Publications by authors named "Fania Cristina Santos"

13 Publications

  • Page 1 of 1

Development and validation of the sleep assessment instrument for older adults with pain.

Arq Neuropsiquiatr 2021 10;79(10):904-911

Universidade Federal de São Paulo, Departamento de Geriatria e Gerontologia, Serviço de Doenças Musculoesquelentas, São Paulo SP, Brazil.

Background: The co-occurrence of chronic pain and sleep disturbance contribute to a significant functional and social impact in older adults. However, there are no validated instruments to measure sleep disturbance and pain in this population that could be used to screen or diagnose individuals or monitor treatment effectiveness.

Objective: Our aim was to develop and validate a brief, practical, and comprehensive tool to assess the impact of co-occurring pain and sleep disturbance in older adults.

Methods: Development and validation of a measurement tool for assessing pain and sleep in older adults consisting of seven items.

Results: We applied the "Sleep Assessment Instrument for Pain in older adults" (SAIOAP) in a sample of 100 older individuals. A Cronbach's alpha of 0.602 indicated a moderate level of reliability, and item-total correlations of ≥0.4 for all items indicated good homogeneity. There were statistically significant correlations between the SAIOAP and sleep quality (PSQI, r=61.5), pain intensity (VNS, r=30.5), the multidimensional impacts of pain (GPM, r=40.5), depression (GEAP, r=45.5), comorbidity (r=27.9), and medication use (r=30.4). A ROC curve indicated a sensitivity of 73.2% and a specificity of 79.1% in relation to the prediction of sleep disturbances associated with pain in older adults.

Conclusions: The SAIOAP presented adequate metric properties and was demonstrated to be a simple and practical tool for the assessment of the impact of pain on sleep in older adults.
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http://dx.doi.org/10.1590/0004-282X-ANP-2020-0433DOI Listing
October 2021

Motor cortex transcranial direct current stimulation effects on knee osteoarthritis pain in elderly subjects with dysfunctional descending pain inhibitory system: A randomized controlled trial.

Brain Stimul 2021 May-Jun;14(3):477-487. Epub 2021 Mar 5.

Department of Evidence-Based Medicine, Brazilian Cochrane Centre, Federal University of São Paulo, São Paulo, SP, Brazil; Department of Rheumatology, Santo Amaro University, São Paulo, SP, Brazil. Electronic address:

Background: Although evidence has indicated a positive effect of transcranial direct current stimulation (tDCS) on reducing pain, few studies have focused on the elderly population with knee osteoarthritis (KOA).

Objective: To evaluate whether tDCS reduces KOA pain in elderly individuals with a dysfunctional descending pain inhibitory system (DPIS).

Methods: In a double-blind trial, individuals ≥ 60 years with KOA pain and a dysfunctional DPIS, we randomly assigned patients to receive 15 daily sessions of 2 mA tDCS over the primary motor cortex (anode) and contralateral supraorbital area (cathode) (M1-SO) for 20 min or sham tDCS. Change in pain perception indexed by the Brief Pain Inventory (BPI) at the end of intervention was the primary outcome. Secondary outcomes included: disability, quantitative sensory testing, pain pressure threshold and conditioned pain modulation (CPM). Subjects were followed-up for 2 months.

Results: Of the 104 enrolled subjects, with mean (SD) age of 73.9 (8.01) years and 88 (84.6%) female, 102 finished the trial. In the intention-to-treat analysis, the active tDCS group had a significantly greater reduction in BPI compared to the sham group (difference, 1.59; 95% CI, 0.95 to 2.23; P < 0.001; Cohen's d, 0.58); and, also a significantly greater improvement in CPM-pressure in the knee (P = 0.01) and CPM-pain in the hand (P = 0.01). These effects were not sustained at follow-up. The intervention was well tolerated, with no severe adverse effects.

Conclusion: M1-SO tDCS is associated with a moderate effect size in reducing pain in elderly patients with KOA after 15 daily sessions of stimulation. This intervention has also shown to modulate the DPIS.
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http://dx.doi.org/10.1016/j.brs.2021.02.018DOI Listing
November 2021

Transcranial direct current stimulation for fatigue in patients with Sjogren's syndrome: A randomized, double-blind pilot study.

