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&#233; instrumento gen&#233;rico&#44; autopreenchido&#44; para a avalia&#231;&#227;o do impacto secund&#225;rio aos conviventes com portadores de doen&#231;as dermatol&#243;gicas&#46; Comp&#245;e&#8208;se de 10 itens de respostas graduadas em escala do tipo <span class="elsevierStyleItalic">Likert</span>&#44; que variam de 0 &#40;&#8220;nada&#8221;&#41; a 3 &#40;&#8220;muit&#237;ssimo&#8221;&#41;&#44; considerando aspectos f&#237;sicos &#40;cansa&#231;o e sobrecarga f&#237;sica&#41;&#44; psicol&#243;gicos e sociais&#44; assim como os relacionados a rela&#231;&#245;es pessoais&#44; laborais e financeiras&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">2</span></a> O FDLQI apresentou elevada consist&#234;ncia interna para diversas l&#237;nguas como ingl&#234;s &#40;original&#41;&#44; japon&#234;s e persa&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">3&#44;4</span></a> Foi desenvolvido na Universidade de Cardiff &#40;Pa&#237;s de Gales&#41;&#44; pelo mesmo grupo que elaborou o <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> &#40;DLQI&#41;&#46; N&#227;o h&#225; outros instrumentos gen&#233;ricos para avalia&#231;&#227;o da QV de conviventes com portadores de dermatoses&#46; Todavia&#44; h&#225; question&#225;rios espec&#237;ficos dispon&#237;veis&#44; como o <span class="elsevierStyleItalic">Psoriasis Family Index</span> &#40;PFI&#41; e o <span class="elsevierStyleItalic">Family</span><span class="elsevierStyleItalic">Dermatitis Impact</span> &#40;FDI&#41;&#44; ambos traduzidos e validados no Brasil&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Conduziu&#8208;se estudo tipo metodol&#243;gico com objetivo de traduzir&#44; adaptar culturalmente e validar o FDLQI para a l&#237;ngua portuguesa do Brasil &#40;FDLQI&#8208;BRA&#41;&#46; O projeto foi aprovado pelo comit&#234; de &#233;tica institucional e o consentimento foi obtido dos participantes&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Ap&#243;s autoriza&#231;&#227;o dos autores&#44; conduziu&#8208;se a tradu&#231;&#227;o para o portugu&#234;s e retrotradu&#231;&#227;o&#46; Para essa etapa&#44; quatro especialistas fluentes em portugu&#234;s e ingl&#234;s&#44; e um n&#227;o especialista&#44; geraram vers&#227;o traduzida consensual&#44; cuja retrotradu&#231;&#227;o foi aprovada pelos autores do instrumento&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Para a adapta&#231;&#227;o cultural&#44; 10 familiares de pacientes portadores de doen&#231;as dermatol&#243;gicas responderam ao question&#225;rio&#44; e foram interrogados a respeito da clareza da linguagem utilizada&#44; sobre a adequa&#231;&#227;o dos termos lingu&#237;sticos adotados&#44; acerca da aplicabilidade do instrumento e sua relev&#226;ncia na pr&#225;tica cl&#237;nica dermatol&#243;gica&#46; Essa etapa gerou a vers&#227;o final brasileira&#58; FDLQI&#8208;BRA &#40;<a class="elsevierStyleCrossRef" href="#sec0020">Material Suplementar 1 e 2</a>&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Para valida&#231;&#227;o de conte&#250;do&#44; foram selecionados cinco dermatologistas experientes&#44; e solicitados que avaliassem os itens conforme sua relev&#226;ncia e pertin&#234;ncia&#46; Essa avalia&#231;&#227;o foi realizada por escala do tipo <span class="elsevierStyleItalic">Likert</span>&#44; graduada de 1 a 5 &#8208; em que 1 &#233; irrelevante&#47;pouco pertinente e 5 &#233; muit&#237;ssimo relevante&#47;pertinente&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> O c&#225;lculo do &#205;ndice de Valida&#231;&#227;o de Conte&#250;do &#40;IVC&#41; resultou em escores &#8805; 0&#44;8 na maioria dos itens&#44; com exce&#231;&#227;o ao item 6 &#40;&#8220;recrea&#231;&#227;o e lazer&#8221;&#41;&#44; com 0&#44;6&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Para a fase de valida&#231;&#227;o do FDLQI&#8208;BRA&#44; foram inclu&#237;dos 111 participantes com idade &#8805; 18 anos&#44; que coabitavam o domic&#237;lio do paciente&#46; Os crit&#233;rios de n&#227;o inclus&#227;o foram familiares portadores de comorbidades complicadas ou n&#227;o controladas&#44; que possam interferir em sua QV&#46; O dimensionamento amostral inicial baseou&#8208;se na necessidade de cerca de 10 participantes para cada item do instrumento unidimensional em valida&#231;&#227;o&#44; totalizando ao menos 100 