Association between spirituality and adherence to management in outpatients with heart failure

Fundamento: A espiritualidade pode influenciar a maneira com que os pacientes lidam com sua doença. Objetivos: Avaliamos a possibilidade de a espiritualidade influenciar a adesão ao tratamento de pacientes ambulatoriais com insuficiência cardíaca. Métodos: Estudo transversal com pacientes ambulatoriais com insuficiência cardíaca, cuja adesão ao tratamento multidisciplinar foi avaliada. Os pacientes foram avaliados sobre qualidade de vida, depressão, religiosidade e espiritualidade, utilizando questionários validados. Foram obtidas correlações entre adesão e variáveis psicossociais de interesse. Modelos de regressão logística exploraram preditores independentes de adesão. Resultados: Cento e trinta pacientes (idade 60 ± 13 anos; 67% masculinos) foram entrevistados. Observou-se adequado escore de adesão em 38,5% dos pacientes. Nem a depressão ou a religiosidade foram correlacionados à adesão, quando avaliados separadamente. É interessante notar que quando a espiritualidade foi avaliada por ambos, o somatório total de score (r = 0,26; p = 0,003) e os domínios específicos, ela estava positivamente correlacionada à adesão. Por fim, a combinação de espiritualidade, religiosidade e crenças pessoais mostrou-se um preditor independente de adesão quando ajustado às características demográficas, clínicas e a instrumentos psicossociais. Conclusão: Espiritualidade, religiosidade e crenças pessoais foram as únicas variáveis consistentemente associadas à adesão em relação à medicação em uma coorte de pacientes ambulatoriais com insuficiência cardíaca. Nossos dados sugerem que abordar adequadamente esses aspectos no cuidado com o paciente pode auxiliar a melhorar o padrão de adesão no complexo tratamento da insuficiência cardíaca.Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusions: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management

Las Provincias : diario de Valencia: Año LIV Número 16322 - 1919 Mayo 12

Mudanças ocorridas no estilo de vida da população, principalmente no que diz respeito aos hábitos alimentares, têm causado aumento da prevalência de excesso de peso e, como consequência, desfechos desfavoráveis na saúde, como a alta incidência de doenças crônicas não transmissíveis (DCNT). Este estudo transversal teve como objetivo estudar a qualidade da dieta de carteiros de Porto Alegre, RS. Os dados foram obtidos por meio de dois recordatórios alimentares de 24 horas (R24h), no período de agosto de 2011 a dezembro de 2012, em seis diferentes Centros de Distribuição Domiciliar dos Correios (CDD). A composição dietética foi analisada por meio do software DietWin. A qualidade da dieta foi avaliada por meio do Índice de Alimentação Saudável adaptado para a população brasileira – IASad. Para análises estatísticas, foi utilizado o software SPSS. Dos 194 participantes, 147 (75,8%) eram homens com idade média de 40 anos, escolaridade média de 13 anos e 62,9% eram casados. Quanto ao estado nutricional, 80 indivíduos (41,2%) apresentaram sobrepeso e 41 (21,1%) obesidade. A média do IASad foi de 80,07 ± 11,36, em escala que varia de zero a 120 pontos, indicando dieta precisando de melhorias. Carnes/ovos apresentaram maior pontuação enquanto que açúcares/doces apresentaram a menor. A dieta de 11 carteiros (5,7%) foi classificada como de boa qualidade, de 141 (72,7%) como precisando de melhorias e de 42 (21,6%) como de má qualidade. Para os grupos das carnes/ovos, leguminosas, doces/açúcares e óleos/gorduras, o consumo foi significativamente superior ao recomendado. Indivíduos com baixo peso e eutrofia apresentaram maior consumo de leite/derivados quando comparados a indivíduos com sobrepeso e obesidade. Não houve associação da qualidade da dieta com o estado nutricional. A maioria dos carteiros apresentou dieta precisando de melhorias ou de má qualidade. Considerando-se que este indicador pressupõe importante fator de predisposição para o desenvolvimento de DCNT, os dados do presente estudo permitem concluir que os trabalhadores desta amostra incluem-se em um grupo de risco, demonstrando a necessidade de intervenções dietéticas como o desenvolvimento de programas de educação alimentar e nutricional direcionados a trabalhadores.Changes in population´s lifestyle, especially regarding eating habits, have caused an increase in the prevalence of overweight and, as a consequence, unfavorable health outcomes, such as high incidence of chronic noncommunicable diseases (NCDs). This cross-sectional study aimed to study the quality of the postmen's diet in Porto Alegre, RS. The data were obtained through two 24-hour diet recall (R24h), from August 2011 to December 2012, in six different Post Office Home Delivery Centers (CDD). Dietary composition was analyzed using DietWin software. The diet quality was evaluated through the Healthy Eating Index adapted for the Brazilian population - IASad. For statistical analysis, SPSS software was used. Of the 194 participants, 147 (75.8%) were men with a mean age of 40 years, average schooling of 13 years and 62.9% were married. Regarding nutritional status, 80 individuals (41.2%) were overweight and 41 (21.1%) were obese. The IASad mean was 80.07 ± 11.36, on a scale ranging from zero to 120 points. Meat/eggs had the highest score while sugars/sweets presented the lowest. The diet of 11(5.7%) postmen was classified as good quality, 141 (72.7%) as needing improvement and 42 (21.6%) as poor quality. Consumption was significantly higher than recommended for the groups of meat/eggs, legumes, sweets/sugars and oils/fats. Individuals with low and normal weight presented higher consumption of milk/dairy products when compared to overweight and obese individuals. There was no association between diet quality and nutritional status. Most postmen presented a diet needing improvement or poor quality. Considering that this indicator presupposes an important predisposing factor for the development of NCD, the data of the this study allow to conclude that the workers of this sample are included in a risk group, demonstrating the need of dietary interventions such as the development of education programs regarding food and nutrition

