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INTRODUCTION: Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru. MATERIALS AND METHODS: We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses. RESULTS: Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]). DISCUSSION: Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.

Factors affecting depression in older people with HIV in PeruIntroductionDepression is common in older people living with HIV (PLWH) worldwide. We identified depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.Materials and MethodsWe assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered.ResultsMean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).DiscussionOur study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early treatment or interventions that can improve mental health in PLWH in Peru.

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OBJETIVES: Obtain a version to validate it in a population of adults with AD. MATERIALS AND METHODS: 1) Translation into Spanish and cross-cultural adaptation of the questionnaire from the original version in English, through a seven-step process. 2) Evaluation of the unidimensionality of the resulting scale by means of an exploratory factor analysis (EFA), of its reliability by means of Cronbach's alpha coefficient, and of its validity by evaluating the correlation of its score with those of the POEM and DLQI questionnaires. (external reference criteria). RESULTS: The version resulting from the translation and cross-cultural adaptation process was well understood by the target population. The AFE of the 66 questionnaires documented the unidimensionality of the scale based on compliance with all the criteria used for its verification. Its reliability was excellent (Cronbach's Alpha: 0.917) and its score had a very high correlation with the external reference criteria (POEM: Spearman's Rho 0.85; p < 0.0001; DLQI Spearman's Rho = 0.81; p < 0 .0001). CONCLUSIONS: The version translated into Spanish and adapted for transculturation of the ADCT questionnaire has appropriate psychometric characteristics, which will contribute to optimizing the care processes of Spanish-speaking patients.

INTRODUCCIÓN: El cuestionario ADCT (Atopic Dermatitis Control Tool) permite objetivar en forma breve y autoadministrada la repercusión de la dermatitis atópica (DA) sobre la vida cotidiana de quien la padece. OBJETIVO: Obtener una versión validarla en una población de adultos con DA. MATERIALES Y METODOS: 1) Traducción al español y adaptación transcultural del cuestionario a partir de la versión original en inglés, a través de un proceso de siete pasos. 2) Evaluación de la unidimensionalidad de la escala resultante mediante un análisis factorial exploratorio (AFE), de su confiabilidad mediante el coeficiente alfa de Cronbach, y de su validez mediante la evaluación de la correlación de su puntaje con los de los cuestionarios POEM y DLQI (criterios externos de referencia). RESULTADOS: La versión resultante del proceso de traducción y adaptación transcultural fue bien comprendida por la población blanco. El AFE de los 66 cuestionarios documentó la unidimensionalidad de la escala a partir del cumplimiento de todos los criterios utilizados para su verificación. Su confiabilidad fue excelente (Alfa de Cronbach: 0,917) y su puntaje tuvo muy alta correlación con los criterios de referencia externos (POEM: Spearman's Rho 0,85; p < 0,0001; DLQI Spearman's Rho = 0,81; p < 0,0001). CONCLUSION: La versión traducida al español y adaptada transculturación del cuestionario ADCT tiene características psicométricas apropiadas, lo que contribuirá a optimizar los procesos de cuidado de pacientes de habla hispana.

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Introducción: los trastornos mentales comunes pueden tener un impacto significativo en la vida de los indígenas, pueden provocar discapacidad, disminución de la productividad y aumento de la mortalidad. Objetivo: determinar la prevalencia de trastornos mentales comunes en indígenas de cinco departamentos de Paraguay durante el 2022. Metodología: se realizó un estudio observacional, descriptivo de corte transversal en indígenas residentes en los departamentos de Alto Paraguay, Boquerón, Concepción, Caaguazú, Presidente Hayes de Paraguay. Para la recolección de datos se utilizó el Self Reporting Questionnaire (SRQ-20). Este instrumento constó de 20 preguntas de tipo sí/no correspondientes al mes anterior a la entrevista. Resultados: participaron del estudio 779, indígenas de entre 18 a 69 años de edad. El alfa de Cronbach fue de 0,89, la medida de Kaiser-Meyers-Olkin fue 0,88. El SRQ+ fue del 25,80 % (201), el 14,51 % (113) tuvo síntomas de depresión, el 16,17 % (126) tuvo síntomas de ansiedad, y el 12,58 % (98) tuvo síntomas de psicosis. Conclusión: se encontró una alta prevalencia de trastornos mentales comunes, de acuerdo al Self Reporting Questionnaire, siendo el más frecuente al psicosis. Estos hallazgos subrayan la necesidad de mejorar el acceso a los servicios de salud mental para los indígenas de Paraguay.