familiares&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">9</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Os participantes foram recrutados tanto nos ambulat&#243;rios do servi&#231;o de dermatologia da Faculdade de Medicina de Botucatu &#40;Unesp&#44; Botucatu&#8208;SP&#44; Brasil&#41; quanto no consult&#243;rio privado da pesquisadora &#40;Sorocaba&#8208;SP&#41;&#46; N&#227;o houve sele&#231;&#227;o por doen&#231;a&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Um subgrupo de 20 familiares respondeu novamente o question&#225;rio em intervalo de 3 a 10 dias&#44; conquanto que relatada a manuten&#231;&#227;o do quadro dermatol&#243;gico do paciente&#44; para estimar a estabilidade temporal do instrumento&#46; Outro subgrupo de 20 familiares respondeu o question&#225;rio em intervalo de 30 a 60 dias&#44; ap&#243;s constata&#231;&#227;o de melhora cl&#237;nica do quadro dermatol&#243;gico&#44; para estimar a responsividade do instrumento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A consist&#234;ncia interna foi avaliada pelo coeficiente Cronbach&#8208;&#945;&#46; A correla&#231;&#227;o entre os itens do instrumento foi calculada pelo coeficiente de Spearman&#46; A estabilidade temporal foi estimada pelo coeficiente de correla&#231;&#227;o intraclasses&#44; e a responsividade&#44; pelo teste de Wilcoxon&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Os achados demogr&#225;ficos dos familiares est&#227;o representados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; e os diagn&#243;sticos dermatol&#243;gicos dos pacientes est&#227;o descritos na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Todos os question&#225;rios foram preenchidos completamente&#44; n&#227;o havendo d&#250;vidas sobre a composi&#231;&#227;o dos itens&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Os escores do FDLQI&#8208;BRA variaram de 0 a 27&#46; A distribui&#231;&#227;o das pontua&#231;&#245;es foi assim&#233;trica para a maioria dos itens &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Concomitante a isso&#44; os itens F5 &#40;&#8220;vida social&#8221;&#41;&#44; F6 &#40;&#8220;recrea&#231;&#227;o&#47;lazer&#8221;&#41; e F9 &#40;&#8220;trabalho&#47;estudo&#8221;&#41; apresentaram mais de 60&#37; das ocorr&#234;ncias classificadas como &#8220;nada&#8221;&#44; gerando &#8220;efeito ch&#227;o&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A an&#225;lise da consist&#234;ncia interna global do FDLQI&#8208;BRA &#40;coeficiente Cronbach&#8208;&#945;&#41; resultou em 0&#44;855 &#40;95&#37;CI 0&#44;818&#8208;0&#44;887&#41;&#44; revelando&#8208;se adequada para esse instrumento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A an&#225;lise paralela de Horn indicou unidimensionalidade para o FDLQI&#8208;BRA&#46; O coeficiente KMO foi de 0&#44;803 &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; indicando adequa&#231;&#227;o da amostra para an&#225;lise fatorial explorat&#243;ria&#46; A vari&#226;ncia da vari&#225;vel latente explicada pelo fator unidimensional foi de 53&#44;6&#37;&#44; e a matriz de correla&#231;&#227;o item&#8208;item e item&#8208;total resultou nos coeficientes dispostos na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Quanto &#224; estabilidade temporal&#44; o coeficiente de correla&#231;&#227;o intraclasse para completa concord&#226;ncia foi de 0&#44;998 &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; J&#225; na an&#225;lise da responsividade&#44; ou sensibilidade do instrumento &#224; mudan&#231;a&#44; houve redu&#231;&#227;o dos escores de FDLQI&#8208;BRA ap&#243;s institu&#237;dos tratamentos e melhora cl&#237;nica da doen&#231;a &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#59;&#46; os valores do teste tiveram m&#233;dia &#40;DP&#41; 11 &#40;4&#44;6&#41;&#44; e os valores do reteste&#44; 4 &#40;3&#44;7&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A an&#225;lise psicom&#233;trica do FDLQI&#8208;BRA promoveu resultados que garantiram a validade de conte&#250;do&#44; estrutural&#44; de construto&#44; estabilidade temporal e responsividade&#44; indicando&#8208;o como instrumento v&#225;lido para uso cl&#237;nico no Brasil&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A distribui&#231;&#227;o dos escores e a consist&#234;ncia interna foram similares a outras valida&#231;&#245;es internacionais&#44; o que maximiza sua interpretabilidade&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">2&#44;3</span></a> Entretanto&#44; o