Digital Health Literacy in the Training of Informal Caregivers – Community Intervention

Background

Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden.

Aim

Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy.

Methods

The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993).

Results

It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all.

Conclusions

Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created.

Key messages

• Primary care health professionals may use digital technologies to promote health literacy.

• Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.

Cross-cultural adaptation and validation of the VISA-A questionnaire for Portuguese-speaking (Portugal) patients with Achilles tendinopathy

Introduction Achilles tendinopathy is considered one of the most frequent injuries in individuals who practice regular physical activity, thus the existence of an instrument that allows the evaluation of the degree of severity of the lesion is important. The VISA-A was developed for English-speaking population to evaluate patients with this condition, and there is a need to adapt this tool to Portuguese (Portugal).

Objectives To cross-cultural adapt and validate the VISA-A questionnaire for Portuguese-speaking (Portugal) Achilles tendinopathy patients.

Methodology The VISA-A questionnaire was translated and cross-culturally adapted into Portuguese (VISA-A-Por) according to specific guidelines, using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 10), and appraisal of the adaptation process. The resulting VISA-A-Por was then subjected to an analysis of the psychometric properties (construct validity, reproducibility [agreement and reliability], internal consistency and floor and ceiling effects) in 57 Achilles tendinopathy patients and 58 asymptomatic people. Participants completed the questionnaire at baseline and after a minimum interval of 48 hours.

Results The Visa-A-Por semantic and content validity was considered good by the expert committee and has construct validity shown by the differences between groups (p < 0,001). The questionnaire presented good internal consistency, with a Cronbach α of 0,88. Concerning reproducibility, agreement levels were considered optimal which can be verified in the Bland Altman graph, the standard error measurement (6,49) and the minimally important change (17,99 points), as well as the excellent ICC value (0,88). No ceiling-floor effect was found.

Conclusion The VISA-A-Por questionnaire has been shown to be equivalent to the original questionnaire, which indicates that it is a valid and reliable measure for the evaluation of the severity and functional impact of patellar tendinopathy in Portuguese-speaking (Portugal) patients.

Cross-cultural adaptation and validation of the VISA-P questionnaire for Portuguese-speaking (Portugal) patients with patellar tendinopathy

Introduction Patellar tendinopathy is a condition frequently verified in individuals who practice regular physical activity, therefore functional evaluation is crucial to monitor symptoms. The VISA-P was developed for English-speaking population to evaluate patients with this condition, and there is a need to adapt this tool to Portuguese (Portugal).

Objectives To cross-cultural adapt and validate the VISA-P questionnaire for Portuguese-speaking (Portugal) patellar tendinopathy patients

Methodology The VISA-P questionnaire was translated and cross-culturally adapted into Portuguese (VISA-P-Por) according to specific guidelines, using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 10), and appraisal of the adaptation process. The resulting VISA-P-Por was then subjected to an analysis of the psychometric properties (construct validity, reproducibility [agreement and reliability], internal consistency and floor and ceiling effects) in 73 patellar tendinopathy patients and 73 asymptomatic people. Participants completed the questionnaire at baseline and after a minimum interval of 48 hours.

Results The Visa-P-Por questionnaire revealed a high level of agreement, presenting semantic and content validity. Construct validity showed differences between both groups (p < 0,001) and the questionnaire exhibited very good internal consistency, with an excellent α Cronbach (0,91). Concerning reproducibility, agreement levels were considered optimal which can be proven by the Bland Altman graph, the standard error of measurement (5,74) and the minimally important change (15,91 points), as well as the excellent ICC value (0,92). There were no ceiling and floor effects detected.

Conclusion The VISA-P-Por questionnaire is a valid and reliable tool, with psychometric properties comparable with the original version. Thus, it can be recommended as a robust tool for measuring clinical severity and functional impact of patellar tendinopathy in Portuguese-speaking (Portugal) patients.

Orthodontic camouflage versus orthodontic-orthognathic surgical treatment in class II malocclusion: a systematic review and meta-analysis

This systematic review was performed to compare dental, skeletal, and aesthetic outcomes between orthodontic camouflage and surgical-orthodontic treatment, in patients with a skeletal class II malocclusion and a retrognathic mandible who have already finished their growth period. A literature search was conducted, and a modified Downs and Black checklist was used to assess methodological quality. The meta-analysis was conducted using the DerSimonian-Laird random-effects method to obtain summary estimates of the standardized mean differences and corresponding 95% confidence intervals. Nine articles were included in the qualitative synthesis and seven in the meta-analysis. The difference between treatments was not statistically significant regarding SNA angle, linear measurement of the lower lip to Ricketts' aesthetic line, convexity of the skeletal profile, or the soft tissue profile excluding the nose. In contrast, surgical-orthodontic treatment was more effective with regard to ANB, SNB, and ML/NSL angles and the soft tissue profile including the nose. Different treatment effects on overjet and overbite were found according to the severity of the initial values. These results should be interpreted with caution, due to the limited number of studies included and because they were non-randomized clinical trials. Further studies with larger sample sizes and similar pre-treatment conditions are needed.