Introduction: common mental disorders can have a significant impact on the lives of indigenous people, leading to disability, decreased productivity, and increased mortality. Objective: to determine the prevalence of common mental disorders in indigenous people from five departments of Paraguay in 2022. Methods: a cross-sectional, descriptive observational study was conducted in indigenous people residing in the departments of Alto Paraguay, Boquerón, Concepción, Caaguazú, and Presidente Hayes, Paraguay. Data were collected using the Self Reporting Questionnaire (SRQ-20). This instrument consisted of 20 yes/no questions pertaining to the month prior to the interview. Results: a total of 779 indigenous people aged 18-69 years participated in the study. The Cronbach's alpha was 0.89, and the Kaiser-Meyers-Olkin measure was 0.88. The SRQ+ was 25.80 % (201), 14.51 % (113) had symptoms of depression, 16.17 % (126) had symptoms of anxiety, and 12.58 % (98) had symptoms of psychosis. Conclusion: a high prevalence of common mental disorders was found, according to the SRQ, with psychosis being the most common. These findings underscore the need to improve access to mental health services for indigenous people in Paraguay.

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Introduction: The COVID-19 pandemic has brought consequences to the mental health of the undergraduate population of nursing programs. Objective: To identify the factors associated with mental health disturbances among university students in nursing programs during the COVID-19 pandemic. Materials and Methods: A multicenter, cross-sectional study was conducted during the COVID-19 pandemic among students enrolled in nursing programs at two Colombian universities and one Spanish university. An online sociodemographic, economic, and personal survey was administered along with the GHQ-12, the Family APGAR, the MOS Social Support Survey, and the IES-R for posttraumatic stress. The prevalence of mental health disturbances and their differences according to the characteristics of the students were estimated; prevalence ratios were also obtained. Results: Of the 302 students, a prevalence of clinically significant mental was found in 61.92%, family dysfunction in 61.58%, and low social support in 9.33%. In addition, 44.46% had posttraumatic stress symptoms, 52.65% had economic difficulties, 54.61% had academic difficulties, and 69.87% had personal difficulties. These mental disturbances were frequent in the presence of moderate family dysfunction (PR=1.77 CI95%=1.15;2.73), difficulty in paying for food (PR=1.35 CI95%=1.09;1.67), a breakup with a partner (PR=1.27 CI95%=1.02;1.59) and clinically relevant posttraumatic stress symptoms (PR=1.69 CI95%=1.28;2.24). Discussion: Psychological distress and its related factors found in nursing students agree with other findings in the literature. Conclusion: A significant proportion of nursing students were affected in their mental health during the pandemic, demonstrating the need for systematic, continuous, and comprehensive strategies by educational institutions.

Introducción: La pandemia de COVID-19 ha traído consecuencias en la salud mental de la población universitaria de enfermería. Objetivo: Identificar los factores relacionados con las alteraciones en la salud mental de universitarios de los programas de enfermería durante la pandemia por COVID-19. Materiales y Métodos: Estudio transversal multicéntrico, en estudiantes de enfermería de dos universidades colombianas y una española durante la pandemia por COVID-19. Se aplicó una encuesta por internet sobre aspectos sociodemográficos, económicos y personales, junto con los cuestionarios de salud mental GHQ-12, APGAR familiar, apoyo social MOS y estrés postraumático IES-R. Se estimó la prevalencia de alteraciones de la salud mental y sus diferencias según las características de los estudiantes, también se obtuvieron razones de prevalencia. Resultados: En 302 estudiantes se encontró una prevalencia de alteraciones mentales de importancia clínica de 61,92%, de disfunción familiar en 61,58%, con bajo apoyo social en 9,33%; además, presentaron síntomas de estrés postraumático (44,46%), sufrieron dificultades económicas (52,65%), académicas (54,61%) y personales (69,87%). Adicionalmente, estas alteraciones fueron más prevalentes ante una disfuncionalidad familiar moderada (RP=1,77 IC95%=1,15;2,73), ante la dificultad para pagar alimentos (RP=1,35 IC95%=1,09;1,67), la pérdida de la pareja (RP=1,27 IC95%=1,02;1,59) y ante síntomas de estrés postraumático (RP=1,69 IC95%=1,28;2,24). Discusión: El sufrimiento psicológico y sus factores relacionados encontrados en los estudiantes de enfermería concuerdan con otros hallazgos en la literatura. Conclusión: Una importante proporción de estudiantes de enfermería estuvieron afectados en su salud mental durante la pandemia, mostrando una necesidad de estrategias sistemáticas, continuas e integrales por parte de las instituciones formativas.

