RESUMO
OBJECTIVE: To develop and validate a specific instrument to measure lifestyle of type 2 diabetes mellitus (DM2) patients. MATERIAL AND METHODS: A longitudinal, observational, prospective study was conducted between March 2001 and April 2002 at family medicine healthcare units of the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security (MISS)) in Mexico State's East District. A self-administered instrument (instrument to measure diabetic lifestyles, IMEVID) was designed to measure the lifestyles of diabetic patients. It was submitted for review by a multidisciplinary group of experts who assessed its logical and content validity to measure the lifestyle in DM2 patients. The instrument was administered on two different days to 412 adult subjects with DM2. Some items were excluded on the basis of the frequency with which their answer choices were selected, as well as the item-total correlation, and the item's significant loads in several domains in factorial analysis. RESULTS: The sample population consisted of 389 (94.7% response) subjects who completed the study. Intraclass correlation coefficients for logical and content validity were 0.91 and 0.95 respectively. After depuration of items, the instrument had 25 closed items grouped in 7 domains: nutrition, physical activity, tobacco consumption, alcohol consumption, information on diabetes, emotions, and therapeutic adherence. The global rating of the questionnaire had a Cronbach's alpha of 0.81 and a test-retest correlation coefficient of 0.84. CONCLUSIONS: The specific questionnaire IMEVID is the first to measure the lifestyle in subjects with DM2. It has logical validity, content validity, and a good level of consistency.
Assuntos
Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Indicadores Básicos de Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJETIVO: Construir y validar un instrumento específico para medir el estilo de vida en los pacientes con diabetes mellitus tipo 2. MATERIAL Y MÉTODOS: Entre marzo de 2001 y abril de 2002 se hizo un estudio observacional, longitudinal y prospectivo en unidades de medicina familiar de la delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Se diseñó un instrumento de autoadministración, denominado instrumento para medir el estilo de vida en diabéticos, el cual fue sometido a revisión por un panel multidisciplinario de expertos para determinar su validez lógica y de contenido. Se aplicó el instrumento en dos días diferentes a 412 sujetos adultos con diabetes mellitus. Fueron depurados los ítems considerando la frecuencia de selección de sus opciones de respuesta, su correlación ítem-total y su carga significativa en los dominios durante el análisis factorial. RESULTADOS: Completaron el estudio 389 (94.7 por ciento) sujetos. Los coeficientes de correlación intra-clase para la validez lógica y de contenido fueron de 0.91 y 0.95, respectivamente. Después de la depuración de ítems se obtuvo un instrumento conformado por 25 preguntas cerradas, distribuidas en siete dominios: nutrición, actividad física, consumo de tabaco, consumo de alcohol, información sobre diabetes, emociones y adherencia terapéutica. El a de Cronbach para la calificación total fue de 0.81 y el coeficiente de correlación test-retest de 0.84. CONCLUSIONES: El instrumento para medir el estilo de vida en diabéticos es el primer cuestionario específico para sujetos con diabetes mellitus tipo 2 y tiene validez aparente, validez de contenido y buen nivel de consistencia
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /psicologia , Qualidade de Vida , Inquéritos e Questionários , Indicadores Básicos de Saúde , Estilo de Vida , Estudos ProspectivosRESUMO
OBJECTIVE: To develop and validate a diagnostic-therapeutic guideline (DTG) for the management of hospitalized diabetic patients, and apply it to a sample of medical files. MATERIAL AND METHODS: The DTG was constructed and then validated by a consensus of internist physicians, afterwards it was applied to a sample of 97 randomly selected medical files of diabetic patients discharged from a internal medicine service. Hospitalization time, studies requested, average glycemia, glycemic prior to the discharge, time for to achieve glycemic control and mortality were compared at different percentages of the DTG's application. The results were analyzed by U of Mann-Whitney and ANOVA of Kruskal-Wallis. RESULTS: The intra-class correlation coefficient among the physicians for the guide validation was 0.94, with minimal modifications of content and format. The time, in hours, to achieve glycemic control was minor with a higher application percentage of the complete guide, p < 0.001, and also of the therapeutic domain, p = 0.05. The last glycemic prior to the discharge was lower with a higher application than 75% of the diagnostic domain, p < 0.001. A higher application percentage of the entire guide was found in living subjects more than in deceased subjects, p = 0.001, and also of the therapeutic domain, p = 0.008, and of the diagnostic domain p = 0.05. CONCLUSIONS: A higher level of application of the DTG is associated with a shorter time to achieve glycemic control, lower glycemic prior to the discharge and lower mortality.