Brain Stimul 2021 Jan-Feb;14(1):141-151. Epub 2020 Dec 17.

Rheumatologist. Discipline of Emergency and Evidence-Based Medicine, EPM - UNIFESP, São Paulo, SP, Brazil.

Background: Transcranial direct-current stimulation (tDCS) has shown promise to decrease fatigue. However, it has never been examined in primary Sjogren Syndrome (pSS).

Objective: To assess the effect of a tDCS protocol on fatigue in patients with pSS.

Methods: This is a parallel, double-blind pilot study (NCT04119128). Women aged 18-65 years, with pSS, on stable pharmacological therapy, with complaints of fatigue for at least three months, and with scores >5 on Fatigue Severity Scale (FSS) were included. We randomized 36 participants to receive five consecutive or sham tDCS sessions, with an intensity of 2 mA, for 20 min/day.

Results: After five tDCS sessions, fatigue severity assessed by the FSS (primary outcome) demonstrated a mean group difference of -0.85 [95% confidence interval (CI) -1.57, -0.13; effect size 0.80] favouring the active group. The active group presented significantly greater reductions in fatigue as measured by the EULAR Sjögren's Syndrome Patient Reported Index after five tDCS sessions [mean group difference: 1.40; 95%CI -2.33, -0.48; effect size 1.04]. Although there were no between-group differences in the secondary outcomes of sleep, mood and anxiety, within-group comparisons evidenced a small but significant difference in the active group for pain and sleep. There were no significant cortisol changes. All reported adverse events were mild and transitory.

Conclusion: tDCS seems to be safe and reduce fatigue in pSS. A differential effect on pain and sleep may underlie its effects. Further studies are needed to optimise tDCS treatment strategies in pSS.
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http://dx.doi.org/10.1016/j.brs.2020.12.004DOI Listing
October 2021

Locomotive Syndrome is associated with chronic pain and poor quality of life in Brazilian oldest old: LOCOMOV Project.

J Orthop Sci 2021 Jan 12;26(1):162-166. Epub 2020 Mar 12.

Federal University of São Paulo (UNIFESP), Discipline of Geriatrics and Gerontology, Pain and Osteoarticular Diseases Group, Address 105, St Professor Francisco de Castro, CEP 04020-050, Sao Paulo, SP, Brazil.

Background: In 2007, the Japanese Orthopedic Association established the term "Locomotive Syndrome" (LS) for the concept of locomotor organ dysfunction with potential loss of independence. The purpose of this study was to identify characteristics of LS and establish a diagnostic cut-off for the Geriatric Locomotive Function Scale (GLFS 25-p) for the Brazilian population.

Methods: A cross-sectional observational study of the LOCOMOV Project cohort of independent outpatients aged ≥80 years was conducted. Questionnaires on functional status in Basic and Instrumental Activities of Daily Living (Katz and Lawton, respectively) and quality of life (WHOQOL-Bref) were applied, together with the Geriatric Locomotive Function Scale (GLFS 25-p) to identify individuals with LS. Mobility was assessed using the five-times sit-to-stand test, 4-m gait speed, two-step test, one-leg standing time with eyes open and hand-grip test. The data were analyzed using Student's t-test, the Chi-Square test, and multiple logistic regression (stepwise). The significance level was set at 0.05 (5%).

Results: A sample of 102 individuals with mean age of 87.3 (±4.2) years and predominantly female (73.5%) was assessed. We determined a cut-off score of 19 (sensitivity of 0.86 and specificity of 0.67) for diagnosis of LS, as assessed by the GLFS 25-p, and a high prevalence (55%) of the syndrome was found in the sample. In the multiple regression analysis, LS was directly associated with chronic pain (OR 22.24, 95%CI 3.13-157.87), use of a walking device (OR 17.121, 95%CI 1.94-150.49), and inversely associated with gait speed ≥0.8 m/s (OR 0.42, 95%CI 0.006-0.278), perception of good health (OR 0.153, 95%CI 0.029-0.799) and male gender (OR 0.086, 95%CI 0.0105-0.714).

