Análise da estrutura fatorial da versão em português da Escala de Auto-Silenciamento

This study focuses on the adaptation of the Portuguese version of the Escala de Autosilenciamiento [EAS, for its Portuguese acronym] (Neves, 2005) that has been designed to assess the use of cognitive schemas for self silencing in intimate relationships. Participants were 371 women with a mean age of 22.36 years (SD=2.69; Min=18; Max=31), who at that time were involved in affective relationships with an average duration of 39.65 months (SD=33.93; Min=10; Max=192).The exploratory factor analysis suggests a factor solution of three factors, where the first factor includes items from the silencing of the sef and divided self subscales. The second factor includes items from the care-giving subscale such as self-sacrifice. And the third factor includes items from the externalized self-perception subscale. Results of the confirmatory factor analysis show reliable global indices of fitness of the model, confirming the quality of the model in terms of adjustment to empirical data (X2/df=1.964, CFI=.862, GFI=.894, RMSEA=.051) compared to the original model. Implications for a further study of the construct validity of the scale are discussed.Este estudo se centra na adaptação da versão em português da Escala de Auto-silenciamento (EAS; Neves, 2005) que está desenhada para avaliar o uso de esquemas cognitivos de auto-silenciamento nas relações íntimas. Neste estudo participaram 371 mulheres, com uma idade média de 22,36 anos (DP = 2,69, mín. = 18, máx. = 31), que nessa época estavam envolvidas em relações afetivas com uma duração média de 39,65 meses. (DP = 33,93, mín. = 0,10; máx. = 192). Uma análise fatorial exploratória posterior sugere uma solução de três fatores, aonde o primeiro fator inclui os itens da sub-escala de silenciamento do self e do self dividido; o segundo inclui os itens da sub-escala de Provisão de cuidados como o auto sacrifício, e o terceiro inclui os itens da sub-escala de auto percepção externalizada. Os resultados da análise fatorial confirmatória mostram índices gerais de adequação confiáveis, o que confirma a qualidade do ajuste do modelo aos dados empíricos (X2/df = 1964, CFI = .862, GFI = 0,894, RMSEA = 0,051) em comparação com a teste original. Analisam-se as implicações para um estudo más profundo da validez de constructo da escala.Este estudio se centra en la adaptación de la versión en portugués de la Escala de Autosilenciamiento (EAS; Neves, 2005) que está diseñada para evaluar el uso de esquemas cognitivos de autosilenciamiento en las relaciones íntimas. En este estudio participaron 371 mujeres, con una edad media de 22,36 años (DP = 2,69, mín. = 18, máx. = 31), que en esa época estaban involucradas en relaciones afectivas con una duración promedio de 39,65 meses. (DP = 33,93, mín. = 0,10; máx. = 192). Un análisis factorial exploratorio posterior sugiere una solución de tres factores, donde el primer factor incluye los ítems de la subescala de silenciamiento del self y del self dividido; el segundo incluye los ítems de la subescala de Provisión de cuidados como el autosacrificio, y el tercero incluye los ítems de la subescala de autopercepción externalizada. Los resultados del análisis factorial confirmatorio muestran índices generales de adecuación fiables, lo que confirma la calidad del ajuste del modelo a los datos empíricos (X2/df = 1964, CFI = .862, GFI = 0,894, RMSEA = 0,051) en comparación con la prueba original. Se analizan las implicaciones para un estudio más profundo de la validez de constructo de la escala

SexIDI study - sexual satisfaction in inflammatory bowel disease

Sexual satisfaction is among the concerns of patients with Inflammatory Bowel Disease (IBD) being rarely addressed in the outpatient clinic and Quality of Life (QoL) questionnaires. At a time where patient-reported outcomes (PRO) grow in importance, the impact of the disease on sexual health must be valued

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients