Banca de DEFESA: PATRICIA APARECIDA TAVARES

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : PATRICIA APARECIDA TAVARES
DATE: 23/08/2023
TIME: 14:00
LOCAL: Videoconferência
TITLE:

FUNCTIONAL DISABILITY IN INDIVIDUALS WITH CHAGAS DISEASE: EVALUATION OF PATIENTS IN THE SAMI-TROP COHORT BY WHODAS-12

KEY WORDS:

Chagas disease; Health assessment; Disability assessment; WHODAS.

PAGES: 103
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: In recent years, several studies have sought to highlight the real health status of people with heart problems, especially in the process of functionality and disability. Many instruments are used to predict the cardiac and functional condition of this population such as the cardiopulmonary exercise test and the ergometric test, the first being the gold standard used for this evaluation. However, both tests are expensive and available only in cities with more health care resources, which does not correspond to the reality of many patients, especially those with Chagas disease and its endemic regions. The use of simple tools such as scales and questionnaires can be used in clinical practice and research due to their low cost, ease of application and the fact that they reflect the patient's performance and perception of their health, its quality and the limitations of daily life. In this context, the aim of this study was to validate the WhoDAS 12 for a population of patients with Chagas Disease followed by the SaMi-Trop project and then to evaluate the functional disability of this population. Method: This study is part of a prospective cohort that follows individuals with Chagas Disease in an endemic region of Minas Gerais and involves four Brazilian public universities (USP, UFMG, UF SJ and UNIMONTES). The baseline of the study was performed in 2013-2014 and follow-up visits were performed in 2015-2016 (V1) and in 2019-2021 (V2). Functional disability was assessed at the last wave V2. This study was divided into two stages, and the findings of the first stage are presented in this volume by means of an article. Data collection of the first stage took place between October 2019 and March 2020. The variables collected were those related to sociodemographic and clinical information and disability indicators measured by WHODAS-12. Descriptive analysis was performed and the internal consistency and construct validity of the instrument were verified. For the second stage, sociodemographic, clinical, behavioral and quality of life information was collected from 1034 participants. Logistic regression analysis was used to compare possible variables related to functional disability. Correlation analyses of the WHODAS-12 with daily tasks and quality of life measured by the WHOQOL-Bref instrument were performed. Results: First stage: of the 1116 who participated in the second follow-up, 628 HIV-positive participants in the SaMi-Trop cohort completed the WHODAS-12 in the first stage. The majority were women (69.5%), aged 51-65 years (44.9%). Self-perceived health was classified as average for 43.4% of participants, and 32% had chronic Chagas cardiomyopathy (CCC) dysfunction. After factor analysis the 12 items of the scale were distributed into three factors, which, grouped together, account for 61% of the variance, with initial eigenvalues for Factor 1 of 5.04, Factor 2 of 1.17 and Factor 3 of 1.05.  The factor loading in the respective factors ranged from 0.41 to 0.87. The Kaiser-Meyer-Olkin (KMO) index was 0.90, indicating adequacy of the sample for factor analysis. The internal consistency of the overall scale, including the 12 items, showed alpha = 0.87, indicating excellent internal consistency. Second stage: The sample was composed mainly of females (70.6%), with a mean age of 63.3 years, and declared themselves illiterate (59.3%).  The WHODAS-12 score was 15.3, indicating low functional disability.  Worse functional disability was associated with being female, having hypercholesterolemia, Chagas cardiomyopathy and a previous history of AMI. Being literate and drinking at least once a week were positively correlated with lower functional disability in this population. Conclusion: WHODAS-12 is a valid and reliable measure to assess disability in this population with CD. Although CD is a condition that can cause functional impairment, a high disability score was not observed by WHODAS-12, a fact that may be reflecting that other issues are important in this population that are involved with functionality and that go beyond cardiac impairment. 

BANKING MEMBERS:
Presidente - 823.696.317-91 - CLAUDIA DI LORENZO OLIVEIRA - UFSJ
Externa ao Programa - 1615288 - ELIETE ALBANO DE AZEVEDO GUIMARAES
Externa à Instituição - FABIANE RIBEIRO FERREIRA - UFMG
Externa à Instituição - MERY NATALI SILVA ABREU - UFMG
Externo ao Programa - 1252298 - TIAGO SILVEIRA GONTIJO