Translation, Cross-Cultural Adaptation, and Validation of the Portuguese Version of the Rotterdam Elderly Pain Observation Scale

INTRODUCTION: This study reports on the translation, cultural adaptation, and validation of a Portuguese version of the Rotterdam Elderly Pain Observation Scale (REPOS), a Dutch scale to assess pain in patients who cannot communicate, with or without dementia. METHODS: This is a multicenter study in pain and neurological units involving Brazil (clinical phase) and the Netherlands (training phase). We performed a retrospective cross-sectional, 2-staged analysis, translating and culturally adapting the REPOS to a Portuguese version (REPOS-P) and evaluating its psychometric properties. Eight health professionals were trained to observe patients with low back pain. REPOS consists of 10 behavioral items scored as present or absent after a 2-min observation. The REPOS score of ≥3 in combination with the Numerical Rating Scale (NRS) of ≥4 indicated pain. The Content Validity Index (CVI) in all items and instructions showed CVI values at their maximum. According to the higher correlation coefficient found between NRS and REPOS-P, it may be suggested that there was an adequate convergent validity. RESULTS: The REPOS-P was administered to 80 patients with a mean age of 60 years (SD 11.5). Cronbach's alpha coefficient showed a moderate internal consistency of REPOS-P (α = 0.62), which is compatible with the original study of REPOS. All health professionals reached high levels of interrater agreement within a median of 10 weeks of training, assuring reproducibility. Cohen's kappa was 0.96 (SD 0.03), and the intraclass correlation coefficient was 0.98 (SD 0.02), showing high reliability of REPOS-P scores between the trainer (researcher) and the trainees (healthcare professionals). The Pearson correlation coefficient was 0.95 (95% confidence interval 0.94–0.97), showing a significant correlation between the total scores of REPOS-P and NRS. CONCLUSION: The REPOS-P was a valuable scale for assessing elderly patients with low back pain by different healthcare professionals. Short application time, ease of use, clear instructions, and the brief training required for application were essential characteristics of REPOS-P

Sexual Education, Body and Sexuality in the Vision of Students and Teachers of Elementary Education

A presente pesquisa resgata a visão dos alunos e professores do Ensino Fundamental sobre as temáticas que envolvem educação sexual, corpo e sexualidade na escola, dentro do contexto histórico e demandas atuais. Objetivo: Levantar o significado que alunos e professores dão sobre o tema central articulado com a escola, tendo em vista planejar proposta de programa educativo, sobre esses assuntos, favorecendo o conhecimento do educando e educador para lidarem com estas questões no cotidiano escolar. Visando ainda, a incentivar, sensibilizar e mobilizar o desenvolvimento do senso-crítico sobre os temas em questão. Além disso, procurar contribuir para o debate sobre a formação de educadores que lidam com estes temas no dia-a-dia escolar. Metodologia: Pesquisa qualitativa, utilizando o método da pesquisa-ação, que permite levantar problemas e intervir juntamente com os participantes, de forma participativa e dialogal, através de ações educativas. Como técnicas de coleta de dados, foram utilizadas a Observação Participante: usando o Diário de Campo para o registro dos achados (local e participantes) e a entrevista norteada por um questionário. A amostra constituiu-se de 44 alunos de 7ª. e 8ª. séries e 6 professores (de língua portuguesa, ciências e educação física) do ensino fundamental, de uma Escola Estadual, localizada em Ribeirão Preto S-P. Análise dados: Se deu por categorização e a interpretação dos dados se fundamentou nos referenciais teóricos metodológicos propostos por FREIRE e THIOLLENT adaptados por BUENO. Resultados: Pôde-se verificar que os alunos relataram dúvidas precárias e básicas, revelando que a escola quase não fala sobre o assunto. Os temas menstruação, bolinação e beijo na escola, são os que mais despertam interesse e preocupação. Os professores citam significado de sexo ligado ao prazer e responsabilidade, ressaltando a banalização. Em relação ao corpo, ligam-no à saúde. Já os alunos trazem a preocupação com a atração física. Em relação à diferença de ser homem e mulher, associam-na às desvantagens de ser mulher: menstruação, parto e gravidez. Mostram uma concepção machista ao falar de gênero. Os professores evidenciam que quando são questionados pelos alunos, procuram trabalhar informações. Salientam que os maiores problemas que enfrentam na escola é o despreparo para orientar sobre o assunto, além da falta de materiais didáticos. Revelam dar importância à educação/orientação sexual, sendo fundamental como forma dos alunos obterem informações adequadas. A maioria ressalta a importância dos temas transversais na escola. Mas, revelam que os assuntos transversais não estão funcionando, porque alguns professores responsabilizam somente os professores de ciências para lidar com educação sexual. A maioria dos alunos procuram pais, depois procuram amigos, poucos procuram professores, médicos e outros profissionais para sanar as dúvidas. Os professores, no geral, sugerem a prevenção e necessidade de capacitação para trabalharem melhor esses temas. Sobre o bullying os professores revelam que existe de forma explícita na escola. Os alunos entenem o bullying como violência e briga entre alunos Em relação à autoestima, de acordo com alunos e professores, é essencial para a vida plena e a felicidade. Este estudo indicou uma nova linha de intervenção no sentido de efetivação da educação sexual na escola. Foi desenvolvida uma proposta de intervenção através da programação de ações educativas. Esse já teve seu início na escola, desenvolvendo os achados desta pesquisa e mostrando a problematização emergente em estudo, começando com a organização dos próximos encontros que ocorrerão ao longo prazo, à busca de solução dos problemas em foco.This present research comes back the students and elementary school teachers vision on issues involving sex education, body and sexuality in school, within the historical context and current demands. Objective: Raise the meaning that students and teachers give on the central theme of pleading with the school in order to plan educational program about these matters, foster knowledge of the learner and educator to deal with these issues in the classroom. Aiming also to stimulate, sensitize and mobilize the development of a sensecritical and expanded analysis on the issues in question. Also, try to contribute to the debate about the training of educators who deal with these issues in the classroom day to day routine. Methodology: Qualitative research, using the method of action research, which allows problems and intervene with the participants in a participatory and dialogical, through educational activities. As data collection techniques were used to Participant Observation: Using the Field Journal to record the findings (and local participants) and guided by an interview questionnaire. The sample consisted of 44 students of the 7th. and 8th. levels and 6 teachers (from Portuguese, science and physical education) in elementary school, a State School , located in Ribeirão Preto SP. Data Analysis: It was given by categorization and data interpretation was based on the theoretical methodology proposed by FREIRE and THIOLLENT and adapted by BUENO. Results: It was verified that the students said that they had poorest and basic doubts, revealing that the school does not often talk about the subject. Themes like menstruation, petting and kissing in school, are the ones that arouse interest and concern. The teachers show that the meaning of sex is linked to pleasure and responsibility, resulting vulgarization. In relation to the body, it´s linked to health. Now the students bring concern with the physical attraction. In relation to the difference to be a man and woman, they associate them to the disadvantages to be a woman: menstruation, childbirth and pregnancy. They show a male sexist concept when talking about gender. Teachers show that when the students make questions they try to work information. They say that the biggest problem that they find out in school is not to be prepared to advising on the subject, beyond the lack of teaching materials. They reveal to Giving importance to sexual Education / Orientation, which is important as a way for students to obtain appropriate information. Most of them emphasize the importance of transversals themes in school. But they reveal that the transversal issues are not working because some teachers only blame science teachers to deal with sexual education. Most students find out their parents, others find out for friends, little of them find out teachers, doctors and other professionals to solve the doubts in this sense. Teachers, in general, suggest the need and prevention to capacity to work these issues better. Students note the bullying understanding them as violence and fighting among students. Teachers reveals that the bullying exist in school explicitly. According to students and teachers, self-esteem is essential for the full life and happiness. This study indicated a new intervention line at the sense of effective Sexual Education in school. It was developed a proposal for intervention through educational actions programming. This action has already had start in school, developing the findings of this research and showing the emergent problem in study, starting with the organization of next meetings, which will happen in the long run, to find the solve to the problems in focus

The Sexuality in the teachers Fundamental Teaching Understanding

Para identificarmos a forma pela qual professores de Ensino Fundamental compreendem a sexualidade/ sexo na escola, procuramos levantar dados relativos a estas questões no cotidiano escolar verificando a posição da escola frente a essa temática e como lidam com isto no contexto escolar. Posteriormente, procuramos desenvolver um programa educativo com eles, visando prepará-las para lidar com o assunto, em foco. Esta investigação trata-se de uma pesquisa qualitativa, humanista, por meio de pesquisa-ação constando de um tratamento estatístico complementar para análise dos dados sócio-demográficos. A amostra foi constituída de 13 professores de ensino fundamental de ambos os sexos, de uma Escola Estadual, localizada numa cidade do interior de São Paulo, que aceitaram participar desta investigação, após assinatura do termo de consentimento livre e esclarecido, aprovado no CEP da EERP-USP. Foi adotado como critério de inclusão, ser professor do local, no nível de ensino (fundamental) e participar voluntariamente, da pesquisa. A coleta dos dados foi realizada de forma qualitativa, por meio da observação participante para melhor conhecer a realidade em estudo e da entrevista individual, usando um questionário com questões norteadoras. Os dados levantados foram construídos através de quadros e para análise, classificamos os achados em categorização. Verificamos que os professores pesquisados, se caracterizam em sua grande maioria do sexo feminino, acima de 40 anos. No que se refere à vida pessoal, poucos falaram desses dados. No que se refere ao profissional e do sentido de ser professor, todos destacaram de maneira significativa, a importância que dão à sua profissão revelando, a sua forma vocacional como educador, ao lidar com a educação e com o educando. O Significado que deram à Sexualidade é o ligado à descobertas, desejo, auto- conhecimento, naturalidade e atração. O significado que dão ao Sexo é a prática do ato em si, o interesse pelo sexo oposto, fisiologia, mudança de interesses com a idade, realização, amor e companheirismo. Citam a sexualidade como algo natural e mostram importância em tratar adequadamente do assunto na educação sexual. Quando os professores são questionados pelos alunos sobre temas gerais relacionados à Sexualidade e Sexo, referiram que costumam, em sua maioria, orientá-los, tratando o assunto com naturalidade, usando alguns materiais como elementos didáticos facilitadores. A maioria dos professores dá grande relevância ao diálogo aberto com os alunos, para envolvê-los à orientação, à informação, à prevenção, destacando haver necessidades de contar com o apoio de profissionais qualificados nesta área, bem como integrar o familiar nesse processo. Finalmente desenvolvemos ações/intervenções educativas conjuntamente com os professores, visando prepará-los para atuarem no cotidiano escolar, bem como prepará-los como agentes multiplicadores. A grande maioria dos professores já deu aula para alunas grávidas na escola e reforça que a causa da gravidez precoce é ligada à falta de orientação, tentando tratar o assunto, mostrando deveres e responsabilidades diante desta questão. Os professores sugerem buscar parcerias e formas de trabalhar a prevenção, através de palestras, oficinas e o cuidado, entre outros.For we identify the form of the which the teachers of the Fundamental Teaching understand the sexuality /sex in the school, we tried to lift relative data to these subjects in the daily scholar verifying the position of the school front to that thematic one and as they work with this in the school context. Later on, we tried to develop an educational program with them, seeking to prepare them to work with the subject, in focus. This investigation is a qualitative research, humanist, by means of research-action consisting of a complementary statistical treatment for analysis of the partner-demographic data. The sample was constituted of 13 teachers of fundamental teaching of both sexes, of a State School, located in a city of the State of São Paulo, in which they accepted to participate in this investigation, after signature of the term of free and illustrious consent, approved in CEP of EERP-USP. It was adopted as inclusion approach, to be teacher of the place, in the teaching level (fundamental) and to participate voluntarily, of the research. The collection of data was accomplished in qualitative way, by means of the participant observation for best to know the reality in study and of individual interview, using questionnaire with intriguing questions. The lifted up data were built through pictures and for analysis, we classified the discoveries in categorizations. We verified that researched teachers are characterized in its great majority of the feminine sex, above 40 years. In which refers to personal, few life they spoke about those data. In which refers to professional and of the sense of being a teacher, everybody highlighted in significant way, the importance that they give to profession revealing, its form vocational as educator, when working with education and with students. The Meaning that they gave to Sexuality is tied up to discovery, knowledge, naturalness and attraction. The meaning that they give to Sex is practice of the act in itself, interest for opposite sex, physiology, change of interests with the age, accomplishment and love. They mention the sexuality as something natural and show importance in negotiating appropriately of subject in sexual education. When the teachers plows questioned on general themes related to Sexuality and Sex, they referred in majority, treating the subject naturally, using adds materials facilitative didactic elements. Most of the teachers gives relevance to dialogue open with the students, to involve them to orientation, information, prevention, there needs to count with professionals support qualified in this area, as well to integrate the relative in that process. Finally we developed educational actions/interventions jointly with teachers, seeking to prepares them to act in the daily school, as well as to prepares them as multipliers agents. The majority of teachers already gave class for pregnant students in the school and they reinforce that cause of precocious pregnancy is linked to orientation lack, trying to treat the subject, showing duties and responsibilities. The teachers suggest to look for partnerships, forms of working prevention, lectures, shops and care, among others