Adaptation And Evaluation Of The Measurement Properties Of The Brazilian Version Of The Self-efficacy For Appropriate Medication Adherence Scale

To undertake the cultural adaptation of, and to evaluate the measurement properties of, the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale in coronary heart disease (CHD) patients, with outpatient monitoring at a teaching hospital. Method: the process of cultural adaptation was undertaken in accordance with the international literature. The data were obtained from 147 CHD patients, through the application of the sociodemographic/clinical characterization instrument, and of the Brazilian versions of the Morisky Self-Reported Measure of Medication Adherence Scale, the General Perceived Self-Efficacy Scale, and the Self-efficacy for Appropriate Medication Adherence Scale. Results: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of semantic-idiomatic, conceptual and cultural equivalencies, with high acceptability and practicality. The floor effect was evidenced for the total score and for the domains of the scale studied. The findings evidenced the measure's reliability. The domains of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented significant inverse correlations of moderate to strong magnitude between the scores of the Morisky scale, indicating convergent validity, although correlations with the measure of general self-efficacy were not evidenced. The validity of known groups was supported, as the scale discriminated between "adherents" and "non-adherents" to the medications, as well as to "sufficient dose" and "insufficient dose". Conclusion: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of reliability and validity in coronary heart disease outpatients.2

Adaptación y evaluación de las propiedades de medición de la versión brasileña de la Self-efficacy for Appropriate Medication Adherence Scale

Objectives: to undertake the cultural adaptation of, and to evaluate the measurement properties of, the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale in coronary heart disease (CHD) patients, with outpatient monitoring at a teaching hospital. Method: the process of cultural adaptation was undertaken in accordance with the international literature. The data were obtained from 147 CHD patients, through the application of the sociodemographic/clinical characterization instrument, and of the Brazilian versions of the Morisky Self-Reported Measure of Medication Adherence Scale, the General Perceived Self-Efficacy Scale, and the Self-efficacy for Appropriate Medication Adherence Scale. Results: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of semantic-idiomatic, conceptual and cultural equivalencies, with high acceptability and practicality. The floor effect was evidenced for the total score and for the domains of the scale studied. The findings evidenced the measure's reliability. The domains of the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented significant inverse correlations of moderate to strong magnitude between the scores of the Morisky scale, indicating convergent validity, although correlations with the measure of general self-efficacy were not evidenced. The validity of known groups was supported, as the scale discriminated between "adherents" and "non-adherents" to the medications, as well as to "sufficient dose" and "insufficient dose". Conclusion: the Brazilian version of the Self-efficacy for Appropriate Medication Adherence Scale presented evidence of reliability and validity in coronary heart disease outpatients.Objetivos: realizar a adaptação cultural e avaliar as propriedades de medida, versão brasileira, da Self-efficacy for Appropriate Medication Adherence Scale em coronariopatas, com seguimento ambulatorial em hospital universitário. Método: o processo de adaptação cultural foi realizado conforme a literatura internacional. Os dados foram obtidos junto a 147 coronariopatas, pela aplicação do instrumento de caracterização sociodemográfica/clínica e das versões brasileiras da Morisky Self-Reported Measure of Medication Adherence Scale, da General Perceived Self-Efficacy Scale e da Self-efficacy for Appropriate Medication Adherence Scale. Resultados: a versão brasileira da Self-efficacy for Appropriate Medication Adherence Scale apresentou evidências de equivalências semântico-idiomática, conceitual e cultural, com elevada aceitabilidade e praticabilidade. Foi evidenciado efeito chão para o escore total e domínios da escala em estudo. Os achados evidenciaram confiabilidade da medida. Os domínios da versão brasileira da Self-efficacy for Appropriate Medication Adherence Scale apresentaram correlações inversas significativas de moderada a forte magnitude entre os escores da escala de Morisky, apontando validade convergente, embora não tenham sido evidenciadas correlações com a medida de autoeficácia geral. A validade de grupos conhecidos foi apoiada, uma vez que a escala discriminou entre "aderentes" e "não aderentes" aos medicamentos bem como "dose suficiente" e "dose insuficiente". Conclusão: a versão brasileira da Self-efficacy for Appropriate Medication Adherence Scale apresentou evidências de confiabilidade e validade em coronariopatas em seguimento ambulatorial.Objetivos: realizar la adaptación cultural y evaluar las propiedades de medición, de la versión brasileña, de la Self-efficacy for Appropriate Medication Adherence Scale, en pacientes con coronariopatías, con acompañamiento en ambulatorio, en hospital universitario. Método: el proceso de adaptación cultural fue realizado conforme la literatura internacional. Los datos fueron obtenidos de 147 pacientes con enfermedad de las arterias coronarias (coronariopatía) aplicando el instrumento de caracterización sociodemográfica/clínica y las versiones brasileñas de la Morisky Self-Reported Measure of Medication Adherence Scale, de la General Perceived Self-Efficacy Scale y de la Self-efficacy for Appropriate Medication Adherence Scale. Resultados: la versión brasileña de la Self-efficacy for Appropriate Medication Adherence Scale presentó evidencias de equivalencias semánticas idiomáticas, conceptuales y culturales, con elevada aceptabilidad y practicidad. Fueron evidenciados el efecto suelo para el puntaje total y para los dominios de la escala que se estudia. Los hallazgos evidenciaron la confiabilidad de la medición. Los dominios de la versión brasileña de la Self-efficacy for Appropriate Medication Adherence Scale presentaron correlaciones inversas significativas de moderada a fuerte magnitud, entre los puntajes de la escala de Morisky, apuntando una validez convergente, a pesar de que en éste fueron evidenciadas correlaciones con la medición de autoeficacia general. La validez de grupos conocidos fue soportada, debido a que la escala discriminó entre "adherentes" y "no adherentes" a los medicamentos, así como "dosis suficiente" y "dosis insuficiente". Conclusión: la versión brasileña de la Self-efficacy for Appropriate Medication Adherence Scale presentó evidencias de confiabilidad y validez en pacientes con coronariopatías, acompañados en ambulatorio

