Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba

Detalhes bibliográficos
Autor(a) principal: Soares , Mathaus de Lucena Lira
Data de Publicação: 2020
Tipo de documento: Trabalho de conclusão de curso
Idioma: por
Título da fonte: Repositório do Centro Universitário Braz Cubas
Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1451
Resumo: Multiple sclerosis (MS) is the most prevalent chronic inflammatory disease in the central nervous system (CNS), affecting more than 2 million people worldwide and is currently incurable. Multiple sclerosis can cause important repercussions in the lives of patients, especially the impaired quality of life (QOL) of patients with this disease. Thus, for a greater measurement of the impact on quality of life in people with MS, the structured interview of the abbreviated version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) was used to collect data. In addition, as a way of measuring dysfunctions in functional systems, the Kurtzke Expanded Disability Status Scale (EDSS) is a wellestablished clinical measure for over 30 years and is able to evaluate the evolution of the disease. Therefore, the present study seeked to analyze the quality of life in patients with Multiple Sclerosis at a Reference Center for Multiple Sclerosis in Paraíba (CREM / PB) through the application of WHOQOL-BREF and EDSS between February and March 2020. Therefore, it is a cross-sectional, exploratory and descriptive study. The statistical data were analyzed using IBM SPSS statistics version 26.0. The Spearman correlation showed that there is a negative and reasonable correlation between EDSS and the physical domain of assessing quality of life (ρ = -0.392, p <0.05) and a negative and reasonable correlation between EDSS and field relations aspects of assessing quality of life (ρ = -0.303; p <0.05). There is a positive correlation between the environment domain and the educational level component (ρ = 0.541; p <0.05). Individuals with MS experience decreased perception of QOL in the physical and social relations domains, with greater perception among men to the detriment of women. There is a correlation between the level of disability and quality of life.
id CUB_68ccf45034f2005a328fd3c6f4f80f54
oai_identifier_str oai:repositorio.cruzeirodosul.edu.br:123456789/1451
network_acronym_str CUB
network_name_str Repositório do Centro Universitário Braz Cubas
repository_id_str
spelling Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da ParaíbaQualidade de vidaEsclerose múltiplaWHOQOL-BREFEDSSCNPQ::CIENCIAS DA SAUDE::MEDICINAMultiple sclerosis (MS) is the most prevalent chronic inflammatory disease in the central nervous system (CNS), affecting more than 2 million people worldwide and is currently incurable. Multiple sclerosis can cause important repercussions in the lives of patients, especially the impaired quality of life (QOL) of patients with this disease. Thus, for a greater measurement of the impact on quality of life in people with MS, the structured interview of the abbreviated version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) was used to collect data. In addition, as a way of measuring dysfunctions in functional systems, the Kurtzke Expanded Disability Status Scale (EDSS) is a wellestablished clinical measure for over 30 years and is able to evaluate the evolution of the disease. Therefore, the present study seeked to analyze the quality of life in patients with Multiple Sclerosis at a Reference Center for Multiple Sclerosis in Paraíba (CREM / PB) through the application of WHOQOL-BREF and EDSS between February and March 2020. Therefore, it is a cross-sectional, exploratory and descriptive study. The statistical data were analyzed using IBM SPSS statistics version 26.0. The Spearman correlation showed that there is a negative and reasonable correlation between EDSS and the physical domain of assessing quality of life (ρ = -0.392, p <0.05) and a negative and reasonable correlation between EDSS and field relations aspects of assessing quality of life (ρ = -0.303; p <0.05). There is a positive correlation between the environment domain and the educational level component (ρ = 0.541; p <0.05). Individuals with MS experience decreased perception of QOL in the physical and social relations domains, with greater perception among men to the detriment of women. There is a correlation between the level of disability and quality of life.Agência 2A esclerose múltipla (EM) é a doença inflamatória crônica mais prevalente no sistema nervoso central (SNC), afetando mais de 2 milhões de pessoas em todo o mundo e é atualmente incurável. A esclerose múltipla pode causar repercussões importantes na vida dos pacientes, sobretudo no comprometimento da qualidade de vida (QV) dos portadores dessa doença. Dessa forma, para mensurar o impacto na qualidade de vida em portadores de EM foi utilizada a entrevista estruturada de versão abreviada do Questionário de Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-BREF) para coletar dados. Além disso, como forma de mensurar as disfunções nos sistemas funcionais, foi aplicada a Escala Expandida do Estado de Incapacidade de Kurtzke (EDSS), que é uma medida clínica bem estabelecida há mais