instrumento apresentou algumas ressalvas no comportamento de alguns itens pouco correlatos entre si&#44; especialmente influenciados pelo efeito &#8220;ch&#227;o&#8221; de alguns temas abordados&#44; uma vez que trabalho&#44; esporte&#47;lazer e vida social podem n&#227;o ser homog&#234;neos na popula&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Deve ser destacado que a amostra de familiares compreendeu&#44; em sua maioria&#44; mulheres e m&#227;es&#46; os dados de homens foram restritos&#46; Al&#233;m disso&#44; como os question&#225;rios foram aplicados ap&#243;s consultas ambulatoriais&#44; e n&#227;o em pronto&#8208;atendimentos e unidades de interna&#231;&#227;o&#44; foi inclu&#237;da uma maioria de pacientes de leve a moderado impacto na QV&#46; Por fim&#44; n&#227;o h&#225; outro instrumento padr&#227;o ouro para a valida&#231;&#227;o de crit&#233;rio do tipo concorrente&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">7&#44;11</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Dada a dimens&#227;o do impacto das doen&#231;as dermatol&#243;gicas na QV&#44; alguns autores j&#225; demonstraram aumento na frequ&#234;ncia de doen&#231;as psiqui&#225;tricas em pacientes dermatol&#243;gicos&#44; bem como risco aumentado de suic&#237;dio&#59; a doen&#231;a dermatol&#243;gica muitas vezes pode causar maior preocupa&#231;&#227;o nos indiv&#237;duos do que certas doen&#231;as sist&#234;micas&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Diante disso&#44; o entendimento&#44; aperfei&#231;oamento e desenvolvimento de instrumentos de avalia&#231;&#227;o da QV s&#227;o fundamentais para a pr&#225;tica cl&#237;nica do dermatologista&#44; para os ensaios terap&#234;uticos e para o aperfei&#231;oamento das pol&#237;ticas educativas para a popula&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; traduziu&#8208;se e adaptou&#8208;se uma vers&#227;o brasileira para FDLQI&#44; que se mostrou v&#225;lida e consistente &#40;FDLQI&#8208;BRA&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0115" class="elsevierStylePara elsevierViewall">Maria Laura Malzoni Souza&#58; Concep&#231;&#227;o e o desenho do estudo&#59; revis&#227;o cr&#237;tica da literatura&#59; levantamento dos dados&#59; reda&#231;&#227;o do artigo&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Idealiza&#231;&#227;o do estudo&#44; coleta dos dados&#44; an&#225;lise dos dados&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jos&#233; Eduardo Martinez&#58; Concep&#231;&#227;o e o desenho do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Souza ML&#44; Miot HA&#44; Martinez JE&#46; Translation&#44; cultural adaptation&#44; and validation of the Family Dermatology Life Quality Index instrument into the Brazilian Portuguese language &#40;FDLQI&#8208;BRA&#41;&#46; An Bras Dermatol&#46; 2024&#59;99&#58;939&#8211;42&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Ambulat&#243;rio de Dermatologia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil e Pr&#225;tica Privada&#44; Sorocaba&#44; SP&#44; Brasil&#46;</p>"
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          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o dos escores de <span class="elsevierStyleItalic">Family Dermatology Life Quality Index</span> vers&#227;o brasileira em cada item &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">54 &#40;49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">30 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Irm&#227;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">8 &#40;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;6&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;71&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">32 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">42 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">M&#233;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FDLQI&#8208;BRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mediana &#40;p25&#8208;p75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#8208;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab3706862.png"
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Principais dados dos familiares que participaram do est&#225;gio de valida&#231;&#227;o do FDLQI&#8208;BRA &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;</p>"
        ]
      ]
