Validação da escala de Catherine Bergego em pacientes com Negligência Espacial Unilateral após acidente vascular cerebral
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Data
2018-06-28
Autores
Marques, Carlos Leonardo Sacomani
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Universidade Estadual Paulista (Unesp)
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Introdução: A negligência espacial unilateral (NEU) é uma manifestação prevalente entre os pacientes com acidente vascular cerebral, porém seu diagnóstico é difícil e sua mensuração e repercussão na vida do paciente carecem de métodos de avaliação. A escala de Catherine Bergego tem por objetivo mensurar esse acometimento e o impacto no cotidiano do paciente. Não há validação desta escala na população brasileira. Objetivo: Avaliar a confiabilidade, compreensão e aceitação da versão em português da escala CBS em paciente com diagnóstico clínico de negligência espacial unilateral após Acidente Vascular Cerebral. Método: CBS foi traduzida, culturalmente adaptada e aplicada por dois investigadores independentes. O estudo foi transversal, em 22 pacientes após AVC confirmado por neuroimagem, tomografia de crânio e/ou ressonância de encéfalo. tomografia computadorizada. Além da CBS, foi aplicada a NHISS na entrada do paciente no hospital e no momento da avaliação da CBS, a BIT para diagnóstico da NEU e Barthel. A consistência e coerência foram analisados por meio de α-Cronbach, confiabilidade interobservador por meio do Kappa e a correlação entre as escalas de CBS, BIT mRS, NIHSS e Barthel por meio do coeficiente de Pearson. Resultados: Foram avaliados 22 pacientes sendo encontrado consistência e coerência de = 0,913, obtendo excelente consistência. Em análise de reprodutibilidade interobservador através do Coeficiente de Kappa, a escala para os 10 itens, mostrou uma confiabilidade razoável e alta entre os avaliadores. A CBS apresentou correlação negativa em comparação com á BIT, sendo que a taxa de concordância interobservador não diferiu significativamente entre as escalas. O resultado da correlação de Pearson realizada entre CBS e BIT foi de 0.03 para o avaliador 1 e 0.03 para o avaliador 2. Além da baixa correlação citada, não obtivemos boa correlação entre os demais escores das escalas de NIHSS, Barthel e Rankin, analisados através do coeficiente de Pearson. Conclusão: A CBS é adequada e validada para estudar pacientes com NEU após AVC em uma população brasileira, multicultural e de língua portuguesa.
Introduction: spatial unilateral neglect (SUN) is a prevalent clinical manifestation in stroke patients, however its diagnosis is difficult, also mensuration and repercussion in patients’ life lacks evaluation methods. Catherine Bergego’s scale (CBS) has the objective of evaluate the impact in quotidian life. There is no validation fo r this scale in Brazilian population. Objective: evaluate confiability, comprehension and acceptation of the Portuguese version of CBS for patients with clinical diagnosis of SUN after stroke. Methods: CBS was translated, culturaly adapted and applied by two independent investigators. It’s a transversal study that evaluated 22 patients with stroke diagnosis confirmed by computed tomography, and a previous score in modified Rankin (mRs) scale of 0. Besides CBS there was application of the National Institute of Health Stroke Scale (NIHSS) at patients’ admission. Together with the CBS the Behaviour Innatention Test (BIT) was applied for NEU diagnosis, and Bartel scale for independency in daily life. Consistency and consistency were analyzed using α-Cronbach, inter-observer reliability using Kappa and the correlation between the CBS, BIT mRS, NIHSS and Barthel scales using the Pearson coefficient. Results: Twenty-two patients were evaluated and was observed consistency and coherence of = 0.913. In the intra-observer reproducibility analysis using the Kappa Coefficient, the scale for the 10 items showed a reasonable and high reliability among the evaluators. CBS had a negative correlation compared to BIT, and the inter-observer agreement rate did not differ significantly between scales. The result of the Pearson correlation between CBS and BIT was 0.03 for the evaluator 1 and 0.03 for the evaluator 2. In addition to the low correlation, we did not obtain a good correlation between the NIHSS, Barthel and Rankin, analyzed using the Pearson coefficient. Conclusion: CBS is adequate and validated to study patients with SUN after stroke in a Brazilian, multicultural and of Portuguese language.
Introduction: spatial unilateral neglect (SUN) is a prevalent clinical manifestation in stroke patients, however its diagnosis is difficult, also mensuration and repercussion in patients’ life lacks evaluation methods. Catherine Bergego’s scale (CBS) has the objective of evaluate the impact in quotidian life. There is no validation fo r this scale in Brazilian population. Objective: evaluate confiability, comprehension and acceptation of the Portuguese version of CBS for patients with clinical diagnosis of SUN after stroke. Methods: CBS was translated, culturaly adapted and applied by two independent investigators. It’s a transversal study that evaluated 22 patients with stroke diagnosis confirmed by computed tomography, and a previous score in modified Rankin (mRs) scale of 0. Besides CBS there was application of the National Institute of Health Stroke Scale (NIHSS) at patients’ admission. Together with the CBS the Behaviour Innatention Test (BIT) was applied for NEU diagnosis, and Bartel scale for independency in daily life. Consistency and consistency were analyzed using α-Cronbach, inter-observer reliability using Kappa and the correlation between the CBS, BIT mRS, NIHSS and Barthel scales using the Pearson coefficient. Results: Twenty-two patients were evaluated and was observed consistency and coherence of = 0.913. In the intra-observer reproducibility analysis using the Kappa Coefficient, the scale for the 10 items showed a reasonable and high reliability among the evaluators. CBS had a negative correlation compared to BIT, and the inter-observer agreement rate did not differ significantly between scales. The result of the Pearson correlation between CBS and BIT was 0.03 for the evaluator 1 and 0.03 for the evaluator 2. In addition to the low correlation, we did not obtain a good correlation between the NIHSS, Barthel and Rankin, analyzed using the Pearson coefficient. Conclusion: CBS is adequate and validated to study patients with SUN after stroke in a Brazilian, multicultural and of Portuguese language.
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Palavras-chave
acidente vascular cerebral, negligência espacial unilateral, stroke, unilateral spatial neglect, rehabilitation, reabilitação