Adaptation and validation of the Diabetes Management Self-Efficacy Scale to Brazilian Portuguese

Objective: to perform the cultural adaptation and validation of the Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus with a Brazilian population sample. Method: cross-sectional methodological study in which the adaptation and validation process included the stages recommended in the literature. Construct validity and reliability were assessed with 200 adults with type 2 diabetes mellitus. Results: the items indicated by the panel of judges and by the target population were adjusted in the cultural adaptation to improve clarity and understanding. The instrument's four factors remained in the confirmatory factor analysis with factor loadings of items greater than 0.30, except for factor 4; convergent validity, verified by the multitrait-multimethod analysis, presented inter-item correlations from 0.37 to 0.92, while for discriminant validity, 100% of the items presented greater correlation in their own factors. Cronbach's coefficient alpha for the total scale was 0.78, ranging from 0.57 to 0.86 among factors. Conclusion: semantic, cultural, conceptual and idiomatic equivalences were achieved and the instrument's Brazilian version also presented psychometric properties that showed evidence of reliability and validity. Thus, it can be applied both in clinical practice and research. Self-efficacy is useful for planning and assessing educational interventions, as well as predicting behavior modification in self-care.Objetivo: realizar a adaptação cultural e validação da Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus para uma amostra populacional brasileira. Método: estudo metodológico transversal, cujo processo de adaptação e validação incluiu as etapas preconizadas pela literatura. A validade de construto e a confiabilidade foram avaliadas em 200 adultos com diabetes mellitus tipo 2. Resultados: na adaptação cultural, foram ajustados itens indicados pelo Comitê de Juízes e pela população alvo, para maior clareza e compreensão. Na análise fatorial confirmatória manteve-se os quatro fatores, com cargas fatoriais dos itens superiores a 0,30, exceto para o fator 4; a análise multitraço-multimétodo mostrou para a validade convergente, correlações inter-itens de 0,37 a 0,92, e para a discriminante, que 100% dos itens obtiveram maior valor de correlação em seu próprio fator. O coeficiente alfa de Cronbach para a escala total foi de 0,78, com variação de 0,57 a 0,86 entre os fatores. Conclusão: as equivalências semântica, cultural, conceitual e idiomática foram mantidas, e as propriedades psicométricas mostraram evidências de confiabilidade e de validade da versão brasileira do instrumento, portanto, poderá ter aplicação clínica e em pesquisas. A autoeficácia é útil para planejar e avaliar intervenções educativas e predizer mudanças comportamentais para o cuidado.Objetivo: realizar la adaptación cultural y validación de la Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus en una muestra poblacional brasileña. Método: estudio metodológico transversal, cuyo proceso de adaptación y validación incluyó las etapas preconizadas por la literatura. La validez de constructo y la confiabilidad fueron evaluadas en 200 adultos con diabetes mellitus tipo 2. Resultados: para mayor clareza y comprensión, en la adaptación cultural fueron ajustados los ítems indicados por el Comité de Jueces y por la población objetivo. En el análisis factorial confirmatorio se mantuvieron los cuatro factores, con cargas factoriales de los ítems superiores a 0,30, excepto para el factor 4; el análisis multirrasgo y multimétodo mostró para la validez convergente, correlaciones entre ítems de 0,37 a 0,92, y en el caso del discriminante que 100% de los ítems obtuvieron mayor valor de correlación en su propio factor. El coeficiente alfa de Cronbach para la escala total fue de 0,78, con variación de 0,57 a 0,86 entre los factores. Conclusión: las equivalencias semántica, cultural, conceptual e idiomática fueron mantenidas; las propiedades psicométricas mostraron evidencias de confiabilidad y de validez en la versión brasileña del instrumento; por tanto, la adaptación podrá tener aplicación en la clínica e investigaciones. La autoeficacia es útil para planificar y evaluar intervenciones educativas y predecir cambios comportamentales para el cuidado

Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study

<p>Abstract</p> <p>Background</p> <p>Self-monitoring of blood glucose (SMBG), including self-regulation, is an important tool to achieve good glycemic control. However, many patients measure their glucose concentrations less often than is recommended. This study investigates patients' perspectives of SMBG and all relevant aspects influencing SMBG in patients with type 1 and insulin-treated type 2 diabetes.</p> <p>Methods</p> <p>In depth interviews were conducted with 13 patients with type 1 diabetes from an outpatient clinic and 15 patients with type 2 diabetes from general practices. All interviews were transcribed verbatim and analyzed using the Grounded Theory approach.</p> <p>Results</p> <p>A wide variety of SMBG was encountered. Perceptions, goals of SMBG and personal and contextual factors were identified, influencing the respondents' perspective of SMBG, and leading to this variety. Respondents experienced a discrepancy between their own and the professionals' perceptions and goals. Respondents' perception of SMBG ranged along a continuum from 'friend' to 'foe'. With respect to the goals, the respondents experienced tension between achieving good glycemic control and quality of life, and deliberately made their own choices. The performance of SMBG was tailored to their perceptions and personal goals. Personal and contextual factors such as hypo- or hyper (un)awareness, knowledge, and contact with professionals acted as either facilitating factors or as barriers to SMBG, depending on the respondents' perspective. A SMBG model was developed providing a representation of the factors and their interrelations.</p> <p>Respondents with type 1 diabetes seemed more resigned to their situation and SMBG was more integrated into their lives.</p> <p>Conclusions</p> <p>From the patients' perspective, professionals positively present SMBG as a 'friend' in order to achieve strict glycemic control. Whereas patients can also perceive SMBG as a 'foe'. They primarily seek a personal balance between achieving glycemic control and quality of life, leading them to deliberately make other choices regarding SMBG performance than was recommended. Gaining insight and discussing all factors affecting SMBG will help professionals and patients come to mutually agreed goals and to tailor the performance of SMBG to the individual patient. This should result in a more optimal use of SMBG, an improved quality of life, and improved clinical parameters.</p

Congres Sweden

Lezing STTI-congres in Gothenborg, Zweden op 18 juni 201

Beleving van wachten bij verkeerslichten

De wachttijdbeleving van automobilisten bij verkeerslichten is een belangrijke maat voor de effectiviteit van een verkeerslichtenregeling. Lage acceptatie, mogelijk met gedragsverandering tot gevolg, kan allerlei onbedoelde neveneffecten met zich meebrengen. In deze bijdrage worden de resultaten van een video-enquête over de beleving en acceptatie van wachten gepresenteerd én vertaald naar concrete toepassingsmogelijkheden

Self-efficacy and its influence on recovery of patients with stroke:a systematic review

Aims. To provide an overview of the literature focusing on the influence of self-efficacy and self-efficacy enhancing interventions on mobility, activities of daily living, depression and quality of life of patients with stroke. Background. There is growing evidence for the importance of self-efficacy in the care of people with enduring illness. Therefore, it is important to describe the association of self-efficacy and patient outcomes and the evidence for the effects of self-efficacy interventions for stroke patients. Data sources. Studies were retrieved from a systematic search of published studies over the period of 1996-2009, indexed in the Cumulative Index to Nursing and Allied Health Literature, Medline, Psychinfo and Embase and focusing on stroke, the influence of self-efficacy and self-efficacy enhancing interventions. Methods. A systematic review was carried out. Studies were critically appraised and important characteristics and outcomes were extracted and summarized. Results. Seventeen articles were included in the review. Self-efficacy was positively associated with mobility, activities of daily living and quality of life and negatively associated with depression. Four self-efficacy interventions were identified. The evidence for the effects of these interventions was inconclusive. Conclusions. Patients with high self-efficacy are functioning better in daily activities than patients with low self-efficacy. The evidence concerning the determinants influencing self-efficacy and the self-efficacy interventions makes clear how nurses can develop and tailor self-efficacy interventions for the clinical practice of people with stroke. Therefore, it is necessary to further emphasize the role of self-efficacy in the care for stroke patients in the nursing curriculum

Car Drivers’ Perception and Acceptance of Waiting Time at Signalized Intersections

While waiting at a traffic light, drivers' perceived waiting time can differ from the actual waiting time. Through a comprehensive video survey this paper shows that the perceived waiting time depends not only on the actual waiting time but also on other factors such as the number of stops in the queue and the presence of a red wave between adjacent intersections. Both waiting times with very short and very long durations are likely to be overestimated. Compared to a long standstill waiting, moving and stopping several times at the same intersection (due to short signal cycles) lead to lower perceived waiting times. When passing two adjacent intersections, car drivers dislike stopping at both intersections, especially if the second stop is relatively short. Based on the survey results, models are proposed for estimating drivers' perception and their acceptance of waiting time. These models have been validated by a real-world experiment