Conclusion: The LS in the oldest old proved a very common condition in this survey, especially in women, and was strongly associated with chronic pain, worse performance on physical tests and poor quality of life.
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http://dx.doi.org/10.1016/j.jos.2020.02.007DOI Listing
January 2021

Correlation of sleep quality with fatigue and disease activity among patients with primary Sjögren's syndrome: a cross-sectional study.

Sao Paulo Med J 2020 Mar 9;138(2):146-151. Epub 2020 Mar 9.

Discipline of Emergency Medicine and Evidence-Based Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Background: Fatigue is a frequent symptom in patients with primary Sjögren's syndrome (pSS) and can be a cause of or be associated with sleep disorders.

Objective: To assess the sleep quality of pSS patients and its relationship with fatigue and disease activity.

Design And Setting: Analytical observational study conducted at an exercise psychobiology laboratory.

Methods: Sleep quality was evaluated using the Pittsburg sleep quality index (PSQI) and actigraphy. Fatigue was evaluated through the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI-SF) and a visual analogue scale for fatigue (VAS-fatigue). Disease activity was evaluated using a visual analogue scale for pain (VAS-pain), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) and Disease Activity Index (ESSDAI). We summarized the data through descriptive statistics.

Results: A total of 50 female patients with pSS, of average age 56.4 years, were included in the study; 80% presented low disease activity. The total PSQI score showed that 74% had poor sleep. The actigraphy showed mean sleep latency of 26.2 minutes and mean nightly awakening of 48.2 minutes (duration of wakings after sleep onset, WASO). There were correlations between PSQI and VAS-pain, VAS-fatigue, PROFAD-SSI and ESSPRI. Actigraphy showed a correlation between the duration of WASO and ESSDAI.

Conclusion: The present study provides important information regarding correlations between sleep disorders and disease activity. There is a need for proper control over disease activity and for development of strategies to help patients to sleep better in order to diminish their fatigue.
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http://dx.doi.org/10.1590/1516-3180.2019.0251.R1.1912019DOI Listing
March 2020

High Prevalence of Vertebral Fracture in a Very Elderly Community-Dwelling: "Longevous Project".

J Clin Densitom 2020 Jul - Sep;23(3):497-502. Epub 2019 May 17.

Department of Medicine, Discipline of Geriatrics and Gerontology, Federal University of São Paulo, Sao Paulo, Brazil.

Introduction: Vertebral fractures (VF) are associated with poorer quality of life, morbidity, and mortality in aging, and are the main risk factors for new VF or fractures in other sites. Thus, to explore them in the elderly is important, especially considering the very elderly individuals (age ≥ 80), who belong to the fastest growing population in the world, a portion that is still very little studied.

Objective: To evaluate the prevalence, specific characteristics and associations of VFs in a very elderly population.

Method: Observational, descriptive, and analytical cross-sectional study of the "Longevous Project" - São Paulo, Brazil, an ongoing prospective cohort that includes elderly of both gender, aged 80 yr or more. For the diagnosis of VF 2 methods were used VFA ("VF Assessment) by bone densitometry and X-ray, by 2 independent physicians, and using the Genant semiquantitative technique. The VFs by VFA were correlated with demographic, anthropometric, clinical, laboratory, and densitometric data. Statistical tests applied were qui-square and ANOVA.

Results: We analyzed data of 125 individuals with a mean age of 86.7 ± 4.1 yr and majority of female (71.2%). The prevalence of osteoporosis and osteopenia was 35.5% and 47.6%, respectively. A higher prevalence of VF was verified by VFA (30.4%) than by X-ray (20.8%), besides the majority was considered severe, 52.6% and 57.7%, by VFA and X-ray, respectively. A concordance index between the 2 methods was considered regular for the diagnosis of VF (Kappa = 0.419), and good for the VF severity (Kappa = 0.743). The VF were significantly associated to bone densitometry analysis VF (p = 0.05), and its severity was significantly correlated with total hip BMD (p = 0.049) and glomerular filtration rate (p = 0.017).

