Validade de Conteúdo e Confiabilidade da Escala de Avaliação da Alfabetização em Saúde quanto a Adesão Medicamentosa entre Diabéticos

Abstract

Diabetes has been plaguing more and more people around the world, posing a major challenge for health systems. To prevent acute and chronic complications of the disease, behavioral changes and adherence to drug treatment are essential. Non-adherence to the treatment of diabetes mellitus is a known problem in the national and international scenario, as it impairs the physiological response and consequent glycemic control. In this context, drug adherence has been the subject of research in an ascending way around the world. The interest in understanding medication adherence leads researchers to investigate the issue in several ways, including associating it with Health Literacy, since this is a growing concern for researchers and health professionals, due to the rapid accumulation of evidence associated with Literacy In Health with measures and outcomes associated with health. Literacy in Health refers to the personal, cognitive, and social skills that determine people's ability to access, understand, evaluate, and utilize health-related information necessary to promote and / or maintain good health, involves individual and systemic determinants, including Communication skills between the patient and the health professional, cultural aspects, complexity of the health system, as well as the demands of the situation or the context. Health assessments, among those of Health Literacy and drug adherence, require the use of instruments capable of producing robust results, from the scientific point of view. The capacity of the instruments is directly related to their quality, that is, to the reliability, validity, responsiveness and interpretability of the instrument. The purpose of this study was to construct and verify the validity of content and reliability (psychometric properties) of an instrument to evaluate the Health Literacy with regard to smoking. It is a methodological study conducted from January 2015 to August 2016. The stages of construction of the instrument were: establishment of the conceptual framework; Definition of the objectives and population involved; Construction of items or response scales; Selection and organization of items; Structuring; Validity of content and pilot. The instrument developed was called the Health Literacy Assessment Scale for Drug Adherence among Diabetics - (AASAM-D). Reliability was measured through test-retest and internal consistency in a sample of 62 participants enrolled in two Family Health Strategies. The reliability by test and retest showed substantial to near perfect indexes. Therefore, future studies with longitudinal designs may use AASAM-D to assess levels of Health Literacy regarding drug adherence in order to identify changes at these levels over time and after intervention measures.