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#250;mero de pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acne&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite at&#243;pica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#226;ncer de pele&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Verruga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite de contato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ceratose act&#237;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Melasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ros&#225;cea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia areata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite seborreica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#218;lcera dos membros inferiores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia androgen&#233;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L&#250;pus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disidrose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Molusco contagioso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Outros&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos dermatol&#243;gicos dos pacientes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;</p>"
        ]
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        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">FDLQI&#8208;BRA&#44; Family Dermatology Life Quality Index vers&#227;o brasileira&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">F1&nbsp;\t\t\t\t\t\t\n
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Cartas ‐ Investigação
Tradução, adaptação cultural e validação do instrumento Family Dermatology Life Quality Index para a língua portuguesa (FDLQI‐BRA)
Maria Laura Malzoni Souzaa,
Corresponding author
dralauramalzoni@gmail.com

Autor para correspondência.
, Hélio Amante Miotb, José Eduardo Martineza
a Departamento de Dermatologia, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brasil
b Departamento de Infectologia, Dermatologia, Diagnóstico por Imagem e Radioterapia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Afec&#231;&#245;es dermatol&#243;gicas s&#227;o muito prevalentes&#59; entretanto&#44; apesar de geralmente apresentarem baixa mortalidade&#44; podem infligir alta morbidade e impacto na qualidade de vida &#40;QV&#41;&#46; Ademais&#44; o conv&#237;vio com portadores de dermatoses pode refletir ang&#250;stia&#44; demandar cuidados e gasto financeiro&#46; Assim&#44; a doen&#231;a dermatol&#243;gica pode interferir na din&#226;mica familiar&#46; O impacto da doen&#231;a na QV do paciente &#233; denominado &#8220;impacto prim&#225;rio&#8221;&#44; e quando envolve os familiares e&#47;ou conviventes&#44; chama&#8208;se &#8220;impacto secund&#225;rio&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">1</span></a> Compreender as dificuldades enfrentadas pelos familiares &#233; essencial para a cria&#231;&#227;o de programas educacionais e planejamento de apoio para a promo&#231;&#227;o de QV de quem convive com pacientes dermatol&#243;gicos&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">Family Dermatology Life Quality Index</span> &#40;FDLQI&#41; &#233; instrumento gen&#233;rico&#44; autopreenchido&#44; para a avalia&#231;&#227;o do impacto secund&#225;rio aos conviventes com portadores de doen&#231;as dermatol&#243;gicas&#46; Comp&#245;e&#8208;se de 10 itens de respostas graduadas em escala do tipo <span class="elsevierStyleItalic">Likert</span>&#44; que variam de 0 &#40;&#8220;nada&#8221;&#41; a 3 &#40;&#8220;muit&#237;ssimo&#8221;&#41;&#44; considerando aspectos f&#237;sicos &#40;cansa&#231;o e sobrecarga f&#237;sica&#41;&#44; psicol&#243;gicos e sociais&#44; assim como os relacionados a rela&#231;&#245;es pessoais&#44; laborais e financeiras&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">2</span></a> O FDLQI apresentou elevada consist&#234;ncia interna para diversas l&#237;nguas como ingl&#234;s &#40;original&#41;&#44; japon&#234;s e persa&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">3&#44;4</span></a> Foi desenvolvido na Universidade de Cardiff &#40;Pa&#237;s de Gales&#41;&#44; pelo mesmo grupo que elaborou o <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> &#40;DLQI&#41;&#46; N&#227;o h&#225; outros instrumentos gen&#233;ricos para avalia&#231;&#227;o da QV de conviventes com portadores de dermatoses&#46; Todavia&#44; h&#225; question&#225;rios espec&#237;ficos dispon&#237;veis&#44; como