Conclusion: This study observed a high prevalence of VF in a very elderly population, being the great majority severe fractures and suggests that VFA might be more effective to detect VF in oldest-old individuals.
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http://dx.doi.org/10.1016/j.jocd.2019.05.004DOI Listing
September 2021

Effects of Transcranial Direct Current Stimulation on Knee Osteoarthritis Pain in Elderly Subjects With Defective Endogenous Pain-Inhibitory Systems: Protocol for a Randomized Controlled Trial.

JMIR Res Protoc 2018 Oct 29;7(10):e11660. Epub 2018 Oct 29.

Department of Evidence-Based Medicine, Brazilian Cochrane Centre, Federal University of São Paulo, Sao Paulo, Brazil.

Background: Knee osteoarthritis (OA) has been the main cause behind chronic pain and disabilities in the elderly population. The traditional treatment for knee OA pain currently concerns a number of combinations of pharmacological and nonpharmacological therapies. However, such combinations have displayed little effects on a significant group of subjects. In addition to this, pharmacological treatments often cause adverse effects, which limits their use on this population. Previous studies showed that chronic knee OA pain may be associated with maladaptive compensatory plasticity in pain-related neural central circuits indexed by a defective descending pain-inhibitory system. Transcranial direct current stimulation (tDCS) can revert some of these maladaptive changes, thus decreasing chronic pain sensation. Numerous studies have demonstrated that the use of anodal tDCS stimulation over the primary motor cortex (M1) has positive effects on chronic neuropathic pain. Yet, data on OA pain in elderly patients, including its effects on the endogenous pain-inhibitory system, remain limited.

Objective: The objective of this study is to evaluate the efficacy of tDCS in reducing pain intensity caused by knee OA in elderly subjects with defective endogenous pain-inhibitory systems.

Methods: We designed a randomized, sham-controlled, single-center, double-blinded clinical trial. Patients with knee OA who have maintained a chronic pain level during the previous 6 months and report a pain score of 4 or more on a 0-10 numeric rating scale (NRS) for pain in that period will undergo a conditioned pain modulation (CPM) task. Participants who present a reduced CPM response, defined as a decrease in NRS during the CPM task of less than 10%, and meet all of the inclusion criteria will be randomly assigned to receive 15 sessions of 2 mA active or sham tDCS for 20 minutes. A sample size of 94 subjects was calculated. The Brief Pain Inventory pain items will be used to assess pain intensity as our primary outcome. Secondary outcomes will include pain impact on functioning, mobility performance, quality of life, CPM, pressure pain threshold, touch-test sensory evaluation, and safety. Follow-up visits will be performed 2, 4, and 8 weeks following intervention. The data will be analyzed using the principle of intention-to-treat.

Results: This study was approved by the institutional review board with the protocol number 1685/2016. The enrollment started in April 2018; at the time of publication of this protocol, 25 subjects have been enrolled. We estimate we will complete the enrollment process within 2 years.

Conclusions: This clinical trial will provide relevant data to evaluate if anodal tDCS stimulation over M1 can decrease chronic knee OA pain in elderly subjects with defective CPM. In addition, this trial will advance the investigation of the role of central sensitization in knee OA and evaluate how tDCS stimulation may affect it.

Trial Registration: ClinicalTrials.gov NCT03117231; https://clinicaltrials.gov/ct2/show/NCT03117231 (Archived by WebCite at http://webcitation.org/73WM1LCdJ).

International Registered Report Identifier (irrid): RR1-10.2196/11660.
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http://dx.doi.org/10.2196/11660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234349PMC
October 2018

Pain-induced depression in the elderly: Validation of psychometric properties of the Brazilian version of the "Geriatric Emotional Assessment of Pain" - GEAP-b.

