Effects of non-invasive ventilatory support in tolerance to the effort of patients with hemodialysis

Abstract Introduction The kidney system is responsible for the maintenance of homeostasis and in patients with Chronic Kidney Disease the kidney functions changes, contributing for the development of various complications that will have adverse effects in tolerance to the physical exercise and in Quality of Life of this patients. Objective To evaluate the Effects of non-invasive ventilatory support in tolerance to the patients’ physical exercise in dialysis. Methods The patients performed two 6-minute walk tests, following an adapted protocol for treadmill, one of them without the use of non-invasive ventilatory support and the other with non-invasive ventilatory support during the walk. Besides, the patients answered a questionnaire of quality of life and the KDQOL-SFTM specific for the population under study. Results It was noticed that there was not statistical difference in the distance recorded during the 6-minute walk tests. Regarding the quality of life, the greater impact of the disease was in relation to “Professional Activity”. Conclusion In conclusion, a non-invasive ventilatory support did not cause significant effects in tolerance to the exercise of this population. However, we should take into consideration the limitations suffered during the research development

Cultural Adaptation and Reliability Analysis of the Modified Dyspnea Index for the Brazilian Culture

This study aims to present the cross-cultural adaptation process of the Modified Dyspnea Index to the Brazilian culture and to investigate its content validity and reliability. This process included the steps of translation, back translation and review by two experts to assess semantic, conceptual, idiomatic, cultural and metabolic equivalence. The Index of Content Validity was used to evaluate the extent of inter-observer agreement. A Guide to implement the Modified Dyspnea Index was developed and validated. Two different professionals assessed the reliability of the Brazilian version of the Modified Dyspnea Index, according to the inter-observer equivalence criterion, with 31 patients, indicating a Kappa coefficient=0.960 (pEste estudio presenta el proceso de adaptación cultural del Modified Dyspnea Index para la cultura brasileña y la evaluación de su validad de contenido y confiabilidad. Este proceso incluyó las etapas de traducción, retrotraducción y evaluación de la equivalencia semántica, idiomática, conceptual, cultural/experimental y metabólica. El Índice de Validad de Contenido fue utilizado para evaluar la proporción de concordancia entre los jueces. Fue desarrollado y validado un guión para orientar la aplicación del Modified Dyspnea Index. Dos diferentes profesionales evaluaron la confiabilidad de la versión brasileña del Modified Dyspnea Index, de acuerdo con el criterio de la equivalencia inter-observador, en 31 pacientes, apuntando para un coeficiente Kappa=0,960 (pEste estudo apresenta o processo de adaptação cultural do Modified Dyspnea Index para a cultura brasileira e a avaliação de sua validade de conteúdo e confiabilidade. Esse processo incluiu as etapas de tradução, retrotradução e avaliação da equivalência semântica, idiomática, conceitual, cultural/experimental e metabólica. Utilizou-se o Índice de Validade de Conteúdo para avaliar a proporção de concordância entre os juízes. Foi desenvolvido e validado um roteiro para nortear a aplicação do Modified Dyspnea Index. Dois diferentes profissionais avaliaram a confiabilidade da versão brasileira do Modified Dyspnea Index, de acordo com o critério da equivalência interobservador, em 31 pacientes, apontando para um coeficiente Kappa=0,960 (p<0,001). A versão brasileira do Modified Dyspnea Index apresentou provas de equivalência interobservador em amostra de pacientes cardíacos

Respir Res

Background: Sexual function is often affected in patients suffering from chronic diseases especially chronic obstructive pulmonary disease (COPD). However, the effect of COPD on sexual satisfaction is underappreciated in clinical practice. The aim of this study is to evaluate the impact of COPD on patient’s sexuality and the explanatory variables of sexual dissatisfaction. Methods: Questionnaires were emailed to participants and they submitted their responses on the Santé Respiratoire France website. Data about sexual well-being (Arizona Sexual Experience Scale, ASEX), Quality of life (VQ11), anxiety, depression (Hospitalized anxiety and depression, HAD) and self-declared COPD grade were collected. Results: Seven hundred and fifty one subjects were included and were characterized as follows: women—51%, mean age—61 years, in a couple—62% and 70%—retired. Every grade of COPD was represented. Out of 751 participants, 301 participants (40%) had no sexual activity and 450 (60%) had sexual activity. From the 450 participants, 60% needed to change their sexual life because of their disease (rhythm, frequency and position). Subjects often used medications to improve sexual performance (43% used short-acting bronchodilator and 13% -specific erectile dysfunction drugs). ASEX questionnaire confirmed patients’ dissatisfaction (diminution of sexual appetite for 68% and sexual desire for 60%) because of breathlessness and fatigue. Eighty one percent of the responders had an altered quality of life (VQ11 mean score 35) and frequent suspected anxiety or depression (HAD mean score 10.8). Ninety percent declared that sexual dysfunction had never been discussed by their doctors, while 36% of patients would have preferred to undergo a specialized consultation. Conclusion: Sexual dysfunction is frequent among COPD patients and leads to an altered well-being, however being a cultural taboo, it remains frequently neglected. Sexual guidance should be a part of patient’s consultations improve quality of sexual life. © 2020, The Author(s)