Student nurses' perceptions of mental health care: Validation of a questionnaire

AIM: This article describes the results of a study into the psychometric properties of a questionnaire about student nurses' perceptions of mental health care. The questionnaire was constructed in 2008, but has not yet been tested in terms of construct validity and reliability. A validated questionnaire is essential as a standardized method of analyzing student nurses' perceptions of mental health care. METHOD: To investigate the construct validity, an exploratory factor analysis was performed. Reliability was determined by measuring the internal consistency of the questionnaire. RESULTS: A principal component analysis (PCA) yielded a two-factor solution. The first factor comprised 9 items referring to the views of student nurses on psychiatric patients; the second factor comprised 6 items referring to the views of the students about professional careers in mental health care. CONCLUSION: The factor analysis and questionnaire produced two easily interpretable factors covering the same categories as those identified in the literature as determinants of a student nurse's choice for or against a career in mental health care. The questionnaire's construct validity was rated as sufficient, its reliability as acceptable. The problem is the low explained variance (25.6%). The usefulness of the questionnaire is therefore questionable. The usefulness might be improved through the expansion of some of the categories by additional items. Relevant suggestions are made in this article

Student nurses' perceptions of mental health care: Validation of a questionnaire

This article describes the results of a study into the psychometric properties of a questionnaire about student nurses' perceptions of mental health care. The questionnaire was constructed in 2008, but has not yet been tested in terms of construct validity and reliability. A validated questionnaire is essential as a standardized method of analyzing student nurses' perceptions of mental health care

Systematic review of self-management in patients with schizophrenia: psychometric assessment of tools, levels of self-management and associated factors

AIMS: The aim of this study was to provide an overview of existing knowledge about self-management assessment tools used in patients with schizophrenia, and levels of self-management and associated factors in these patients. BACKGROUND: Self-management empowers patients with chronic conditions to manage their illness and psychosocial consequences. With respect to patients with schizophrenia, knowledge concerning self-management is scarce. A systematic review of existing literature focusing on self-management in these patients may contribute to further research programming and practice development. DESIGN: A systematic review of the literature. DATA SOURCES: A systematic literature search was conducted in March 2015 in Medline, Embase, PsycINFO and CINAHL. REVIEW METHODS: Twelve articles were included. Data were extracted and categorized following the objectives of this review: (1) self-management assessment tools and their psychometric properties; (2) level of self-management; and (3) factors associated with self-management in patients with schizophrenia. RESULTS: The PIH scale, the PAM-MH and the IMR scale were used to assess self-management. The overall psychometric quality of these instruments showed to be fair to poor. The level of self-management in patients with schizophrenia is comparable with other mental health conditions, higher than general population and lower than patients with physical health conditions. Several factors (e.g. sense of coherence, recovery and hope) were found to be associated. CONCLUSION: Further efforts are needed to increase the methodological quality of psychometric research on self-management assessment tools. More insight in the level of self-management and associated factors may enhance the development of future interventions

Effects of three frequencies of self-monitored blood glucose on HbA1c and quality of life in patients with type 2 diabetes with once daily insulin and stable control:A randomized trial

Objective: The optimal frequency of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes (T2DM) with stable glycemic control is unknown. This study investigated effects of 3 frequencies of SMBG on glycemic control and quality of life after 9 months in patients using one long-acting insulin injection a day. In an open-label, multi-center, primary-care, parallel (1:1:1) randomized trial in the Netherlands including patients with T2DM, HbA1c ≤ 58 mmol/mol (≤ 7.5%), stable glycemic control, treated with one insulin injection daily, three frequencies of 4-point glucose measurements (before meals and bedtime) were weekly (n = 22), every 2 weeks (n = 16) and monthly (n = 20) were compared. Results: A total of 58 patients with T2DM were included by 38 general practitioners, which was lower then anticipated. There were no significant between group differences in HbA1c (mmol/mol); group C compared to A and B; - 2.7 (95% CI - 6.4, 1.0) and - 1.0 (95% CI - 4.9, 3.0) and quality of life. Baring in mind the lower than anticipated inclusion rate, there were no significant differences in HbA1c and quality of life between three different frequencies of SMBG in patients with stable glycemic control using one long-acting insulin injection.</p