Rev Assoc Med Bras (1992) 2017 Sep;63(9):741-746

DIGG, Unifesp, São Paulo, SP, Brazil.

Objective: In order to introduce an instrument within our midst that allows a comprehensive clinical evaluation of pain-induced depression in the elderly, we proposed the translation, cross-cultural adaptation into Brazilian Portuguese, and study of the psychometric properties of the "Geriatric Psychosocial Assessment of Pain-induced Depression" (GEAP) scale. This instrument was especially developed for the screening of depression associated with chronic pain in the elderly.

Method: We performed translation and cross-cultural adaptation of the GEAP scale, whose psychometric properties were analyzed in a sample of 48 elderly individuals. Sociodemographic data and information related to chronic pain were ascertained, as well as those related to depression. The GEAP-b scale was applied at three different times on the same day by two different interviewers (I1 and I2), and after 15 days by one of those interviewers (I3).

Results: The GEAP-b proved to be an easy-to-apply instrument with a high internal consistency value, according to the Cronbach's alpha coefficient (0.835). The reproducibility of the instrument was optimal, achieving intraclass correlations of 98.5 and 92% for interobserver and intraobserver, respectively. There was "considerable" agreement (between 0.419 and 1.0) for each GEAP-b item, except for item 19, according to the kappa statistic. As for the validity of the GEAP-b criterion, positive and statistically significant correlations were obtained for pain, according to GPM-p (r=49.5%, p<0.001), and depression, according to GDS (r=59%, p<0.001), both values being considered regular (between 40-60%).

Conclusion: The GEAP-b scale has proven to be reliable and valid in the screening of pain-related depression in the elderly.
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http://dx.doi.org/10.1590/1806-9282.63.09.741DOI Listing
September 2017

Comparison between intra-articular ozone and placebo in the treatment of knee osteoarthritis: A randomized, double-blinded, placebo-controlled study.

PLoS One 2017 24;12(7):e0179185. Epub 2017 Jul 24.

Department of Evidence-Based Medicine, Paulista School of Medicine, Sao Paulo Federal University, Sao Paulo, Sao Paulo, Brazil.

Objective: The aim of the trial was to determine the effectiveness of oxygen-ozone injections on knee osteoarthritis concerning pain reduction, joint functional improvement, and quality of life.

Methods: In this randomized, double-blinded, placebo controlled clinical trial, 98 patients with symptomatic knee osteoarthritis (OA) were randomized into two groups receiving intra-articular 20 μg/ml of ozone (OZ) or placebo (PBO) for 8 weeks. The efficacy outcomes for knee OA were the Visual Analogue Scale (VAS), Lequesne Index, Timed Up and Go Test (TUG Test), SF-36, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Geriatric Pain Measure (GPM).

Results: After 8 weeks of treatment, ozone was more effective than the placebo: VAS [mean difference (MD) = 2.16, p < 0.003 (CI 95% 0.42-3.89)], GPM [MD = 18.94, p < 0.004 (CI 95% 3.43-34.44)], LEQ [MD = 4.05, p < 0.001 (CI 95% 1.10-7.00)], WOMAC (P) [median of diff = 9.999, p = 0.019 (CI 95% 0.000-15.000)], WOMAC (JS) [median of diff = 12.499, p < 0.001 (CI 95% 0.000-12.500)], WOMAC (PF) = [median of diff = 11.760, p = 0.003 (CI 95% 4.409-19.119)], TUG (no statistical difference) and SF-36 (FC) [(MD = -25.82, p < 0.001 (CI 95% 33.65-17.99)], SF-36 (PH) [MD = -40.82, p < 0.001 (CI 95% -54.48-27.17)], SF-36 (GSH) [MD = -3.38, p < 0.001 (CI 95% -4.83-1.93)], SF-36 (SA) [MD = 2.17, p < 0.001 (CI 95% -19.67-8.24), SF-36 (EA) [MD = -35.37, p < 0.001 (CI 95% -48.86-21.89)]. Adverse events occurred in 3 patients (2 in the placebo group and 1 in the ozone group) and included only puncture accidents.