Introdução: A pandemia de COVID-19 trouxe consequências para a saúde mental da população universitária de enfermagem. Objetivo: Identificar os fatores relacionados às alterações na saúde mental de estudantes universitários dos cursos de enfermagem durante a pandemia de COVID-19. Materiais e Métodos: Estudo transversal multicêntrico em estudantes de enfermagem de duas universidades colombianas e uma espanhola durante a pandemia de COVID-19. Foi aplicado um inquérito online sobre aspectos sociodemográficos, económicos e pessoais, juntamente com os questionários GHQ-12 de saúde mental, APGAR familiar, MOS de apoio social e IES-R de stress pós-traumático. Também foram estimadas as prevalências de transtornos de saúde mental e suas diferenças de acordo com as características dos estudantes. Resultados: Em 302 estudantes foi encontrada uma prevalência de transtornos mentais clinicamente importantes de 61,92%, de disfunção familiar em 61,58%, com baixo apoio social em 9,33%; além disso, apresentaram sintomas de estresse pós-traumático (44,46%), sofreram dificuldades econômicas (52,65%), acadêmicas (54,61%) e pessoais (69,87%). Além disso, essas alterações foram mais prevalentes diante da disfunção familiar moderada (RP=1,77 IC 95%=1,15;2,73), diante da dificuldade para pagar a alimentação (RP=1,35 IC 95%=1,09;1,67), a perda do companheiro (RP=1,27 IC 95%=1,02;1,59) e sintomas de estresse pós-traumático (RP=1,69 IC 95%=1,28;2,24). Discussão: O sofrimento psíquico e seus fatores relacionados encontrados em estudantes de enfermagem concordam com outros achados da literatura. Conclusão: Uma proporção significativa de estudantes de enfermagem foi afetada em sua saúde mental durante a pandemia, mostrando a necessidade de estratégias sistemáticas, contínuas e abrangentes por parte das instituições formadoras.

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PURPOSE: To translate and cross-culturally adapt the Spine Functional Index (SFI) into Brazilian Portuguese (SFI-Br) in individuals with musculoskeletal spine disorders. METHODS: Participants (n=194) answered the Numerical Pain Rating Scale (NPRS), 36-item Short-Form Health Survey (SF-36), Roland-Morris Disability Questionnaire for General Pain (RMDQ-g), and SFI-25 incorporating the SFI-10. Structural validity, from confirmatory factor analysis (CFA), used comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). The best structure was considered from the lower values of the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). Construct and criterion validity used Spearman's correlation coefficient (rho). Internal consistency used Cronbach's alpha, reliability used intraclass correlation coefficient (ICC2,1), with ceiling and floor effects determined. Error used the standard error of the measurement (SEM) and minimal detectable change, 90% level (MDC90). RESULTS: Adequate fit indices demonstrated an unequivocal one-factor structure only for the SFI-10 (chi-square/DF <3.00, CFI and TLI >0.90, RMSEA <0.08). The SFI-10-Br correlation was high with the SFI-Br (rho=0.914, p<0.001), moderate for the RMDQ-g (rho=-0.78), SF-36 functional capacity domain (rho=0.718) and NPRS (rho=-0.526); and adequate for the remaining SF-36 domains (rho>0.30). Test-retest reliability (ICC2,1=0.826) and internal consistency (alpha=0.864) were high. No ceiling or floor effects were observed, and error was satisfactory (SEM=9.08%, MDC90=25.15%). CONCLUSION: The SFI Brazilian version was successfully produced with the 10-item version showing an unequivocal one-factor structure, high construct and criterion validity, reliability, internal consistency, and satisfactory error. Further research on responsiveness is required.

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Abstract Objective: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). Methods: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. Results: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. Conclusion: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.

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OBJECTIVE: Abdominal obesity (AO) is characterised by excess adipose tissue. It is a metabolic risk that affects the physical and mental health, particularly in women since they are more prone to mental health problems like depression. This study investigated the association between AO and depressive symptoms in Peruvian women of reproductive age (18-49 years). DESIGN: This is a cross-sectional observational study. SETTING: Peruvian women population of reproductive age. PARTICIPANTS: We used data from the Peruvian Demographic and Family Health Survey (DHS) for 2018 and 2019 to assess 17 067 women for the presence of depressive symptoms (using the Patient Health Questionnaire (PHQ-9): cut-off score ≥ 10) and AO (measured by abdominal circumference; cut-off score ≥88 cm). RESULTS: We observed a 64·55 % prevalence of AO and 7·61 % of depressive symptoms in the study sample. Furthermore, 8·23 % of women with AO had depressive symptoms (P < 0·05). Initially, women with AO appeared to have a 26 % higher risk of depressive symptoms compared with women without AO (P = 0·028); however, after adjustment for covariates, no statistically significant association was observed. CONCLUSIONS: Therefore, although both conditions are common in women of this age group, no significant association was found between AO and depressive symptoms.

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BACKGROUND: Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings. OBJECTIVE: This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics. METHODS: A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women. RESULTS: The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups. CONCLUSION: The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context.

