Validade e confiabilidade de um instrumento de avaliação do Letramento em Nutrição entre pessoas com Diabetes

Abstract

Diabetes Mellitus (DM) is a chronic non-communicable disease considered a public health problem worldwide, representing a major challenge for health systems. Metabolic control is directly related to adequate food intake, regular physical activity and the continuation of drug treatment. It is important not only for the health professional, but also for people with diabetes and people directly connected to them to know how much DM can compromise the quality of life (QOL) of the sick person. Health education can be considered a strategy to promote, stimulate and improve the level of health literacy (LS) of people and communities. Functional health literacy represents the individual's ability to gain access, assess and understand health information and services necessary to apply and make appropriate decisions to promote their health. There are some instruments for measuring and evaluating LS, however, after reviewing the literature on instruments that assess general and specific LS, no one was identified to assess the levels of literacy in nutrition among people with diabetes, which contributed to the proposal of this study: to elaborate and evaluate the psychometric properties (validity, reliability and interpretability) of an instrument that aims to assess nutritional literacy among people with diabetes.This is a methodological study, part of a project called “Projeto Health literacy” that had as a first step a literature review, in the period from 2016 to 2018, in the scientific databases in order to identify publications about LS and nutritional habits among people with type 2 diabetes mellitus, as well as the main measurement instruments used to measure LS. Five steps were defined for the process of creating and judging the instrument: verification of content validity; pre-test; reliability estimate; estimate of the validity of competing criteria; construct validity (hypothesis testing); and interpretability. After creation and judgment, the instrument called Nutrition Literacy among People with Diabetes (LND) had satisfactory content validity and good reliability. Concerning concurrent validity, a correlation was found between LND and education. In the hypothesis test, it was found that the higher the level of education, the higher the LND and this was lower among men. Thus, the LND was considered valid in terms of content, reliable and easy to interpret, and it can be used in research or in health services that provide assistance to people with type 2 diabetes mellitus.