Conclusions: The study confirms the efficacy of ozone concerning pain relief, functional improvement, and quality of life in patients with knee osteoarthritis.

Trial Registration: International Standard Randomized Controlled Trial Number Register ISRCTNR55861167.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0179185PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524330PMC
September 2017

Locomotive syndrome in the elderly: translation, cultural adaptation, and Brazilian validation of the tool 25-Question Geriatric Locomotive Function Scale.

Rev Bras Reumatol Engl Ed 2017 Jan - Feb;57(1):56-63. Epub 2016 Aug 1.

Universidade Federal de São Paulo (UNIFESP), Serviço de Dor e Doenças Osteoarticulares, Disciplina de Geriatria e Gerontologia (DIGG), São Paulo, SP, Brazil.

Objective: The term Locomotive Syndrome refers to conditions in which the elderly are at high risk of inability to ambulate due to problems in locomotor system. For Locomotive Syndrome screening, the 25-Question Geriatric Locomotive Function Scale was created. The objective here was to translate, adapt culturally to Brazil, and study the psychometric properties of 25-Question Geriatric Locomotive Function Scale.

Method: The translation and cultural adaptation of 25-Question Geriatric Locomotive Function Scale were carried out, thus resulting in GLFS 25-P, whose psychometric properties were analyzed in a sample of 100 elderly subjects. Sociodemographic data on pain, falls, self-perceived health and basic and instrumental functionalities were determined. GLFS 25-P was applied three times: in one same day by two interviewers, and after 15 days, again by the first interviewer.

Result: GLFS 25-P showed a high internal consistency value according to Cronbach's alpha coefficient (0.942), and excellent reproducibility, according to intraclass correlation, with interobserver and intraobserver values of 97.6% and 98.4%, respectively (p<0.01). Agreements for each item of the instrument were considerable (between 0.248 and 0.673), according to Kappa statistic. In its validation, according to the Pearson's coefficient, regular and good correlations were obtained for the basic (BADL) and instrumental (IADL) activities of daily living, respectively (p<0.01). Statistically significant associations with chronic pain (p<0.001), falls (p=0.02) and self-perceived health (p<0.001) were found. A multivariate analysis showed a significantly higher risk of Locomotive Syndrome in the presence of chronic pain (OR 15.92, 95% CI 3.08-82.27) and with a worse self-perceived health (OR 0.23, 95% CI 0.07-0.79).

Conclusion: GLFS 25-P proved to be a reliable and valid tool in Locomotive Syndrome screening for the elderly population.
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http://dx.doi.org/10.1016/j.rbre.2016.07.015DOI Listing
September 2019

Pain-induced depression is related to overestimation of sleep quality in a very elderly population with pain.

Arq Neuropsiquiatr 2017 Jan;75(1):25-29

Universidade Federal de São Paulo, Disciplina de Geriatria e Gerontologia, Serviço de Dor e Doenças Osteoarticulares, São Paulo SP, Brasil.

Objective:: To study the quality of sleep in very elderly people with chronic pain.

Methods:: We investigated 51 very elderly people without dementia and with chronic pain according to the Geriatric Pain Measure. Katz and Lawton questionnaires were used to evaluate functionality. The Geriatric Depression Scale and Geriatric Psychosocial Assessment of Pain-induced Depression were also used. Self-perceptions of sleep and quality of sleep were checked using the Pittsburgh Sleep Quality Index.

Results:: Moderate pain was seen in 64.7% participants. The tracking of depression was positive for 41.2%. Poor quality of sleep was noted in 49% of them, but 82.3% perceived that they had a very good, or a good, sleep. The main factors associated with poor sleep quality were measurement of pain, self-perception of sleep, and pain-induced depression.

Conclusion:: Very elderly people with chronic pain, and without dementia, had a higher prevalence of poor sleep; however, they overestimated their sleep quality. Poor quality of sleep was associated with a poor self-perception of sleep and pain-induced depression.
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http://dx.doi.org/10.1590/0004-282X20160186DOI Listing
January 2017

Assessment of physicians' addressing sexuality in elderly patients with chronic pain.