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OBJECTIVE: Cultural adaptation of the Patient Health Questionnaire-PHQ-9 to Bolivian Quechua and analysis of the internal structure validity, reliability, and measurement invariance by sociodemographic variables. METHODS: The PHQ-9 was translated and back-translated (English-Quechua-English) to optimise translation. For the cultural adaptation, experts, and people from the target population (e.g., in focus groups) verified the suitability of the translated PHQ-9. For the psychometric analysis, we performed a Confirmatory Factor Analysis (CFA) to evaluate internal validity, calculated α and ω indices to assess reliability, and performed a Multiple Indicator, Multiple Cause (MIMIC) model for evaluating measurement invariance by sex, age, marital status, educational level and residence. We used standard goodness-of-fit indices to interpret both CFA results. RESULTS: The experts and focus groups improved the translated PHQ-9, making it clear and culturally equivalent. For the psychometric analysis, we included data from 397 participants, from which 73.3% were female, 33.0% were 18-30 years old, 56.7% reported primary school studies, 63.2% were single, and 62.0% resided in urban areas. In the CFA, the single-factor model showed adequate fit (Comparative Fit Index = 0.983; Tucker-Lewis Index = 0.977; Standardized Root Mean Squared Residual = 0.046; Root Mean Squared Error of Approximation = 0.069), while the reliability was optimal (α = 0.869-0.877; ω = 0.874-0.885). The invariance was confirmed across all sociodemographic variables (Change in Comparative Fit Index (delta) or Root Mean Square Error of Approximation (delta) < 0.01). CONCLUSIONS: The PHQ-9 adapted to Bolivian Quechua offers a valid, reliable and invariant unidimensional measurement across groups by sex, age, marital status, educational level and residence.

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BACKGROUND: Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. OBJECTIVE: This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. METHODS: The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). RESULTS: The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). CONCLUSION: The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

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OBJECTIVE: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). METHODS: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. RESULTS: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. CONCLUSION: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.

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ABSTRACT Objective: The aim of this study is to cross-culturally adapt the Lymphoedema Functioning, Disability and Health Questionnaire Lymphoedema (LYMPH-ICF) instrument into Brazilian Portuguese and conduct a pilot application (n = 10), without psychometric pretensions. Method: Methodological research was conducted, following the steps of translation, synthesis, back-translation, and evaluation by the expert committee. Two translators, two back-translators, and twelve professionals participated in the expert committee. A pretest was carried out with 10 patients with secondary lymphedema due to breast cancer. The degree of agreement was determined by the content validity coefficient. Results: It was necessary to modify 8 out of the 29 questions comprising the questionnaire, which exhibited idiomatic disagreement. However, despite these changes, there were no indications of impairments, as content reliability was achieved through a validity coefficient of 0.90. Final Considerations: The instrument was successfully translated and cross-culturally adapted for Brazil with a high level of agreement.

RESUMEN Objetivo: Realizar la adaptación transcultural del instrumento Cuestionario de Funcionamiento, Discapacidad y Salud del Linfedema (LYMPH-ICF) al portugués de Brasil y una aplicación piloto (n = 10), sin pretensiones psicométricas. Método: Investigación metodológica, siguiendo los pasos de traducción, síntesis, retrotraducción y evaluación por parte del comité de expertos. Participaron dos traductores, dos retrotraductores y doce profesionales para el comité de expertos. Se realizó una prueba piloto con 10 pacientes con linfedema secundario al cáncer de mama. Y el grado de concordancia se obtuvo mediante el coeficiente de validez de contenido. Resultados: Hubo necesidad de modificar 8 de las 29 preguntas que componen el cuestionario, las cuales mostraron discordancia idiomática. Sin embargo, a pesar de que se realizaron dichas modificaciones, no hubo indicación de perjuicios, ya que se alcanzó la confiabilidad del contenido mediante la obtención de 0,90 en el coeficiente de validez. Conclusiones: El instrumento fue traducido y adaptado transculturalmente para Brasil con un alto grado de concordancia.

RESUMO Objetivo: realizar a adaptação transcultural do instrumento Lymphoedema Functioning, Disability and Health Questionnaire Lymphoedema (LYMPH-ICF) para o português do Brasil e uma aplicação piloto (n = 10), sem pretensão psicométrica. Método: pesquisa metodológica, seguindo os passos de tradução, síntese, retrotradução e avaliação pelo comitê de especialistas. Participaram dois tradutores, dois retrotradutores e doze profissionais para o comitê de especialistas. Realizou-se o pré-teste com 10 pacientes com linfedema secundário ao câncer de mama. E o grau de concordância foi obtido pelo coeficiente de validade de conteúdo. Resultados: houve a necessidade de modificar 8 das 29 questões que compõem o questionário, as quais demonstraram discordância idiomática. Contudo, mesmo que tais alterações tenham sido realizadas, não houve indicação de prejuízos, já que foi alcançada a confiabilidade do conteúdo através da obtenção de 0,90 pelo coeficiente de validade. Considerações finais: o instrumento foi traduzido e adaptado transculturalmente para o Brasil com alto grau de concordância.

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Abstract Background Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. Objectives This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. Methods The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). Results The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). Conclusion The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.