de 30 anos e é capaz de monitorar a evolução da doença. Diante disso, o presente trabalho teve como objetivo analisar a qualidade de vida nos pacientes com Esclerose Múltipla de um Centro de Referência de Esclerose Múltipla da Paraíba (CREM/PB) através da aplicação do WHOQOL-BREF e o EDSS entre fevereiro e março de 2020. Sendo, por isso, um estudo transversal, exploratório e descritivo. Os dados estatísticos foram analisados pelo IBM SPSS statistics versão 26.0. A correlação de Spearman mostrou que há uma correlação negativa e razoável entre o EDSS e o domínio físico da avaliação da qualidade de vida (ρ = -0,392; p < 0,05) e uma correlação negativa e razoável entre o EDSS e o domínio relações sociais da avaliação da qualidade de vida (ρ = -0,303; p < 0,05). Existe correlação positiva entre o domínio meio ambiente e o componente nível de escolaridade (ρ = 0,541; p < 0,05). Indivíduos com EM experimentam diminuição da percepção da QV nos domínios físico e relações sociais, com maior percepção entre os homens em detrimento das mulheres. Há uma correlação entre o nível de incapacidade e a qualidade de vida.Centro Universitário de João PessoaBrasilUNIPÊOliveira , Bianca Etelvina Santos dehttp://lattes.cnpq.br/5102486255424808Soares , Mathaus de Lucena Lira2021-02-03T15:06:59Z2021-02-042021-02-03T15:06:59Z2020-05-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/bachelorThesisapplication/pdfhttps://repositorio.cruzeirodosul.edu.br/handle/123456789/1451porALBUQUERQUE, C.; GERALDO, A.; MARTINS, R.; RIBEIRO, O. Quality of Life of People with Multiple Sclerosis: clinical and psychosocial determinants. Procedia - Social And Behavioral Sciences, [s.l.], v. 171, p. 359-365, jan. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.sbspro.2015.01.133. Disponível em: https://www.sciencedirect.com/science/article/pii/S1877042815001639. Acesso em: 06 abr. 2020. ALMEIDA, M.; GUTIERREZ, G. Políticas públicas de lazer e qualidade de vida: a contribuição do conceito de cultura para pensar as políticas de lazer. (67-84). In: VILARTA, Roberto. Qualidade de vida e políticas públicas: saúde, lazer e atividade física. Campinas, SP: IPES editorial, 2004. Disponível em: https://www.fef.unicamp.br/fef/sites/uploads/deafa/qvaf/qualidade_politicas_publicas_comple to.pdf. Acesso em: 14 abr. 2020. AMATO, M.; PONZIANI, G.; ROSSI, F.; LIEDL, C.; STEFANILE, C.; ROSSI, L. Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Multiple Sclerosis Journal, [s.l.], v. 7, n. 5, p. 340-344, out. 2001. SAGE Publications. http://dx.doi.org/10.1177/135245850100700511. Disponível em: https://journals.sagepub.com/doi/abs/10.1177/135245850100700511. Acesso em: 16 abr. 2020. BENITO-LEÓN, J.; MORALES, J.; RIVERA-NAVARRO, J.; MITCHELL, A. A review about the impact of multiple sclerosis on health-related quality of life. Disability And Rehabilitation, [s.l.], v. 25, n. 23, p. 1291-1303, 2 dez. 2003. Informa UK Limited. http://dx.doi.org/10.1080/09638280310001608591. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/14617435. Acesso em: 09 abr. 2020. BOMPREZZI, R. Dimethyl fumarate in the treatment of relapsing–remitting multiple sclerosis: an overview. : an overview. Therapeutic Advances In Neurological Disorders, [s.l.], v. 8, n. 1, p. 20-30, jan. 2015. SAGE Publications. http://dx.doi.org/10.1177/1756285614564152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286944/. Acesso em: 16 abr. 2020. BRAGA, B.; FIRPO, S.; GONZAGA, G. Escolaridade e diferencial de rendimentos entre o setor privado e o setor público no Brasil. Pesquisa e Planejamento Econômico, Brasília-DF, v. 39, n. 3, Ipea, Brasília, dez. 2009. Disponível em: http://repositorio.ipea.gov.br/handle/11058/5110. Acesso em: 15 abr. 2020. BRASIL. Ministério da Saúde S de C Tecnologia e Insumos Estratégicos. Protocolo Clínico e Diretrizes Terapêuticas Esclerose Múltipla., Brasília – DF, p. 1-31, fev. 2019. Disponível em:http://conitec.gov.br/images/Consultas/2019/Relatorio_PCDT_Esclerose_Multipla_CP03_ 2019.pdf. Acesso em: 07 abr. 2020. BRUNO, M.A. Esclerose múltipla com ausência de patologia oro facial. Revista da Faculdade de Ciências da Saúde Porto, v. 1, n. 2, p. 83-96. 2005. Disponível em: https://core.ac.uk/download/pdf/61007463.pdf. Acesso em: 06 abr. 2020. CALMON, A.; PEREIRA, F.; MARIN, B.; PREUX, P.; ALVARENGA, R. Prevalence of Multiple Sclerosis in the City of Volta Redonda - Rio De Janeiro, Brazil Using the CaptureRecapture Method. Neuroepidemiology, [s.l.], v. 46, n. 2, p. 88-95, 6 jan. 2016. S. Karger AG. http://dx.doi.org/10.1159/000442471. Disponível em: https://www.karger.com/Article/Abstract/442471. Acesso em: 13 abr. 2020. CASETTA, I.; RIISE, T.; NORTVEDT, M.; ECONOMOU, N.; GENNARO, R.; FAZIO, P.; CESNIK, E.; GOVONI, V.; GRANIERI, E. Gender differences in health-related quality of life in multiple sclerosis. Multiple Sclerosis Journal, [s.l.], v. 15, n. 11, p. 1339-1346, 1 out. 2009. SAGE Publications. http://dx.doi.org/10.1177/1352458509107016. Disponível em: https://journals.sagepub.com/doi/10.1177/1352458509107016. Acesso em: 16 abr. 2020. CHAN, YH. Biostatistics 104: Correlational Analysis. Singapore Med J.v. 44, n. 12, p. 614- 9. 2005. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/15800720. Acesso em: 14 abr. 2020. CONFAVREUX, C.; VUKUSIC, S.; MOREAU, T.; ADELEINE, P. Relapses and Progression of Disability in Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 343, n. 20, p. 1430-1438, 16 nov. 2000. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejm200011163432001. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJM200011163432001. Acesso em: 15 abr. 2020. CRUZ, L.; POLANCZYK, C.; CAMEY, S.; HOFFMANN, J.; FLECK, M. Quality of life in Brazil: normative values for the Whoqol-bref in a southern general population sample. Quality Of Life Research, [s.l.], v. 20, n. 7, p. 1123-1129, 29 jan. 2011. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s11136-011-9845-3. Disponível em: https://link.springer.com/article/10.1007/s11136-011-9845-3. Acesso em: 15 abr. 2020. DINTER, H.; STOCK, G.; PEREZ, H. D. Multiple sclerosis: pathogenesis and models. : pathogenesis and models. Journal Of Molecular Medicine, [s.l.], v. 75, n. 3, p. 164-164, 18 mar. 1997. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s001090050100. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/9106072. Acesso em: 16 abr. 2020. DOBSON, R.; GIOVANNONI, G. Multiple sclerosis – a review. European Journal Of Neurology, [s.l.], v. 26, n. 1, p. 27-40, 18 nov. 2018. Wiley. http://dx.doi.org/10.1111/ene.13819. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/30300457. Acesso em: 08 abr. 2020. GULICK, Elsie E. Correlates of Quality of Life Among Persons With Multiple Sclerosis. Nursing Research, [s.l.], v. 46, n. 6, p. 305-311, nov. 1997. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1097/00006199-199711000-00002. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/9422048. Acesso em: 12 abr. 2020. KAHRAMAN, Turhan; SAVCI, Sema; POYRAZ, Esra Coskuner; OZAKBAS, Serkan; IDIMAN, Egemen. Utilization of the Expanded Disability Status Scale as a distinctive instrument for walking impairment in persons with multiple sclerosis with mild disability. Neurorehabilitation, [s.l.], v. 38, n. 1, p. 7-14, 10 fev. 2016. IOS Press. http://dx.doi.org/10.3233/nre-151290. Disponível em: https://content.iospress.com/articles/neurorehabilitation/nre1290. Acesso em: 12 abr. 2020. KASPER, D., BRAUNWALD, E., FAUCI, A., HAUSER, S., LONGO, D., JAMESON, J. Harrison´s Principles of Internal Medicine.16.ed. Estados Unidos da América: McGrawHill Companies Inc. 2005 KOBELT, Gisela; TEICH, Vanessa; CAVALCANTI, Marcela; CANZONIERI, Ana Maria. Burden and cost of multiple sclerosis in Brazil. Plos One, [s.l.], v. 14, n. 1, p. 1-10, 23 jan. 2019. Public Library of Science (PLoS). http://dx.doi.org/10.1371/journal.pone.0208837. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208837. Acesso em: 07 abr. 2020. KOOHI, F.; NEDJAT, S.; YASERI, M.; CHERAGHI, Z. Quality of Life among General Populations of Different Countries in the Past 10 Years, with a Focus on Human Development Index: A Systematic Review and Meta-analysis. Iranian Journal of Public Health, v. 46, n. 1, P. 12-22, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28451525/. Acesso em: 15 abr. 2020. KURTZKE, J.F. Historical and Clinical Perspectives of the Expanded Disability Status Scale. Neuroepidemiology, 2008. Disponível em: https://www.karger.com/Article/Pdf/136645. Acesso em: 07 abr. 2020. LERAY, E.; MOREAU, T.; FROMONT, A.; EDAN, G. Epidemiology of multiple sclerosis. Revue Neurologique, [s.l.], v. 172, n. 1, p. 3-13, jan. 2016. Elsevier BV. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0035378715009194. Acesso em: 10 abr. 2020. LUBLIN, F. D.; REINGOLD, S. C.; COHEN, J. A.; CUTTER, G. R.; SORENSEN, P. S.; THOMPSON, A. J.; WOLINSKY, J. S.; BALCER, L. J.; BANWELL, B.; BARKHOF, F. Defining the clinical course of multiple sclerosis: the 2013 revisions. : The 2013 revisions. Neurology, [s.l.], v. 83, n. 3, p. 278-286, 28 maio 2014. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1212/wnl.0000000000000560. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117366/. Acesso em: 06 abr. 2020. MILLER, D. H., KHAN, O. A., SHEREMATA, W. A., BLUMHARDT, L. D., RICE, G. P. A., LIBONATI, M. A., O’CONNOR, P. W. A Controlled Trial of Natalizumab for Relapsing Multiple Sclerosis. New England Journal of Medicine, v. 348, n.1, 15–23, 2003. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/12510038. Acesso em: 16 abr. 2020. MS INTERNATIONAL FEDERATION. Symptoms: Everyone with Multiple Sclerosis has a different set of symptoms. 2019. Disponível em: https://www.msif.org/about-ms/symptomsof-ms/. Acesso em: 06 abr. 2020. NEVES, C.; RENTE, J.; FERREIRA, A.; GARRETT, A. Quality of life of people with multiple sclerosis and their caregivers. Revista de Enfermagem Referência, [s.l.], v. 4, n. 12, p. 85-96, 24 mar. 2017. Health Sciences Research Unit: Nursing. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_abstract&pid=S0874- 02832017000100010&lng=pt&nrm=iso&tlng=en. Acesso em: 06 abr. 2020. NOSEWORTHY, J.; LUCCHINETTI, C.; RODRIGUEZ, M.; WEINSHENKER, B. Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 343, n. 13, p. 938-952, 28 set. 2000. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejm200009283431307. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/11006371. Acesso em: 07 abr. 2020. PATWARDHAN, M.; MATCHAR, D.; SAMSA, G.; MCCRORY, D.; WILLIAMS, R.; LI, T. Cost of multiple sclerosis by level of disability: a review of literature. : a review of literature. Multiple Sclerosis Journal, [s.l.], v. 11, n. 2, p. 232-239, abr. 2005. SAGE Publications. http://dx.doi.org/10.1191/1352458505ms1137oa. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/15794399. Acesso em: 08 abr. 2020. PEREIRA, A.; LACATIVA, M.; PEREIRA, F.; ALVARENGA, R. Prevalence of multiple sclerosis in Brazil: a systematic review. : A systematic review. Multiple Sclerosis And Related Disorders, [s.l.], v. 4, n. 6, p. 572-579, nov. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.msard.2015.08.004. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26590664. Acesso em: 15 abr. 2020. PEREIRA, E.; TEIXEIRA, C.; SANTOS, A. Qualidade de vida: abordagens, conceitos e avaliação. Revista Brasileira de Educação Física e Esporte, [s.l.], v. 26, n. 2, p. 241-250, jun. 2012. FapUNIFESP (SciELO). Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-55092012000200007. Acesso em: 15 abr. 2020. PITTOCK, S.; MAYR, W.; MCCLELLAND, R.; JORGENSEN, N.; WEIGAND, S.; NOSEWORTHY, J.; RODRIGUEZ, M. Quality of Life Is Favorable for Most Patients With Multiple Sclerosis. Archives Of Neurology, [s.l.], v. 61, n. 5, p. 679-687, 1 maio 2004. American Medical Association (AMA). http://dx.doi.org/10.1001/archneur.61.5.679. Disponível em: https://jamanetwork.com/journals/jamaneurology/fullarticle/785828. Acesso em: 16 abr. 2020. POLMAN, C.; REINGOLD, S.; EDAN, G.; FILIPPI, M.; HARTUNG, H.; KAPPOS, L.; LUBLIN, F.; METZ, L.; MCFARLAND, H.; O'CONNOR, P. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “mcdonald criteria”. : 2005 revisions to the “McDonald Criteria”. Annals Of Neurology, [s.l.], v. 58, n. 6, p. 840-846, 2005. Wiley. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/16283615. Acesso em: 10 abr. 2020. PROVINCIALI, L.; CERAVOLO, M. G.; BARTOLINI, M.; LOGULLO, F.; DANNI, M. A multidimensional assessment of multiple sclerosis: relationships between disability domains. Acta Neurologica Scandinavica, [s.l.], v. 100, n. 3, p. 156-162, 29 jan. 2009. Wiley. http://dx.doi.org/10.1111/j.1600-0404.1999.tb00731.x. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/10478578. Acesso em: 10 abr. 2020. REICH, D.; LUCCHINETTI, C.; CALABRESI, P.. Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 378, n. 2, p. 169-180, 11 jan. 2018. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejmra1401483. Disponível em: https://www.nejm.org/doi/10.1056/NEJMra1401483. Acesso em: 19 mar. 2020. SACCÀ, F.; COSTABILE, T.; CAROTENUTO, A.; LANZILLO, R.; MOCCIA, M.; PANE, C.; RUSSO, C.; BARBARULO, A.; CASERTANO, S.; ROSSI, F.. The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests. Multiple Sclerosis Journal, [s.l.], v. 23, n. 9, p. 1289-1296, 3 nov. 2016. SAGE Publications. http://dx.doi.org/10.1177/1352458516677592. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27811338. Acesso em: 11 abr. 2020. SILVA, P.; SOARES, S.; SANTOS, J.; SILVA, L. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults. Revista de Saúde Pública, [s.l.], v. 48, n. 3, p. 390- 397, jun. 2014. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/s0034- 8910.2014048004912. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102014000300390. Acesso em: 02 mar. 2020. SINGER, M.; HOPMAN, W.; MACKENZIE, T. Physical functioning and mental health in patients with chronic medical conditions. Quality Of Life Research, [s.l.], v. 8, n. 8, p. 687- 691, 1999. Springer Science and Business Media LLC. http://dx.doi.org/10.1023/a:1008917016998. Disponível em: https://link.springer.com/article/10.1023%2FA%3A1008917016998. Acesso em: 16 abr. 2020. SMOLDERS, J.; MENHEERE, P.; KESSELS, A.; DAMOISEAUX, J.; HUPPERTS, R. Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis. Multiple Sclerosis Journal, [s.l.], v. 14, n. 9, p. 1220-1224, 24 jul. 2008. SAGE Publications. http://dx.doi.org/10.1177/1352458508094399. Disponível em: https://journals.sagepub.com/doi/10.1177/1352458508094399. Acesso em: 16 abr. 2020. THOMPSON, A.; BANWELL, B.; BARKHOF, F.; CARROLL, W.; COETZEE, T.; COMI, G.; CORREALE, J.; FAZEKAS, F.; FILIPPI, M.; FREEDMAN, M.. Diagnosis of multiple sclerosis: 2017 revisions of the mcdonald criteria. : 2017 revisions of the McDonald criteria. The Lancet Neurology, [s.l.], v. 17, n. 2, p. 162-173, fev. 2018. Elsevier BV. http://dx.doi.org/10.1016/s1474-4422(17)30470-2. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29275977. Acesso em: 08 abr. 2020. TAKEMOTO, M.; SILVA, N.; RIBEIRO-PEREIRA, A.; SCHILITHZ, A.; SUZUKI, C. Differences in utility scores obtained through Brazilian and UK value sets: a cross-sectional study. : a cross-sectional study. Health And Quality Of Life Outcomes, [s.l.], v. 13, n. 1, p. 119-128, 6 ago. 2015. Springer Science and Business Media LLC. Disponível em: https://hqlo.biomedcentral.com/articles/10.1186/s12955-015-0318-1. Acesso em: 07 abr. 2020. TWORK, S.; WIESMETH, S.; SPINDLER, M.; WIRTZ, M.; SCHIPPER, S.; POEHLAU, D.; KLEWER, J.; KUGLER, J. Disability status and quality of life in multiple sclerosis: nonlinearity of the expanded disability status scale (edss). : non-linearity of the Expanded Disability Status Scale (EDSS). Health And Quality Of Life Outcomes, [s.l.], v. 8, n. 1, p. 55-61, 2010. Springer Science and Business Media LLC. http://dx.doi.org/10.1186/1477- 7525-8-55. Disponível em: https://hqlo.biomedcentral.com/articles/10.1186/1477-7525-8-55. Acesso em: 16 abr. 2020. WORLD HEALTH ORGANIZATION & MULTIPLE SCLEROSIS INTERNATIONAL FEDERATION. Atlas multiple sclerosis resources in the world 2008. Geneva: World Health Organization. 