o <span class="elsevierStyleItalic">Psoriasis Family Index</span> &#40;PFI&#41; e o <span class="elsevierStyleItalic">Family</span><span class="elsevierStyleItalic">Dermatitis Impact</span> &#40;FDI&#41;&#44; ambos traduzidos e validados no Brasil&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Conduziu&#8208;se estudo tipo metodol&#243;gico com objetivo de traduzir&#44; adaptar culturalmente e validar o FDLQI para a l&#237;ngua portuguesa do Brasil &#40;FDLQI&#8208;BRA&#41;&#46; O projeto foi aprovado pelo comit&#234; de &#233;tica institucional e o consentimento foi obtido dos participantes&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Ap&#243;s autoriza&#231;&#227;o dos autores&#44; conduziu&#8208;se a tradu&#231;&#227;o para o portugu&#234;s e retrotradu&#231;&#227;o&#46; Para essa etapa&#44; quatro especialistas fluentes em portugu&#234;s e ingl&#234;s&#44; e um n&#227;o especialista&#44; geraram vers&#227;o traduzida consensual&#44; cuja retrotradu&#231;&#227;o foi aprovada pelos autores do instrumento&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Para a adapta&#231;&#227;o cultural&#44; 10 familiares de pacientes portadores de doen&#231;as dermatol&#243;gicas responderam ao question&#225;rio&#44; e foram interrogados a respeito da clareza da linguagem utilizada&#44; sobre a adequa&#231;&#227;o dos termos lingu&#237;sticos adotados&#44; acerca da aplicabilidade do instrumento e sua relev&#226;ncia na pr&#225;tica cl&#237;nica dermatol&#243;gica&#46; Essa etapa gerou a vers&#227;o final brasileira&#58; FDLQI&#8208;BRA &#40;<a class="elsevierStyleCrossRef" href="#sec0020">Material Suplementar 1 e 2</a>&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Para valida&#231;&#227;o de conte&#250;do&#44; foram selecionados cinco dermatologistas experientes&#44; e solicitados que avaliassem os itens conforme sua relev&#226;ncia e pertin&#234;ncia&#46; Essa avalia&#231;&#227;o foi realizada por escala do tipo <span class="elsevierStyleItalic">Likert</span>&#44; graduada de 1 a 5 &#8208; em que 1 &#233; irrelevante&#47;pouco pertinente e 5 &#233; muit&#237;ssimo relevante&#47;pertinente&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> O c&#225;lculo do &#205;ndice de Valida&#231;&#227;o de Conte&#250;do &#40;IVC&#41; resultou em escores &#8805; 0&#44;8 na maioria dos itens&#44; com exce&#231;&#227;o ao item 6 &#40;&#8220;recrea&#231;&#227;o e lazer&#8221;&#41;&#44; com 0&#44;6&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Para a fase de valida&#231;&#227;o do FDLQI&#8208;BRA&#44; foram inclu&#237;dos 111 participantes com idade &#8805; 18 anos&#44; que coabitavam o domic&#237;lio do paciente&#46; Os crit&#233;rios de n&#227;o inclus&#227;o foram familiares portadores de comorbidades complicadas ou n&#227;o controladas&#44; que possam interferir em sua QV&#46; O dimensionamento amostral inicial baseou&#8208;se na necessidade de cerca de 10 participantes para cada item do instrumento unidimensional em valida&#231;&#227;o&#44; totalizando ao menos 100 familiares&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">9</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Os participantes foram recrutados tanto nos ambulat&#243;rios do servi&#231;o de dermatologia da Faculdade de Medicina de Botucatu &#40;Unesp&#44; Botucatu&#8208;SP&#44; Brasil&#41; quanto no consult&#243;rio privado da pesquisadora &#40;Sorocaba&#8208;SP&#41;&#46; N&#227;o houve sele&#231;&#227;o por doen&#231;a&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Um subgrupo de 20 familiares respondeu novamente o question&#225;rio em intervalo de 3 a 10 dias&#44; conquanto que relatada a manuten&#231;&#227;o do quadro dermatol&#243;gico do paciente&#44; para estimar a estabilidade temporal do instrumento&#46; Outro subgrupo de 20 familiares respondeu o question&#225;rio em intervalo de 30 a 60 dias&#44; ap&#243;s constata&#231;&#227;o de melhora cl&#237;nica do quadro dermatol&#243;gico&#44; para estimar a responsividade do instrumento&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A consist&#234;ncia interna foi avaliada pelo coeficiente Cronbach&#8208;&#945;&#46; A correla&#231;&#227;o entre os itens do instrumento foi calculada pelo coeficiente de Spearman&#46; A estabilidade temporal foi estimada pelo coeficiente de correla&#231;&#227;o intraclasses&#44; e a responsividade&#44; pelo teste de Wilcoxon&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Os