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ABSTRACT Objectives: to assess the University Student Depression Inventory, Brazilian version (USDI-BR), construct. Methods: a methodological study carried out with a snowball probabilistic sample, consisting of 334 undergraduate and graduate students. Confirmatory factor analysis, reliability using McDonald's omega coefficient and Cronbach's alpha were performed. Principal component analysis was performed using the varimax rotation and oblimin rotation, using the Kaiser-Meyer-Olkin criteria, Bartlett's test of sphericity and scree plot. Results: the USDI-BR presented an internal consistency of items of ω = 0.95 and remained with 30 items, with the addition of 1 factor (Death wish and social withdrawal), totaling 4 factors. Conclusions: the USDI-BR has evidence that points to its validity and also its internal consistency, deserving that new studies be carried out to expand the evidence of its psychometric properties.

RESUMEN Objetivos: evaluar el constructo del University Student Depression Inventory, versión brasileña (USDI-BR). Métodos: estudio metodológico, realizado con una muestra probabilística en bola de nieve compuesta por 334 estudiantes de pregrado y posgrado. Se realizaron análisis factoriales confirmatorios, confiabilidad mediante el coeficiente omega de McDonald y alfa de Cronbach. El análisis de componentes principales se realizó mediante rotación ortogonal varimax y rotación oblicua oblimin, utilizando los criterios de Kaiser-Meyer-Olkin, la prueba de esfericidad de Bartlett y scree plot. Resultados: el USDI-BR presentó una consistencia interna de ítems de ω = 0,95 y quedó con 30 ítems, con la adición de 1 factor (Deseo de muerte y alejamiento social), totalizando 4 factores. Conclusiones: el USDI-BR tiene evidencias que apuntan a su validez y también a su consistencia interna, ameritando que se realicen nuevos estudios para ampliar la evidencia de sus propiedades psicométricas.

RESUMO Objetivos: avaliar o construto do University Student Depression Inventory, versão brasileira (USDI-BR). Métodos: estudo metodológico, realizado com uma amostra probabilística bola de neve constituída de 334 estudantes de graduação e pós-graduação. Foram realizadas a análise fatorial confirmatória, a confiabilidade pelo coeficiente de ômega de McDonald e o alfa de Cronbach. A análise por componentes principais foi realizada utilizando a rotação ortogonal varimax e a rotação oblíqua oblimin, por meio dos critérios de Kaiser-Meyer-Olkin, teste de esfericidade de Bartlett e scree plot. Resultados: o USDI-BR apresentou consistência interna dos itens de ω = 0,95 e permaneceu com 30 itens, com acréscimo de 1 fator (Desejo de morrer e retraimento social), totalizando 4 fatores. Conclusões: o USDI-BR possui evidências que remetem à sua validade e também à sua consistência interna, merecendo que novos estudos sejam realizados visando ampliar as evidências de suas propriedades psicométricas.

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Background Depression and anxiety are two of the most prevalent and disabling mental disorders worldwide, both in the general population and in outpatient clinical settings. Objective This study aimed to analyze the psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) based on network analysis metrics. Methods A total of 911 Paraguayans (23.71% women and 76.29% men; mean age 31.25 years, SD = 10.63), selected by non-probabilistic convenience sampling, participated in the study. Network analysis was used to evaluate the internal structure, reliability, and measurement invariance between men and women. Results The results revealed that the PHQ-4 is a unidimensional measure through Exploratory Graph Analysis (EGA). Reliability, through structural consistency, identified that 100% of the time, only a single dimension was obtained, and all items remained stable, as they were always replicated within the empirical dimension. The unidimensional structure has shown evidence of configural invariance; therefore, the network structure functioned equally among the different sex groups. Conclusion The PHQ-4 presented optimal preliminary evidence of validity based on its internal structure, reliability, and invariance between sexes. Therefore, it may be useful as an accurate and brief measure of anxiety and depressive symptoms in the Paraguayan context. (AU)

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Scoliosis is a pathology with multiple etiologies that leads to aesthetic changes, increased morbidity and, especially, psychological damage. Objective: This work aims to compare two mindset types (fixed and growth) and assess levels of quality of life in individuals with scoliosis. Methods: Two questionnaires, Scoliosis Research Society-30 (SRS-30) and Early-Onset Scoliosis-24 Questionnaire (EOSQ-24), associated with the "Health Mindset Scale," were used. We applied the SRS-30 to patients who were independent or whose diagnosis of spinal deformity occurred after the age of 10 years. For patients diagnosed before the age of 10 or who presented dependence due to cognitive impairment, caregivers were subjected to the "Health Mindset Scale" and EOSQ-24 questionnaires. Results: The sample consisted of 35 patients aged from 4 to 46 years, the majority aged from 15 to 18 years old (42.9%), female (71.4%), and with neuromuscular scoliosis (28.6%). The only significant result (p = 0.060) was the increase in pain/discomfort scores in the EOSQ-24 for a patient with a growth mindset. Lastly, there was no statistical difference between groups, however, in patients with a growth mindset, there was a tendency (p = 0.060) to have a higher pain/discomfort score, assessed via the EOSQ-24 score, reported by the caregiver. Level of Evidence III, Retrospective Comparative Study.

A escoliose é uma patologia com múltiplas etiologias e que acarreta alterações estéticas, aumento de morbidade e principalmente danos psicológicos. Objetivo: Comparar dois tipos de mindset (fixo e construtivo) e o nível de qualidade de vida. Métodos: Foram utilizados dois questionários, o Scoliosis Research Society-30 (SRS-30) e o Early-Onset Scoliosis-24 Questionnaire (EOSQ-24), associados à escala Health Mindset Scale. Aplicamos o SRS-30 em pacientes independentes ou cujo diagnóstico de deformidade na coluna ocorreu após os 10 anos. Já no caso de pacientes com diagnóstico antes dos 10 anos ou que apresentassem dependência devido a dificuldades cognitivas, os cuidadores foram submetidos à Health Mindset Scale e ao EOSQ-24. Resultados: A amostra foi composta por 35 pacientes com idades entre 4 e 46 anos, sendo a maioria entre 15 e 18 anos (42,9%), do sexo feminino (71,4%) e com escoliose do tipo neuromuscular (28,6%). O único resultado com significância (p = 0,060) foi o aumento dos escores de dor/desconforto nos questionários EOSQ-24 em paciente com mindset de crescimento. Por fim, não houve diferença estatisticamente significante entre os grupos, porém, em pacientes com mindset construtivo, houve tendência (p = 0,060) de maior escore de dor/desconforto avaliado por meio do EOSQ-24 e referido pelo cuidador. Nível de Evidência III, Estudo Retrospectivo Comparativo.

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Fundamento: la escala de trastorno de ansiedad generalizado es útil para evaluar esta afección psiquiátrica en pacientes con epilepsias; sin embargo, no ha sido adaptada ni lingüística ni culturalmente para pacientes con esta enfermedad en el contexto cubano. Objetivo adaptar lingüística y culturalmente la escala de trastorno de ansiedad generalizado para pacientes con epilepsias en el contexto cubano. Métodos trabajo de desarrollo tecnológico I+D+i, realizado en tres etapas: adaptación lingüística y cultural, evaluación por criterios de expertos en el tema y pilotaje en pacientes con epilepsias. Se combinaron técnicas cualitativas y cuantitativas: consulta a lingüistas y expertos, pilotaje, debriefing, alfa de Cronbach (α) y análisis de eliminación de los ítems. Resultados los lingüistas propusieron cambios semánticos mínimos a dos ítems de la escala. El debriefing arrojó que la escala puede administrarse en menos de cinco minutos, con ítems adecuados e inofensivos. El α = 0,83 del pilotaje evidenció buena fiabilidad del test. No fue necesario eliminar ningún ítem de la escala y las correlaciones ítem total se mantuvieron por encima del nivel mínimo (>0,300). Conclusiones: la adaptación semántica y cultural de la escala al español, como se habla en Cuba, preserva equivalencia con la versión original. Se recomienda comprobar la fiabilidad y validez de la escala GAD-7 en una muestra representativa de pacientes con epilepsias en el contexto cubano.

Foundation: the generalized anxiety disorder scale is useful to evaluate this psychiatric condition in patients with epilepsy; however, it has not been adapted linguistically or culturally for patients with this disease in the Cuban context. Objective: linguistically and culturally adapt the generalized anxiety disorder scale for patients with epilepsy in the Cuban context. Methods: I+D+i technological development work, carried out in three stages: linguistic and cultural adaptation, evaluation by criteria of experts on the subject and trial in patients with epilepsy. Qualitative and quantitative techniques were combined: consultation with linguists and experts, trial, debriefing, Cronbach's alpha (α) and item elimination analysis. Results: the linguists proposed minimal semantic changes to two items of the scale. The debriefing showed that the scale can be administered in less than five minutes, with appropriate and harmless items. The α = 0.83 of the trial showed good reliability of the test. It was not necessary to eliminate any items from the scale and the item-total correlations remained above the minimum level (>0.300). Conclusions: the semantic and cultural adaptation of the scale to Spanish, as spoken in Cuba, preserves equivalence with the original version. It is recommended to verify the reliability and validity of the GAD-7 scale in a representative of patients with epilepsy in the Cuban context.