Intake of oral photoprotectors by postmen in Porto Alegre

Introduction: Postmen are daily exposed to high levels of solar radiation, and lack of protection can result in many health damages. The present study aimed to identify cutaneous phototypes and evaluate the intake of oral photoprotectors by postmen. Methods: Cross-sectional study, carried out from August 2011 to December 2012 in the city of Porto Alegre, state of Rio Grande do Sul, Brazil. Socioeconomic and behavioral data regarding daily solar exposure were collected through a questionnaire. To evaluate the intake of beta-carotene, lycopene and omega-3, two 24-hour dietary recalls were applied. Cutaneous phototypes were assessed by Fitzpatrick’s classification. Results: A total of 181 postmen were analyzed, whose mean age was 40.2±11.4 years old, and 140 (77.3%) were male. The cutaneous phototypes II, III and IV were the most prevalent (n=138), totaling 76.3% of the sample. The median for the oral photoprotectors intake was 1.16 mg (0.46-2.29) of beta-carotene, 3.60 mg (1.01-6.31) of lycopene and 0.95 g (0.61-1.45) of n-3 fatty acids, all values significantly lower than the minimal doses to obtain photoprotective effect (p<0.001). The individuals in the group of phototypes V and VI showed lower adherence to the use of sunscreen and lower intake of beta-carotene, comparing to the other groups. Conclusions: The intake of oral photoprotectors is low in this population. Future studies may evaluate the real effect of oral photoprotectors, so that preventive measures using this approach can be included in photoprotection education actions for outdoor workers

Intake of oral photoprotectors by postmen in Porto Alegre

Introduction: Postmen are daily exposed to high levels of solar radiation, and lack of protection can result in many health damages. The present study aimed to identify cutaneous phototypes and evaluate the intake of oral photoprotectors by postmen. Methods: Cross-sectional study, carried out from August 2011 to December 2012 in the city of Porto Alegre, state of Rio Grande do Sul, Brazil. Socioeconomic and behavioral data regarding daily solar exposure were collected through a questionnaire. To evaluate the intake of beta-carotene, lycopene and omega-3, two 24-hour dietary recalls were applied. Cutaneous phototypes were assessed by Fitzpatrick’s classification. Results: A total of 181 postmen were analyzed, whose mean age was 40.2±11.4 years old, and 140 (77.3%) were male. The cutaneous phototypes II, III and IV were the most prevalent (n=138), totaling 76.3% of the sample. The median for the oral photoprotectors intake was 1.16 mg (0.46-2.29) of beta-carotene, 3.60 mg (1.01-6.31) of lycopene and 0.95 g (0.61-1.45) of n-3 fatty acids, all values significantly lower than the minimal doses to obtain photoprotective effect (p<0.001). The individuals in the group of phototypes V and VI showed lower adherence to the use of sunscreen and lower intake of beta-carotene, comparing to the other groups. Conclusions: The intake of oral photoprotectors is low in this population. Future studies may evaluate the real effect of oral photoprotectors, so that preventive measures using this approach can be included in photoprotection education actions for outdoor workers