Desenvolvimento e avaliação de instrumentos relacionados à literacia em saúde e à qualidade de vida entre pessoas com Diabetes Mellitus

Abstract

Objective: to develop and evaluate instruments related to care and Quality of Life (QOL) among people with Diabetes Mellitus (DM) enrolled in Family Health Strategies (FHS) in a medium-sized municipality. Method: a methodological study carried out between 2016-2018. The following were carried out: literature review; selection of participants; definition of the sample; access to scientific databases for the development of the instrument for evaluation of Health Literacy in Diabetic Foot; as well as to identify instruments for assessing QOL among people with DM. Among the 73 Polo Units (UPs) of the city's ESF, 05 were randomly selected for the study execution. One was considered in the Pre-test; other two in the Reliability Estimate and Concurrent Validity; two in Interpretability, Hypothesis Testing (TH), Exploratory Factor Analysis (AFE) and Confirmatory Factor Analysis (AFC). The managers of the raffled UPs gave the names of the people with DM registered in the ESF. The study included people aged ≥ 18 years with the diagnosis of DM. For the development of an instrument that proposes to evaluate the Health Literacy for Diabetic Foot (LSPD), the following phases were performed: development of the instrument; verification of content validity by the committee of experts; pre-test (n = 20); reliability estimation (n = 62): Cronbach's alpha (AC), Kappa (K) and Intraclass Correlation Coefficient (ICC), satisfactory results (≥0.60); estimation of concurrent validity (n = 62); interpretability of scores; TH (multiple logistic regression): OR / 95% in a probabilistic sample estimated for infinite population. Diabetes-39 (D-39) was identified to assess the QOL of people with DM. A reduced version of the D-39 was developed by constructing the response scales, the pre-test (n = 20), the application of the D39 and World Health Organization Quality of Life-bref (WHOQOL-BREF) instruments, construct validity (n = 288 / AFE / AFC); reliability (n = 50 / AC / K / CCI); concurrent validity; interpretability (n = 288). SPSS and AMOS were used in the analyzes. Results: LSPD has adequate and fast application; good content and construct validity; good reliability (AC = 0.73, two items presented K <0.60 and CCI = 0.79); concurrent validity (correlation with schooling rs = 0.647 / p = 0.000); and good interpretability: 50.2% (n = 112) had inadequate LSPD (> 14), a result found among the oldest (0.96 / 0.93-0.99), with lower educational level (1.15 / 1 , 06-1,25) and lower family income (1.01 / 1.00-1.01) according to the hypothesis test. The D-21, reduced version of the D-39, presented AFE (KMO = 0.91 / Bartlett's Test of Sphericity = 2579,512), demonstrated by 04 factors with 59.2% of the total variance; AFC (X2gl = 2.22, RMSEA = 0.06, CFI = 0.91, GFI = 0.88, TLI = 0.90); and reliability (AC = 0.913 / K≥0.60 / CCI = 0.91). Spearman's Correlation Coefficient between the D-21 and D-21 and the positive correlation with age (rs = -0.136 / p = 0.021 and positive with schooling (rs = 0.756 / p = 0.001) Interpretation: The prevalence of poor QoL by D21 was 53.5% (n = 154), and the prevalence of poor QoL by D21 was 53.5% (n = 154) An educational video was developed to present concepts and recommendations related to the behavior of the person with DM regarding Diabetic Foot: https: //www.youtube.com/watch? V = IPeRghXXugg & t = 46s Conclusion: The LSPD and D-21 instruments were considered valid, reliable and interpretable, being possible tools to evaluate specific health conditions among people with DM in conducting research, as well as health care.