Information Technology Reference
In-Depth Information
Considering the defined issues and goals, we have created a questionnaire for socio-
demographic and clinical characterization of the sample and have selected the
Portuguese versions of three instruments, namely: the Diabetes Empowerment Scale-
Short Form (DES-SF), the Diabetes Knowledge Test (DKT), and the EuroQol EQ-5D.
The DES-SF provides information on the different aspects of the ability that the
diabetic person has to make decisions and control his/her disease [9]. Reliability,
determined by Cronbach's alpha (ʱ), for the DES-SF was 0.85 [9], suggesting a good
internal consistency [10]. The content validity of this instrument was confirmed by
the fact that scores of DES-SF and HbA1c levels obtained better results after the
study subjects completed a training program.
The DKT consists of 23 items of knowledge and was developed by the Michigan
Diabetes Research Training Center. Reliability and validity of this test show that it is
suitable for a variety of contexts and populations of people with diabetes. These 23
items represent a test of global knowledge on diabetes, being the first 14 items aimed
at assessing the general knowledge of diabetic people who are not treated with
insulin, and representing the remaining 9 items a subscale for diabetic people
insulin-treated [11]. The score was determined by the percentage of correct answers,
the percentage of the most frequent incorrect answers and by the percentage of
unanswered questions, also in line with other researchers [12]. It shows a coefficient
ʱ≥0.7 [9] and is therefore considered a reliable instrument. To determine its validity
we examined the differences between groups of patients, based on the hypotheses that
the values of the results obtained by the instrument would be higher in people with
type 1diabetes, as well as in people who were subject to specific therapy education
programs in the area of diabetes.
EQ-5D is a descriptive system of health related
QoL
that includes five dimensions
(mobility, self-care, usual activities, pain/discomfort, anxiety/depression). The answers
foresee three levels of severity: no problem; some problems or moderate problems;
extreme problems. It also includes a visual analogue scale (VAS) in which the person
graduates his/her general health status from 0 (worst imaginable) to 100 (best
imaginable). The global index is generated by an algorithm, based on the preferences of
the responses gathered from the five dimensions. The EQ-5D index is on a scale of 1
(perfect health) to 0 (death), admitting, however, negative values corresponding to
health states considered worse than death [13]. For the Portuguese population the range
of -0.54 and 1.0 [12] is defined. Reliability presents an alpha of 0.716, i.e. a reasonable
internal consistency. Validity was tested and confirmed by examining the behavior of
the EQ-5D
vis-à-vis
the health measuring instrument SF-6D [14].
All the evaluated instruments had previously been validated by CEISUC (Center
for Health Studies and Research of the University of Coimbra). Data analysis, using
SPSS, applied descriptive and inferential techniques (correlation coefficients and
comparisons of averages).
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