Avaliação de métodos de aprendizagem no infarto agudo do miocárdio: uma revisão integrativa

The aim was to analyze aspects related to realistic simulation training for nursing students and nurses, characterizing its advantages and disadvantages when compared to other teaching methods in caring for victims of infarction. It was an integrative literature review, including 14 articles. For the elaboration, some steps were followed: elaboration of the guiding question; definition of the search strategy; selection of studies; evaluation of selected studies; analysis and synthesis of included studies; review presentation. The realistic simulation method showed more satisfactory results when compared to other teaching methods, observing the development of skills such as clinical reasoning, decision-making ability, recognition of patient deterioration and self-reflection. The application of training prior to contact with the patient can benefit the assistance and it is expected that the results favor the use of evidence to influence the development of strategies that contribute to clinical practice.Objetivou-se analisar os aspectos relacionados ao treinamento por simulação realística para acadêmicos de enfermagem e enfermeiros, caracterizando suas vantagens e desvantagens quando comparado a outros métodos de ensino no atendimento a vítimas de infarto. Tratou-se de uma revisão integrativa de literatura, incluindo-se 14 artigos. Para a elaboração seguiram-se algumas etapas: elaboração da questão norteadora; definição da estratégia de busca; seleção dos estudos; avaliação dos estudos selecionados; análise e síntese dos estudos incluídos; apresentação da revisão. O método de simulação realística apresentou resultados mais satisfatórios comparando-o aos outros métodos de ensino, observando-se o desenvolvimento de habilidades como raciocínio clínico, capacidade de tomada de decisão, reconhecimento de deterioração de paciente e autorreflexão. A aplicação de um treinamento prévio ao contato com o paciente pode beneficiar a assistência e espera-se que os resultados favoreçam a utilização de evidências para influenciar o desenvolvimento de estratégias contribuintes à prática clínica

