidedignas para serem aplicadas num desenho retrospectivo. Conclusões: O QSXG que avalia os aspectos comportamentais, fisiológicos e simbólicos da sexualidade é um instrumento confiável em termos de teste e re-teste e capaz de mensurar as adaptações da sexualidade feminina na gestação. A relevância deste estudo vai além do campo teórico, pois discute também o próprio método utilizado para construir esse conhecimento. Sugere-se que as Ciências do Movimento Humano abordem o tema sexualidade em suas pesquisas, uma vez que este é um importante aspecto da saúde e, como demonstrado nesse estudo, relaciona-se com o movimento humano enquanto atividade física.Coordenação de Aperfeiçoamento de Pessoal de Nível Superio

Resilience of athletes with physical disabilities : a cross-sectional study

This study focused on evaluating the resilience of 208 athletes with a physical disability and on testing the Wagnild and Young Resilience Scale. The mean resilience scores, considered to represent moderate resilience, were similar for men (X = 132.4 ± 30.9) and women (X = 131.4 ± 35.7). Participants with spinal cord injuries and myelomeningocele were observed to have achieved higher resilience scores, while those with cerebral palsy obtained the lowest and those with amputations or polio obtained intermediate scores (F = 3, p = .019). The participants in this research study displayed a significantly lower mean resilience (X = 132.13 ± 32.25) than those reported in other studies with the general population. A factor analysis showed multidimensional causes, with seven factors accounting for 61.27% of the total variation. Moreover, the research tool/questionnaire showed a good internal consistency (α = .88). The moderate resilience scores indicate that there is potential for developing these athletes' resilience.El objetivo de este estudio fue evaluar la resiliencia de 208 atletas con discapacidades físicas y examinar la Escala de Resiliencia de Wagnild e Young. Las puntuaciones medias de la resiliencia fueron similares para los hombres (X = 132.4 ± 30.9) y mujeres (X = 131.4 ± 35.7), considerado como resiliencia moderada. Se observó que los participantes con lesión de la médula espinal y mielomeningocele mostraron mejores resultados en resiliencia, mientras que aquellos con parálisis cerebral presentaran los peores y los amputados y con la polio tenían puntuaciones intermedias (F = 3, p = .019). Los participantes en este estudio tenían una media de resiliencia (X = 132.13 ± 32.25) significativamente menor que la reportada en otros estudios que evaluaban la población general. El análisis factorial se mostró multidimensional, con siete factores responsables por 61.27% de la varianza total. Además, el instrumento mostró buena consistencia interna (α = .88). La moderada resiliencia encontrada en este estudio indica que existe un potencial para desarrollo de la resiliencia en estos atletasO objetivo deste estudo foi avaliar a resiliência de 208 atletas com deficiência física e testar a Escala de Resiliência de Wagnild e Young. A média dos escores de resiliência foram similares para homens (X = 132.4 ± 30.9) e mulheres (X = 131.4 ± 35.7), considerados como resiliência moderada. Foi observado que os participantes com lesão medular e mielomeningocele mostraram melhores escores de resiliência, enquanto aqueles com paralisia cerebral apresentaram os piores e os amputados e com poliomielite tiveram escores intermediários (F = 3, p = .019). Os participantes deste estudo apresentaram uma média de resiliência (X = 132.13 ± 32.25) significativamente menor que os relatados em outros estudos avaliando a população em geral. A análise fatorial mostrou-se multidimensional, com sete fatores responsáveis por 61.27% da variância total. Além disso, o instrumento demonstrou boa consistência interna (α = .88). Os escores de resiliência moderados indicam que existe um potencial para desenvolvimento da resiliência nesses atletas