achados demogr&#225;ficos dos familiares est&#227;o representados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; e os diagn&#243;sticos dermatol&#243;gicos dos pacientes est&#227;o descritos na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Todos os question&#225;rios foram preenchidos completamente&#44; n&#227;o havendo d&#250;vidas sobre a composi&#231;&#227;o dos itens&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Os escores do FDLQI&#8208;BRA variaram de 0 a 27&#46; A distribui&#231;&#227;o das pontua&#231;&#245;es foi assim&#233;trica para a maioria dos itens &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Concomitante a isso&#44; os itens F5 &#40;&#8220;vida social&#8221;&#41;&#44; F6 &#40;&#8220;recrea&#231;&#227;o&#47;lazer&#8221;&#41; e F9 &#40;&#8220;trabalho&#47;estudo&#8221;&#41; apresentaram mais de 60&#37; das ocorr&#234;ncias classificadas como &#8220;nada&#8221;&#44; gerando &#8220;efeito ch&#227;o&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A an&#225;lise da consist&#234;ncia interna global do FDLQI&#8208;BRA &#40;coeficiente Cronbach&#8208;&#945;&#41; resultou em 0&#44;855 &#40;95&#37;CI 0&#44;818&#8208;0&#44;887&#41;&#44; revelando&#8208;se adequada para esse instrumento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">A an&#225;lise paralela de Horn indicou unidimensionalidade para o FDLQI&#8208;BRA&#46; O coeficiente KMO foi de 0&#44;803 &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; indicando adequa&#231;&#227;o da amostra para an&#225;lise fatorial explorat&#243;ria&#46; A vari&#226;ncia da vari&#225;vel latente explicada pelo fator unidimensional foi de 53&#44;6&#37;&#44; e a matriz de correla&#231;&#227;o item&#8208;item e item&#8208;total resultou nos coeficientes dispostos na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Quanto &#224; estabilidade temporal&#44; o coeficiente de correla&#231;&#227;o intraclasse para completa concord&#226;ncia foi de 0&#44;998 &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; J&#225; na an&#225;lise da responsividade&#44; ou sensibilidade do instrumento &#224; mudan&#231;a&#44; houve redu&#231;&#227;o dos escores de FDLQI&#8208;BRA ap&#243;s institu&#237;dos tratamentos e melhora cl&#237;nica da doen&#231;a &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#59;&#46; os valores do teste tiveram m&#233;dia &#40;DP&#41; 11 &#40;4&#44;6&#41;&#44; e os valores do reteste&#44; 4 &#40;3&#44;7&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A an&#225;lise psicom&#233;trica do FDLQI&#8208;BRA promoveu resultados que garantiram a validade de conte&#250;do&#44; estrutural&#44; de construto&#44; estabilidade temporal e responsividade&#44; indicando&#8208;o como instrumento v&#225;lido para uso cl&#237;nico no Brasil&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A distribui&#231;&#227;o dos escores e a consist&#234;ncia interna foram similares a outras valida&#231;&#245;es internacionais&#44; o que maximiza sua interpretabilidade&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">2&#44;3</span></a> Entretanto&#44; o instrumento apresentou algumas ressalvas no comportamento de alguns itens pouco correlatos entre si&#44; especialmente influenciados pelo efeito &#8220;ch&#227;o&#8221; de alguns temas abordados&#44; uma vez que trabalho&#44; esporte&#47;lazer e vida social podem n&#227;o ser homog&#234;neos na popula&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Deve ser destacado que a amostra de familiares compreendeu&#44; em sua maioria&#44; mulheres e m&#227;es&#46; os dados de homens foram restritos&#46; Al&#233;m disso&#44; como os question&#225;rios foram aplicados ap&#243;s consultas ambulatoriais&#44; e n&#227;o em pronto&#8208;atendimentos e unidades de interna&#231;&#227;o&#44; foi inclu&#237;da uma maioria de pacientes de leve a moderado impacto na QV&#46; Por fim&#44; n&#227;o h&#225; outro instrumento padr&#227;o ouro para a valida&#231;&#227;o de crit&#233;rio do tipo concorrente&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">7&#44;11</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Dada a dimens&#227;o do impacto das doen&#231;as dermatol&#243;gicas na QV&#44; alguns autores j&#225; demonstraram aumento na frequ&#234;ncia de doen&#231;as psiqui&#225;tricas em pacientes dermatol&#243;gicos&#44; bem como risco aumentado de suic&#237;dio&#59; a doen&#231;a dermatol&#243;gica muitas