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RESUMO A Covid-19 é uma doença multissistêmica e consequências funcionais e tardias estão em estudo. Sequelas psicológicas e neurocognitivas podem comprometer a Capacidade para o Trabalho (CT) dos trabalhadores. Objetivou-se investigar a CT de pessoas previamente infectadas pelo Sars-CoV-2, correlacionando-a com avaliação da sonolência, ansiedade, depressão e fadiga. Estudo transversal, com trabalhadores diagnosticados com Covid-19 e em acompanhamento no Serviço de Neurologia da Universidade Estadual de Campinas (Unicamp). Aplicou-se o instrumento Índice de Capacidade para o Trabalho (ICT), um formulário com dados sociodemográficos e ocupacionais, bem como escalas de sonolência, ansiedade, depressão e fadiga. Dos 119 trabalhadores que participaram do estudo, mais da metade apresentaram comprometimento da CT (52,9%). Distúrbio emocional foi o agravo relatado mais frequente (31,9%). A regressão logística múltipla mostrou que a interação entre ansiedade e sonolência esteve associada ao comprometimento da CT (OR=4,50 com p=0,002). Ansiedade e sonolência foram alterações tardias da Covid-19 e associadas ao comprometimento da CT dos trabalhadores avaliados. Este estudo demonstra a necessidade de que todos os trabalhadores com teste positivo por Covid-19 tenham sua CT avaliada por ocasião do retorno ao trabalho. Ações de promoção à saúde, reabilitação funcional e adaptação do trabalho de acordo com as sequelas apresentadas pelos trabalhadores.

ABSTRACT COVID-19 is a multisystemic disease, with functional and late consequences still under study. Psychological and neurocognitive sequelae impact workers' quality of life and may compromise the Work Ability (WA). The objective was to investigate the WA of people infected with SARS-CoV-2, correlating it with the assessment of sleepiness, anxiety, depression and fatigue. Cross-sectional study, involving workers diagnosed with COVID-19 under follow-up at the Department of Neurology of Universidade Estadual de Campinas (UNICAMP). Application of the Work Ability Index (WAI) analyzed with sociodemographic and occupational variables, as well the sleepiness, anxiety, depression and fatigue scales. Multiple logistic regression analysis was performed. 119 workers participated in the study and, among them, more than half had WA impairment (52.9%). Emotional disorders were the most frequent reported problem (31.9%). Multiple logistic regression showed that the interaction between anxiety and sleepiness was associated with WA impairment (OR=4.50, p=0.002). Anxiety and sleepiness were associated with previous COVID-19 and they were associated with WA impairment among workers. This study shows the WA evaluation should be provided for all workers with a previous history of COVID-19, when they return to work. This assessment can guide health promotion actions, functional rehabilitation and work adaptation to the sequelae presented by workers, singularly.

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Objetivo . Traducir y adaptar culturalmente el Patient Health Questionnaire (PHQ-9) a tres variedades del quechua y analizar su validez, confiabilidad e invarianza. Materiales y métodos . 1) Fase de adaptación cultural: el PHQ-9 fue traducido del inglés a tres variantes del quechua (Central, Chanca, Cuzco-Collao) y traducido nuevamente al inglés, posteriormente expertos y grupos focales permitieron adaptar culturalmente las traducciones. 2) Fase psicométrica: se evaluó la uni-dimensionalidad del PHQ-9 adaptado mediante un Análisis Factorial Confirmatorio (CFA), la confiabilidad se evaluó mediante consistencia interna (Alpha y Omega), y la invarianza de medida según variedades del quechua y variables sociodemográficas se evaluó empleando CFA multigrupos y modelos MIMIC (Múltiples Indicadores y Múltiples Causas). Resultados . Cada una de las adaptaciones del PHQ-9 a las tres variedades de quechua reportaron ítems claros y culturalmente equivalentes. Posteriormente, con 970 datos de quechuahablantes adultos varones y mujeres, el modelo general unidimensional reportó un ajuste adecuado (índice de ajuste comparativo: 0,990, índice de Tucker-Lewis: 0,987, residuo estandarizado cuadrático medio: 0,048, raíz del error cuadrático medio de aproximación: 0,071), lo mismo ocurrió para cada variedad del quechua. La confiabilidad fue alta para todas las variedades (α = 0,865 - 0,915; ω = 0,833 - 0,881). Los resultados del CFA multigrupos y modelos MIMIC confirmaron invarianza de medida según variante del quechua, sexo, residencia, edad, estado civil y nivel educativo. Conclusiones . Las adaptaciones del PHQ-9 a Quechua Central, Chanca y Cuzco-Collao ofrecen una medición válida, confiable e invariante, confirmando que se pueden hacer comparaciones en los grupos evaluados. Su uso beneficiará a la investigación y a la atención en salud mental de poblaciones quechuahablantes.