2008. Disponível em: https://www.who.int/mental_health/neurology/Atlas_MS_WEB.pdf. Acesso em: 08 abr. 2020. WORLD HEALTH ORGANIZATION. Programme on mental health. WHOQOL user manual, 2012 revision. Geneva: World Health Organization. 1998. Disponível em: https://apps.who.int/iris/handle/10665/77932. Acesso em: 06 mar. 2020. WORLD HEALTH ORGANIZATION. The World Health Organization quality of life (WHOQOL) - BREF, 2012 revision. World Health Organization. 2012. Disponível em: https://apps.who.int/iris/handle/10665/77773. Acesso em: 06 mar. 2020.info:eu-repo/semantics/openAccessreponame:Repositório do Centro Universitário Braz Cubasinstname:Centro Universitário Braz Cubas (CUB)instacron:CUB2021-02-03T15:07:50Zoai:repositorio.cruzeirodosul.edu.br:123456789/1451Repositório InstitucionalPUBhttps://repositorio.brazcubas.edu.br/oai/requestbibli@brazcubas.edu.bropendoar:2021-02-03T15:07:50Repositório do Centro Universitário Braz Cubas - Centro Universitário Braz Cubas (CUB)false
dc.title.none.fl_str_mv Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
title Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
spellingShingle Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
Soares , Mathaus de Lucena Lira
Qualidade de vida
Esclerose múltipla
WHOQOL-BREF
EDSS
CNPQ::CIENCIAS DA SAUDE::MEDICINA
title_short Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
title_full Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
title_fullStr Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
title_full_unstemmed Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
title_sort Avaliação da qualidade de vida em indivíduos com esclerose múltipla em um centro de referência da Paraíba
author Soares , Mathaus de Lucena Lira
author_facet Soares , Mathaus de Lucena Lira
author_role author
dc.contributor.none.fl_str_mv Oliveira , Bianca Etelvina Santos de
http://lattes.cnpq.br/5102486255424808
dc.contributor.author.fl_str_mv Soares , Mathaus de Lucena Lira
dc.subject.por.fl_str_mv Qualidade de vida
Esclerose múltipla
WHOQOL-BREF
EDSS
CNPQ::CIENCIAS DA SAUDE::MEDICINA
topic Qualidade de vida
Esclerose múltipla
WHOQOL-BREF
EDSS
CNPQ::CIENCIAS DA SAUDE::MEDICINA
description Multiple sclerosis (MS) is the most prevalent chronic inflammatory disease in the central nervous system (CNS), affecting more than 2 million people worldwide and is currently incurable. Multiple sclerosis can cause important repercussions in the lives of patients, especially the impaired quality of life (QOL) of patients with this disease. Thus, for a greater measurement of the impact on quality of life in people with MS, the structured interview of the abbreviated version of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF) was used to collect data. In addition, as a way of measuring dysfunctions in functional systems, the Kurtzke Expanded Disability Status Scale (EDSS) is a wellestablished clinical measure for over 30 years and is able to evaluate the evolution of the disease. Therefore, the present study seeked to analyze the quality of life in patients with Multiple Sclerosis at a Reference Center for Multiple Sclerosis in Paraíba (CREM / PB) through the application of WHOQOL-BREF and EDSS between February and March 2020. Therefore, it is a cross-sectional, exploratory and descriptive study. The statistical data were analyzed using IBM SPSS statistics version 26.0. The Spearman correlation showed that there is a negative and reasonable correlation between EDSS and the physical domain of assessing quality of life (ρ = -0.392, p <0.05) and a negative and reasonable correlation between EDSS and field relations aspects of assessing quality of life (ρ = -0.303; p <0.05). There is a positive correlation between the environment domain and the educational level component (ρ = 0.541; p <0.05). Individuals with MS experience decreased perception of QOL in the physical and social relations domains, with greater perception among men to the detriment of women. There is a correlation between the level of disability and quality of life.
publishDate 2020
dc.date.none.fl_str_mv 2020-05-25
2021-02-03T15:06:59Z
2021-02-04
2021-02-03T15:06:59Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/bachelorThesis
format bachelorThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://repositorio.cruzeirodosul.edu.br/handle/123456789/1451
url https://repositorio.cruzeirodosul.edu.br/handle/123456789/1451
