RESUMO
PURPOSE: To validate the Brazilian version of the Brief Pain Inventory (BPI-B) scale and to determine the optimal cutpoints for mild, moderate, and severe pain based on patients' rating of their worst pain. METHODS: One hundred forty-three outpatients with cancer were recruited in Hospital das Clinicas-University of Sao Paulo, Brazil. RESULTS: Confirmatory factor analysis confirmed two underlying dimensions, pain severity, and pain interference, with Cronbach's α of 0.91 and 0.87, respectively. Convergent validity was shown by the correlation observed between the BPI dimensions with the EORTC-QLQ-C30 pain scale and the McGill Pain Questionnaire. The BPI-B detected significant differences in the two dimensions by disease and performance status, supporting known-group validity. For the worst pain, the optimal cutpoints were 4 and 7 (1-4 = mild pain, 5-7 = moderate, and 8-10 = severe). CONCLUSIONS: Our data show that BPI-B is a brief, useful, and valid tool for assessing pain and its impact on patient's life.
Assuntos
Neoplasias/complicações , Medição da Dor/métodos , Dor/diagnóstico , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Dor/etiologia , Índice de Gravidade de DoençaRESUMO
Introdução: Pacientes com câncer de cabeça e pescoço (CCP) apresentam diversos sintomas durante o curso de sua doença, sejam decorrentes do câncer ou do tratamento. Entretanto, esses sintomas são raramente avaliados de forma rotineira, resultando em identificação tardia, piora da qualidade da vida, com impacto significativo na capacidade funcional dos pacientes e nos custos da assistência. Há diversos instrumentos genéricos disponíveis para avaliar múltiplos sintomas em pacientes com câncer e, ao menos, dois específicos para pacientes com CCP (o Head and Neck Distress Scale [HNDS] e o M. D. Anderson Symptom Inventory - Head&Neck [MDASI-H&N]). Infelizmente, nenhum desses instrumentos foi traduzido ou validado para o português do Brasil. Objetivo: Apresentar a tradução da versão brasileira do MDASI-H&N, uma ferramenta simples, de auto-relato, validada na língua inglesa, específica para avaliar a presença e intensidade de múltiplos sintomas em pacientes com CCP e o impacto desses sintomas na vida diária. Métodos: Foi realizada tradução e retrotradução do MDASI-H&N, considerando os padrões internacionalmente recomendados, sendo as versões finais comparadas e avaliadas por comitê de pesquisadores brasileiros e do hospital M. D. Anderson Cancer Center. Resultados: O instrumento traduzido é apresentado nessa publicação e, atualmente, passa por processo de validação clínica no Brasil. Conclusão: Por ser um instrumento padronizado internacionalmente e racionalmente estabelecido, recomenda-se que, após sua validação em português, o MDASI-H&N seja adotado como a ferramenta padrão-ouro para avaliação sintomática de pacientes de cabeça e pescoço em protocolos clínicos conduzidos no Brasil e na prática clínica diária.
Introduction: Head and neck cancer (HNC) patients present multiple symptoms during the course of their disease, either as a result of cancer itself or its treatment. Nonetheless, these symptoms are rarely systematically assessed, leading to delays in their identification, quality of life deterioration, thus resulting in significant impact on patient functional capacity and costs of health care. Generic instruments for symptom evaluation in cancer patients are available, and two have been specifically designed for HNC (the Head and Neck Distress Scale [HNDS] and the M. D. Anderson Symptom Inventory - Head&Neck [MDASI-H&N]). Unfortunately, none of these tools have been translated to or validated in Brazilian Portuguese. Objective: To describe the Brazilian Portuguese version of the MDASI-H&N, a simple, self-reporting tool, which was originally developed and validated in English. It was specifically designed to assess the occurrence and severity of multiple symptoms, the overall symptom burden, and the interference of these symptoms with daily life. Methods: Translation and back-translation of the MDASI-H&N to Brazilian Portuguese were performed. The final versions were compared and contrasted by a committee composed of investigators from Brazil and from M. D. Anderson Cancer Center. Results: The translated instrument is presented herein. It is currently undergoing clinical validation in Brazil. Conclusion: Since the MDASI-H&N is an internationally standardized and rationally designed instrument, we strongly recommend that, after the clinical validation in Portuguese, this tool be adopted as the gold-standard instrument for symptom evaluation in HNC patients participating in clinical studies in Brazil, as well as in routine clinical practice.