Disfunção vesical na qualidade de vida de pessoas com lesão medular: tradução, adaptação e validação de um instrumento

Abstract

The spinal cord injury (LM) is a secondary event to a damage to the spinal cord, which leads to alteration of motor function, sensory and autonomic. Among the resulting changes, one that is of great concern is the neurogenic voiding dysfunction, because due to the inadequate management of bladder, historically, kidney disease has been the leading cause of death of people with LM. Studies show that urinary incontinence is closely related to quality of life (QV) as well as the depression after LM. Before, the need arose to study the issues related to this theme. In this direction arose the interest in the questionnaire Spinal Cord Injury Bowel and Bladder Treatment Index (SCI-BBTI). The thesis defended in this study was that the SCIBBTI- Bladder is a safe tool to guide health promotion actions with regard to the evaluation of bladder function in people with neurogenic bladder secondary to spinal cord injury, besides the possibility of exchange assistive technologies. It was a quantitative study, cross-sectional design, methodological, divided into the stages of translation, conducted according to the recommendations of the Baits, and inter-examiners reliability test, tested from AC1 Gwet proposed index and the Kappa index, counting on a sample of 50 participants. As a result of the translation phase, of the 29 questions that made up the instrument, only 17 terms presented differences and had to be revised. No adjustments were suggested Bait Committee. The General profile of the participants was composed of men, single, low income and education, with an average age of 31.22 years, with average time of 27.74 months injury. The reliability of the inter examiners was with values above 0.5 in 84 .3 percent of the issues tested with AC1 index of Gwet proved superior to Kappa compared predominated answers with high agreement. Interexaminer reliability evaluation showed that the index of AC1 Gwet, with values above 0.5 at 97.2% of the issues. It is worth noting that these issues where there has been greater divergence are more flexible because they are more subjective points of the routine. It was observed a still high rate of participants who performed the urinary catheterization (64%), 96% of patients present with incontinence and incontinence devices (82%), 64% had been through changes in urinary management last year, 48% made use of antibiotics in the last year and 40% of the total sample submitted at least 1 episode of urinary tract infection last year, 44% of the sample consider that management was a bladder problem that interfered too much in the routine. Against which change post spinal cord injury has more effect on life in general, by the median, "changes in sexual function" and "living with chronic pain had the greatest scores", while "take care of the bladder" came in second place. Thus, it is concluded that the Spinal Cord Injury Bowel and Bladder Treatment Index (SCI-BBTI)- Bladder is adapted transculturally and suitable for application anywhere in Brazil, by multiple examiners, fulfilling the purpose of the questionnaire is to be situational diagnosis tool.