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv ALBUQUERQUE, C.; GERALDO, A.; MARTINS, R.; RIBEIRO, O. Quality of Life of People with Multiple Sclerosis: clinical and psychosocial determinants. Procedia - Social And Behavioral Sciences, [s.l.], v. 171, p. 359-365, jan. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.sbspro.2015.01.133. Disponível em: https://www.sciencedirect.com/science/article/pii/S1877042815001639. Acesso em: 06 abr. 2020. ALMEIDA, M.; GUTIERREZ, G. Políticas públicas de lazer e qualidade de vida: a contribuição do conceito de cultura para pensar as políticas de lazer. (67-84). In: VILARTA, Roberto. Qualidade de vida e políticas públicas: saúde, lazer e atividade física. Campinas, SP: IPES editorial, 2004. Disponível em: https://www.fef.unicamp.br/fef/sites/uploads/deafa/qvaf/qualidade_politicas_publicas_comple to.pdf. Acesso em: 14 abr. 2020. AMATO, M.; PONZIANI, G.; ROSSI, F.; LIEDL, C.; STEFANILE, C.; ROSSI, L. Quality of life in multiple sclerosis: the impact of depression, fatigue and disability. Multiple Sclerosis Journal, [s.l.], v. 7, n. 5, p. 340-344, out. 2001. SAGE Publications. http://dx.doi.org/10.1177/135245850100700511. Disponível em: https://journals.sagepub.com/doi/abs/10.1177/135245850100700511. Acesso em: 16 abr. 2020. BENITO-LEÓN, J.; MORALES, J.; RIVERA-NAVARRO, J.; MITCHELL, A. A review about the impact of multiple sclerosis on health-related quality of life. Disability And Rehabilitation, [s.l.], v. 25, n. 23, p. 1291-1303, 2 dez. 2003. Informa UK Limited. http://dx.doi.org/10.1080/09638280310001608591. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/14617435. Acesso em: 09 abr. 2020. BOMPREZZI, R. Dimethyl fumarate in the treatment of relapsing–remitting multiple sclerosis: an overview. : an overview. Therapeutic Advances In Neurological Disorders, [s.l.], v. 8, n. 1, p. 20-30, jan. 2015. SAGE Publications. http://dx.doi.org/10.1177/1756285614564152. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286944/. Acesso em: 16 abr. 2020. BRAGA, B.; FIRPO, S.; GONZAGA, G. Escolaridade e diferencial de rendimentos entre o setor privado e o setor público no Brasil. Pesquisa e Planejamento Econômico, Brasília-DF, v. 39, n. 3, Ipea, Brasília, dez. 2009. Disponível em: http://repositorio.ipea.gov.br/handle/11058/5110. Acesso em: 15 abr. 2020. BRASIL. Ministério da Saúde S de C Tecnologia e Insumos Estratégicos. Protocolo Clínico e Diretrizes Terapêuticas Esclerose Múltipla., Brasília – DF, p. 1-31, fev. 2019. Disponível em:http://conitec.gov.br/images/Consultas/2019/Relatorio_PCDT_Esclerose_Multipla_CP03_ 2019.pdf. Acesso em: 07 abr. 2020. BRUNO, M.A. Esclerose múltipla com ausência de patologia oro facial. Revista da Faculdade de Ciências da Saúde Porto, v. 1, n. 2, p. 83-96. 2005. Disponível em: https://core.ac.uk/download/pdf/61007463.pdf. Acesso em: 06 abr. 2020. CALMON, A.; PEREIRA, F.; MARIN, B.; PREUX, P.; ALVARENGA, R. Prevalence of Multiple Sclerosis in the City of Volta Redonda - Rio De Janeiro, Brazil Using the CaptureRecapture Method. Neuroepidemiology, [s.l.], v. 46, n. 2, p. 88-95, 6 jan. 2016. S. Karger AG. http://dx.doi.org/10.1159/000442471. Disponível em: https://www.karger.com/Article/Abstract/442471. Acesso em: 13 abr. 2020. CASETTA, I.; RIISE, T.; NORTVEDT, M.; ECONOMOU, N.; GENNARO, R.; FAZIO, P.; CESNIK, E.; GOVONI, V.; GRANIERI, E. Gender differences in health-related quality of life in multiple sclerosis. Multiple Sclerosis Journal, [s.l.], v. 15, n. 11, p. 1339-1346, 1 out. 2009. SAGE Publications. http://dx.doi.org/10.1177/1352458509107016. Disponível em: https://journals.sagepub.com/doi/10.1177/1352458509107016. Acesso em: 16 abr. 2020. CHAN, YH. Biostatistics 104: Correlational Analysis. Singapore Med J.v. 44, n. 12, p. 614- 9. 2005. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/15800720. Acesso em: 14 abr. 2020. CONFAVREUX, C.; VUKUSIC, S.; MOREAU, T.; ADELEINE, P. Relapses and Progression of Disability in Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 343, n. 20, p. 1430-1438, 16 nov. 2000. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejm200011163432001. Disponível em: https://www.nejm.org/doi/full/10.1056/NEJM200011163432001. Acesso em: 15 abr. 2020. CRUZ, L.; POLANCZYK, C.; CAMEY, S.; HOFFMANN, J.; FLECK, M. Quality of life in Brazil: normative values for the Whoqol-bref in a southern general population sample. Quality Of Life Research, [s.l.], v. 20, n. 7, p. 1123-1129, 29 jan. 2011. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s11136-011-9845-3. Disponível em: https://link.springer.com/article/10.1007/s11136-011-9845-3. Acesso em: 15 abr. 2020. DINTER, H.; STOCK, G.; PEREZ, H. D. Multiple sclerosis: pathogenesis and models. : pathogenesis and models. Journal Of Molecular Medicine, [s.l.], v. 75, n. 3, p. 164-164, 18 mar. 1997. Springer Science and Business Media LLC. http://dx.doi.org/10.1007/s001090050100. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/9106072. Acesso em: 16 abr. 2020. DOBSON, R.; GIOVANNONI, G. Multiple sclerosis – a review. European Journal Of Neurology, [s.l.], v. 26, n. 1, p. 27-40, 18 nov. 2018. Wiley. http://dx.doi.org/10.1111/ene.13819. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/30300457. Acesso em: 08 abr. 2020. GULICK, Elsie E. Correlates of Quality of Life Among Persons With Multiple Sclerosis. Nursing Research, [s.l.], v. 46, n. 6, p. 305-311, nov. 1997. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1097/00006199-199711000-00002. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/9422048. Acesso em: 12 abr. 2020. KAHRAMAN, Turhan; SAVCI, Sema; POYRAZ, Esra Coskuner; OZAKBAS, Serkan; IDIMAN, Egemen. Utilization of the Expanded Disability Status Scale as a distinctive instrument for walking impairment in persons with multiple sclerosis with mild disability. Neurorehabilitation, [s.l.], v. 38, n. 1, p. 7-14, 10 fev. 2016. IOS Press. http://dx.doi.org/10.3233/nre-151290. Disponível em: https://content.iospress.com/articles/neurorehabilitation/nre1290. Acesso em: 12 abr. 2020. KASPER, D., BRAUNWALD, E., FAUCI, A., HAUSER, S., LONGO, D., JAMESON, J. Harrison´s Principles of Internal Medicine.16.ed. Estados Unidos da América: McGrawHill Companies Inc. 2005 KOBELT, Gisela; TEICH, Vanessa; CAVALCANTI, Marcela; CANZONIERI, Ana Maria. Burden and cost of multiple sclerosis in Brazil. Plos One, [s.l.], v. 14, n. 1, p. 1-10, 23 jan. 2019. Public Library of Science (PLoS). http://dx.doi.org/10.1371/journal.pone.0208837. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208837. Acesso em: 07 abr. 2020. KOOHI, F.; NEDJAT, S.; YASERI, M.; CHERAGHI, Z. Quality of Life among General Populations of Different Countries in the Past 10 Years, with a Focus on Human Development Index: A Systematic Review and Meta-analysis. Iranian Journal of Public Health, v. 46, n. 1, P. 12-22, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28451525/. Acesso em: 15 abr. 2020. KURTZKE, J.F. Historical and Clinical Perspectives of the Expanded Disability Status Scale. Neuroepidemiology, 2008. Disponível em: https://www.karger.com/Article/Pdf/136645. Acesso em: 07 abr. 2020. LERAY, E.; MOREAU, T.; FROMONT, A.; EDAN, G. Epidemiology of multiple sclerosis. Revue Neurologique, [s.l.], v. 172, n. 1, p. 3-13, jan. 2016. Elsevier BV. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0035378715009194. Acesso em: 10 abr. 2020. LUBLIN, F. D.; REINGOLD, S. C.; COHEN, J. A.; CUTTER, G. R.; SORENSEN, P. S.; THOMPSON, A. J.; WOLINSKY, J. S.; BALCER, L. J.; BANWELL, B.; BARKHOF, F. Defining the clinical course of multiple sclerosis: the 2013 revisions. : The 2013 revisions. Neurology, [s.l.], v. 83, n. 3, p. 278-286, 28 maio 2014. Ovid Technologies (Wolters Kluwer Health). http://dx.doi.org/10.1212/wnl.0000000000000560. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117366/. Acesso em: 06 abr. 2020. MILLER, D. H., KHAN, O. A., SHEREMATA, W. A., BLUMHARDT, L. D., RICE, G. P. A., LIBONATI, M. A., O’CONNOR, P. W. A Controlled Trial of Natalizumab for Relapsing Multiple Sclerosis. New England Journal of Medicine, v. 348, n.1, 15–23, 2003. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/12510038. Acesso em: 16 abr. 2020. MS INTERNATIONAL FEDERATION. Symptoms: Everyone with Multiple Sclerosis has a different set of symptoms. 2019. Disponível em: https://www.msif.org/about-ms/symptomsof-ms/. Acesso em: 06 abr. 2020. NEVES, C.; RENTE, J.; FERREIRA, A.; GARRETT, A. Quality of life of people with multiple sclerosis and their caregivers. Revista de Enfermagem Referência, [s.l.], v. 4, n. 12, p. 85-96, 24 mar. 2017. Health Sciences Research Unit: Nursing. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_abstract&pid=S0874- 02832017000100010&lng=pt&nrm=iso&tlng=en. Acesso em: 06 abr. 2020. NOSEWORTHY, J.; LUCCHINETTI, C.; RODRIGUEZ, M.; WEINSHENKER, B. Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 343, n. 13, p. 938-952, 28 set. 2000. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejm200009283431307. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/11006371. Acesso em: 07 abr. 2020. PATWARDHAN, M.; MATCHAR, D.; SAMSA, G.; MCCRORY, D.; WILLIAMS, R.; LI, T. Cost of multiple sclerosis by level of disability: a review of literature. : a review of literature. Multiple Sclerosis Journal, [s.l.], v. 11, n. 2, p. 232-239, abr. 2005. SAGE Publications. http://dx.doi.org/10.1191/1352458505ms1137oa. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/15794399. Acesso em: 08 abr. 2020. PEREIRA, A.; LACATIVA, M.; PEREIRA, F.; ALVARENGA, R. Prevalence of multiple sclerosis in Brazil: a systematic review. : A systematic review. Multiple Sclerosis And Related Disorders, [s.l.], v. 4, n. 6, p. 572-579, nov. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.msard.2015.08.004. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26590664. Acesso em: 15 abr. 2020. PEREIRA, E.; TEIXEIRA, C.; SANTOS, A. Qualidade de vida: abordagens, conceitos e avaliação. Revista Brasileira de Educação Física e Esporte, [s.l.], v. 26, n. 2, p. 241-250, jun. 2012. FapUNIFESP (SciELO). Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-55092012000200007. Acesso em: 15 abr. 2020. PITTOCK, S.; MAYR, W.; MCCLELLAND, R.; JORGENSEN, N.; WEIGAND, S.; NOSEWORTHY, J.; RODRIGUEZ, M. Quality of Life Is Favorable for Most Patients With Multiple Sclerosis. Archives Of Neurology, [s.l.], v. 61, n. 5, p. 679-687, 1 maio 2004. American Medical Association (AMA). http://dx.doi.org/10.1001/archneur.61.5.679. Disponível em: https://jamanetwork.com/journals/jamaneurology/fullarticle/785828. Acesso em: 16 abr. 2020. POLMAN, C.; REINGOLD, S.; EDAN, G.; FILIPPI, M.; HARTUNG, H.; KAPPOS, L.; LUBLIN, F.; METZ, L.; MCFARLAND, H.; O'CONNOR, P. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “mcdonald criteria”. : 2005 revisions to the “McDonald Criteria”. Annals Of Neurology, [s.l.], v. 58, n. 6, p. 840-846, 2005. Wiley. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/16283615. Acesso em: 10 abr. 2020. PROVINCIALI, L.; CERAVOLO, M. G.; BARTOLINI, M.; LOGULLO, F.; DANNI, M. A multidimensional assessment of multiple sclerosis: relationships between disability domains. Acta Neurologica Scandinavica, [s.l.], v. 100, n. 3, p. 156-162, 29 jan. 2009. Wiley. http://dx.doi.org/10.1111/j.1600-0404.1999.tb00731.x. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/10478578. Acesso em: 10 abr. 2020. REICH, D.; LUCCHINETTI, C.; CALABRESI, P.. Multiple Sclerosis. New England Journal Of Medicine, [s.l.], v. 378, n. 2, p. 169-180, 11 jan. 2018. Massachusetts Medical Society. http://dx.doi.org/10.1056/nejmra1401483. Disponível em: https://www.nejm.org/doi/10.1056/NEJMra1401483. Acesso em: 19 mar. 2020. SACCÀ, F.; COSTABILE, T.; CAROTENUTO, A.; LANZILLO, R.; MOCCIA, M.; PANE, C.; RUSSO, C.; BARBARULO, A.; CASERTANO, S.; ROSSI, F.. The EDSS integration with the Brief International Cognitive Assessment for Multiple Sclerosis and orientation tests. Multiple Sclerosis Journal, [s.l.], v. 23, n. 9, p. 1289-1296, 3 nov. 2016. SAGE Publications. http://dx.doi.org/10.1177/1352458516677592. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27811338. Acesso em: 11 abr. 2020. SILVA, P.; SOARES, S.; SANTOS, J.; SILVA, L. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults. Revista de Saúde Pública, [s.l.], v. 48, n. 3, p. 390- 397, jun. 2014. FapUNIFESP (SciELO). http://dx.doi.org/10.1590/s0034- 8910.2014048004912. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102014000300390. Acesso em: 02 mar. 2020. SINGER, M.; HOPMAN, W.; MACKENZIE, T. Physical functioning and mental health in patients with chronic medical conditions. Quality Of Life Research, [s.l.], v. 8, n. 8, p. 687- 691, 1999. Springer Science and Business Media LLC. http://dx.doi.org/10.1023/a:1008917016998. Disponível em: https://link.springer.com/article/10.1023%2FA%3A1008917016998. Acesso em: 16 abr. 2020. SMOLDERS, J.; MENHEERE, P.; KESSELS, A.; DAMOISEAUX, J.; HUPPERTS, R. Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis. Multiple Sclerosis Journal, [s.l.], v. 14, n. 9, p. 1220-1224, 24 jul. 2008. SAGE Publications. http://dx.doi.org/10.1177/1352458508094399. Disponível em: https://journals.sagepub.com/doi/10.1177/1352458508094399. Acesso em: 16 abr. 2020. THOMPSON, A.; BANWELL, B.; BARKHOF, F.; CARROLL, W.; COETZEE, T.; COMI, G.; CORREALE, J.; FAZEKAS, F.; FILIPPI, M.; FREEDMAN, M.. Diagnosis of multiple sclerosis: 2017 revisions of the mcdonald criteria. : 2017 revisions of the McDonald criteria. The Lancet Neurology, [s.l.], v. 17, n. 2, p. 162-173, fev. 2018. Elsevier BV. http://dx.doi.org/10.1016/s1474-4422(17)30470-2. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29275977. Acesso em: 08 abr. 2020. TAKEMOTO, M.; SILVA, N.; RIBEIRO-PEREIRA, A.; SCHILITHZ, A.; SUZUKI, C. Differences in utility scores obtained through Brazilian and UK value sets: a cross-sectional study. : a cross-sectional study. Health And Quality Of Life Outcomes, [s.l.], v. 13, n. 1, p. 119-128, 6 ago. 2015. Springer Science and Business Media LLC. Disponível em: https://hqlo.biomedcentral.com/articles/10.1186/s12955-015-0318-1. Acesso em: 07 abr. 2020. TWORK, S.; WIESMETH, S.; SPINDLER, M.; WIRTZ, M.; SCHIPPER, S.; POEHLAU, D.; KLEWER, J.; KUGLER, J. Disability status and quality of life in multiple sclerosis: nonlinearity of the expanded disability status scale (edss). : non-linearity of the Expanded Disability Status Scale (EDSS). Health And Quality Of Life Outcomes, [s.l.], v. 8, n. 1, p. 55-61, 2010. Springer Science and Business Media LLC. http://dx.doi.org/10.1186/1477- 7525-8-55. Disponível em: https://hqlo.biomedcentral.com/articles/10.1186/1477-7525-8-55. Acesso em: 16 abr. 2020. WORLD HEALTH ORGANIZATION & MULTIPLE SCLEROSIS INTERNATIONAL FEDERATION. Atlas multiple sclerosis resources in the world 2008. Geneva: World Health Organization. 2008. Disponível em: https://www.who.int/mental_health/neurology/Atlas_MS_WEB.pdf. Acesso em: 08 abr. 2020. WORLD HEALTH ORGANIZATION. Programme on mental health. WHOQOL user manual, 2012 revision. Geneva: World Health Organization. 1998. Disponível em: https://apps.who.int/iris/handle/10665/77932. Acesso em: 06 mar. 2020. WORLD HEALTH ORGANIZATION. The World Health Organization quality of life (WHOQOL) - BREF, 2012 revision. World Health Organization. 2012. Disponível em: https://apps.who.int/iris/handle/10665/77773. Acesso em: 06 mar. 2020.
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Centro Universitário de João Pessoa
Brasil
UNIPÊ
publisher.none.fl_str_mv Centro Universitário de João Pessoa
Brasil
UNIPÊ
dc.source.none.fl_str_mv reponame:Repositório do Centro Universitário Braz Cubas
instname:Centro Universitário Braz Cubas (CUB)
instacron:CUB
instname_str Centro Universitário Braz Cubas (CUB)
instacron_str CUB
institution CUB
reponame_str Repositório do Centro Universitário Braz Cubas
collection Repositório do Centro Universitário Braz Cubas
repository.name.fl_str_mv Repositório do Centro Universitário Braz Cubas - Centro Universitário Braz Cubas (CUB)
repository.mail.fl_str_mv bibli@brazcubas.edu.br
_version_ 1798311340587089920