Einstein (Sao Paulo) 2016 Apr-Jun;14(2):178-84

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Objective: To determine the frequency with which physicians address their older adult patients with chronic pain about the issue of sexuality.

Methods: It is a cross sectional, descriptive, analytical study in which physicians answered a questionnaire comprising questions related to addressing the issue of sexuality during appointments.

Results: A sample of 155 physicians was obtained, 63.9% stated they did not address sexuality in medical interviews and 23.2% did it most of the time. The main reasons for not addressing were lack of time, fear of embarrassing the patient and technical inability to address the issue.

Conclusion: There is a need to develop strategies to increase and improve addressing of sexuality in elderly patients with chronic pain, in order to have better quality of life.

Objetivo: Determinar a frequência com que os médicos abordam o assunto de sexualidade com seus pacientes mais idosos com dor crônica.

MÉtodos: Este é um estudo transversal, descritivo, analítico em que os médicos responderam a um questionário com perguntas relativas à abordagem de sexualidade nas consultas.

Resultados: Uma amostra de 155 médicos foi obtida, 63,9% afirmaram que não realizavam a abordagem da sexualidade e 23,2% afirmaram fazê-la na maior parte das vezes. As principais razões para não abordarem foram falta de tempo, medo de constranger o paciente e incapacidade técnica para abordar o assunto.

ConclusÃo: Existe uma necessidade de desenvolver estratégias para aumentar e melhorar a abordagem de sexualidade em idosos com dor crônica, de forma a melhorar sua qualidade de vida.
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http://dx.doi.org/10.1590/S1679-45082016AO3556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943350PMC
March 2017

Pain assessment in elderly with dementia: Brazilian validation of the PACSLAC scale.

Einstein (Sao Paulo) 2016 Apr-Jun;14(2):152-7

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Objective: To validate the Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese in demented elderly and to analyze its measurement properties.

Methods: We evaluated 50 elderly with dementia, residing in a nursing home and with limited communication ability, when exposed to potentially painful situations. The tool was applied at two different moments. First, two interviewers applied it simultaneously, and the intensity of pain was asked based on the caregiver's opinion. After 14 days, with no analgesic intervention, one of the interviewers applied it again.

Results: The sample comprised more females, aged over 80 years, with dementia due to Alzheimer, presenting musculoskeletal pain of moderate to severe intensity. The psychometric properties of the tool demonstrated appropriate internal consistency (Cronbach's alpha coefficient of 0.827). The scale had excellent reproducibility, according to the intraclass correlation coefficient, and the tool has been duly validated.

Conclusion: The Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese had adequate measuring properties for use with elderly presenting limited communication.

Objetivo: Validar o Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese em idosos dementados e analisar as propriedades de suas medições.

MÉtodos: Foram avaliados 50 idosos dementados, residentes de uma casa de repouso e com capacidade de comunicação verbal limitada, quando expostos a situações potencialmente dolorosas. A ferramenta foi utilizada em dois momentos diferentes. Primeiro, foi aplicada por dois entrevistadores simultaneamente, e a intensidade da dor foi questionada com base na opinião do cuidador. Depois de 14 dias, sem intervenção de analgésico, a ferramenta foi aplicada novamente por um dos entrevistadores.

Resultados: A amostra teve predominância de mulheres, acima de 80 anos de idade, com demência de Alzheimer, apresentando dores musculoesqueléticas com intensidade moderada a grave. As propriedades psicométricas do instrumento demonstraram consistência interna adequada (coeficiente alfa de Cronbach de 0,827). A escala teve excelente reprodutibilidade, de acordo com o coeficiente de correlação intraclasse, e o instrumento demonstrou validade adequada.

ConclusÃo: O Pain Assessment Checklist for Seniors with Limited Ability to Communicate - Portuguese teve propriedades de medição adequadas para idosos com limitações de comunicação.
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http://dx.doi.org/10.1590/S1679-45082016AO3628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943348PMC
March 2017
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