Objective . To translate and culturally adapt the Patient Health Questionnaire (PHQ-9) to three varieties of Quechua and analyse their validity, reliability, and measurement invariance. Materials and methods . 1) Cultural adaptation phase: the PHQ-9 was translated from English into three variants of Quechua (Central, Chanca, Cuzco-Collao) and translated again into English. Then, experts and focus groups allowed the translations to be culturally adapted. 2) Psychometric phase: the unidimensionality of the adapted PHQ-9 was evaluated by using Confirmatory Factor Analysis (CFA), reliability was evaluated by internal consistency (Alpha and Omega), and measurement invariance according to Quechua varieties and sociodemographic variables was evaluated by using CFA, multigroups and MIMIC models (Multiple Indicator Multiple Cause). Results . Each of the adaptations of the PHQ-9 to the three Quechua varieties reported clear and culturally equivalent items. Subsequently, data from 970 Quechua-speaking adult men and women were analyzed. The general one-dimensional model reported an adequate fit (Comparative fit index = 0.990, Tucker-Lewis index = 0.987, Standardized root mean squared residual= 0.048, Root mean squared error of approximation=0.071); each of the Quechua varieties also showed an adequate fit. Reliability was high for all varieties (α = 0.865 - 0.915; ω = 0.833 - 0.881). The results of the multigroup CFA and MIMIC models confirmed measurement invariance according to Quechua variant, sex, residence, age, marital status and educational level. Conclusions . The PHQ-9 adaptations to Central Quechua, Chanca and Cuzco-Collao offer a valid, reliable and invariant measurement, confirming that comparisons can be made between the evaluated groups. Its use will benefit mental health research and care for Quechua-speaking populations.

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RESUMO Objetivo Analisar os indicadores de prazer e sofrimento no trabalho associados a depressão e ansiedade entre agentes comunitários de saúde (ACSs). Métodos Estudo transversal, no qual variáveis dependentes foram a presença de sintomas de ansiedade e depressão, avaliadas com o Patient Health Questionnaire (PHQ-9) e com o Inventário de Ansiedade de Traço-Estado (IDATE). As variáveis independentes foram avaliadas com um questionário sociodemográfico e a Escala de Indicadores de Prazer e Sofrimento no Trabalho (EIPST) do Inventário do Trabalho e Riscos de Adoecimento (ITRA). As associações entre as variáveis foram testadas com o uso de regressão logística multinominal. Resultados Participaram do estudo 675 ACSs, sendo a maioria mulheres (83,7%), com até 40 anos (51,3%). As chances de apresentar sintomas de ansiedade foram maiores entre ACSs efetivos (1,61 [1,10-2,36]), e avaliações críticas ou graves nos fatores realização (Crítica 1,87 [1,30-2,68]; Grave 4,16 [2,06-8,40]) e esgotamento profissional (Crítica 2,60 [1,78-3,80]; Grave 3,97 [2,53-6,21]). Sexo feminino (2,12 [1,03-4,40]), idade de até 40 anos (1,741 [1,05-2,89]), tempo de serviço superior a cinco anos (1,88 [1,18-2,99]), avaliações crítica ou grave nos fatores realização (Crítica 2,53 [1,55-4,10]; Grave 6,07 [2,76-13,38]), esgotamento profissional (Crítica 5,21 [2,30-11,80]; Grave 15,64 [6,53-37,44]) e falta de reconhecimento (Crítica 1,93 [1,13-3,28]) estiveram associados a maiores chances de sintomas depressivos. Conclusões Apesar de se tratar de estudo transversal, que não permite inferir causalidade, os achados sugerem importante associação entre aspectos laborais dos ACS e os sintomas de ansiedade e depressão. Sexo feminino e possuir 40 anos ou menos também mostraram relação com o aumento dos sintomas de depressão.

ABSTRACT Objective To analyze indicators of pleasure and suffering at work associated with depression and anxiety among community health workers (CHW). Methods Crosssectional study in which the dependent variables were the presence of anxiety and depression symptoms, assessed using the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI). The independent variables were evaluated using the Scale of Indicators of Pleasure and Suffering at Work (EIPST) of the Inventory of Work and Risks of Illness (ITRA). Associations between dependent and independent variables were tested using multinomial logistic regression. Results 675 CHW participated in the study, the majority being women (83.7%), aged up to 40 years (51.3%). The chances of presenting anxiety symptoms were higher among effective CHW (OR=1.61; 95%CI: 1.10-2.36), and critical or severe assessments in the achievement factors (Critical OR=1.87; 95%CI: 1.30-2.68; Severe OR=4.16; 95%CI: 2.06-8.40) and professional exhaustion (Critical OR=2.60; 95%CI: 1.78-3.80; Severe OR=3.97; 95% CI: 2.53-6.21). Female gender (OR=2.12; 95%CI: 1.03-4.40), age up to 40 years (OR=1.74; 95%CI: 1.05-2.89), length of service greater than five years (OR=1.88; 95%CI: 1.18-2.99), critical or severe ratings on achievement factors (Critical OR=2.53; 95%CI: 1.55-4.10; Severe OR= 6.07; 95%CI: 2.76-13.38), professional exhaustion (Critical OR=5.21; 95%CI: 2.30-11.80; Severe OR=15.64; 95%CI: 6.53 -37.44) and lack of recognition (Critical OR=1.93; 95%CI: 1.13-3.28) were associated with greater chances of depressive symptoms. Conclusions Despite being a cross-sectional study, which does not allow inferring causality, the findings suggest an important association between the work aspects of the CHW and the symptoms of anxiety and depression. Female gender and being 40 years old or younger also showed a relationship with increased symptoms of depression.