vezes pode causar maior preocupa&#231;&#227;o nos indiv&#237;duos do que certas doen&#231;as sist&#234;micas&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Diante disso&#44; o entendimento&#44; aperfei&#231;oamento e desenvolvimento de instrumentos de avalia&#231;&#227;o da QV s&#227;o fundamentais para a pr&#225;tica cl&#237;nica do dermatologista&#44; para os ensaios terap&#234;uticos e para o aperfei&#231;oamento das pol&#237;ticas educativas para a popula&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; traduziu&#8208;se e adaptou&#8208;se uma vers&#227;o brasileira para FDLQI&#44; que se mostrou v&#225;lida e consistente &#40;FDLQI&#8208;BRA&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0115" class="elsevierStylePara elsevierViewall">Maria Laura Malzoni Souza&#58; Concep&#231;&#227;o e o desenho do estudo&#59; revis&#227;o cr&#237;tica da literatura&#59; levantamento dos dados&#59; reda&#231;&#227;o do artigo&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Idealiza&#231;&#227;o do estudo&#44; coleta dos dados&#44; an&#225;lise dos dados&#44; escrita e aprova&#231;&#227;o do texto final&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jos&#233; Eduardo Martinez&#58; Concep&#231;&#227;o e o desenho do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Irm&#227;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Filhos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Av&#243;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;6&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;71&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&#44; anos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dia &#40;DP&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#237;vel de educa&#231;&#227;o</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fundamental&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;27&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#233;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FDLQI&#8208;BRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mediana &#40;p25&#8208;p75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#8208;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3706862.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Principais dados dos familiares que participaram do est&#225;gio de valida&#231;&#227;o do FDLQI&#8208;BRA &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#250;mero de pacientes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acne&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite at&#243;pica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#226;ncer de pele&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Verruga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite de contato&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ceratose act&#237;nica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Melasma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ros&#225;cea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia areata&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatite seborreica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#218;lcera dos membros inferiores&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia androgen&#233;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "imagenFichero" => array:1 [
                0 => "xTab3706860.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos dermatol&#243;gicos dos pacientes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;</p>"
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      3 => array:8 [
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            "detalle" => "Tabela "
            "rol" => "short"
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        "tabla" => array:2 [
          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">FDLQI&#8208;BRA&#44; Family Dermatology Life Quality Index vers&#227;o brasileira&#46;</p>"
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          "pt" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Correla&#231;&#227;o &#40;<span class="elsevierStyleItalic">rho</span> de Spearman&#41; item&#8208;item e item&#8208;total do FDLQI&#8208;BRA &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>111&#41;</p>"
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ISSN: 26662752
Original language: Portuguese
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