Avaliação de métodos de aprendizagem no infarto agudo do miocárdio: uma revisão integrativa

The aim was to analyze aspects related to realistic simulation training for nursing students and nurses, characterizing its advantages and disadvantages when compared to other teaching methods in caring for victims of infarction. It was an integrative literature review, including 14 articles. For the elaboration, some steps were followed: elaboration of the guiding question; definition of the search strategy; selection of studies; evaluation of selected studies; analysis and synthesis of included studies; review presentation. The realistic simulation method showed more satisfactory results when compared to other teaching methods, observing the development of skills such as clinical reasoning, decision-making ability, recognition of patient deterioration and self-reflection. The application of training prior to contact with the patient can benefit the assistance and it is expected that the results favor the use of evidence to influence the development of strategies that contribute to clinical practice.Objetivou-se analisar os aspectos relacionados ao treinamento por simulação realística para acadêmicos de enfermagem e enfermeiros, caracterizando suas vantagens e desvantagens quando comparado a outros métodos de ensino no atendimento a vítimas de infarto. Tratou-se de uma revisão integrativa de literatura, incluindo-se 14 artigos. Para a elaboração seguiram-se algumas etapas: elaboração da questão norteadora; definição da estratégia de busca; seleção dos estudos; avaliação dos estudos selecionados; análise e síntese dos estudos incluídos; apresentação da revisão. O método de simulação realística apresentou resultados mais satisfatórios comparando-o aos outros métodos de ensino, observando-se o desenvolvimento de habilidades como raciocínio clínico, capacidade de tomada de decisão, reconhecimento de deterioração de paciente e autorreflexão. A aplicação de um treinamento prévio ao contato com o paciente pode beneficiar a assistência e espera-se que os resultados favoreçam a utilização de evidências para influenciar o desenvolvimento de estratégias contribuintes à prática clínica

[measure Of Disease Impact: Instrument Construct Validity In Patients With Coronary Artery Disease].

This study estimated the known groups construct validity for the Instrument to Measure the Impact of Coronary Disease on Patient's Everyday Life (IDCV) related to signs and symptoms, ventricular systolic function, left ventricular ejection fraction (LVEF) and health-related quality of life (HRQoL) in 153 outpatients with coronary artery disease. Data was obtained through application of IDCV and Brazilian versions of the instruments The Medical Study 36-item Short Form Health Survey - SF-36 and the MacNew Heart Disease Health-related Quality of Life Questionnaire . Mann-Whitney test was used to verify the ability of IDCV in discriminating impact of signs and symptoms, LVEF and ventricular systolic dysfunction. Also, the Kruskal-Wallis test was used to verify the discrimination power of the IDCV in relation to HRQoL. It was observed that the IDCV discriminated the impact between variables scored in HRQOL quartiles (≤Q1, Q1-Q3, ≥Q3). The study findings contribute for improvement of IDCV in measurement of disease impact in coronary artery disease patients.47843-5

Análisis De Factores Del Instrumento De Medición De Impacto De La Enfermedad En El Cotidiano

Verificar a estrutura de fatores do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata (IDCV) quando aplicado em coronariopatas. Método: fizeram parte deste estudo 153 coronariopatas em seguimento ambulatorial. A estrutura de fatores do IDCV foi inicialmente avaliada por meio da análise confirmatória de fatores e, subsequentemente, por meio da análise exploratória de fatores. Utilizou-se o método de estimação dos componentes principais de análise com rotação Varimax e eigenvalues acima de um para extração de fatores e carga fatorial superior a 0,40 para seleção dos itens. A consistência interna foi estimada por meio do coeficiente alfa de Cronbach. Resultados: a análise confirmatória não confirmou a estrutura original de fatores do IDCV. A análise exploratória de fatores evidenciou três dimensões que, em conjunto, explicaram 78% da variância da medida. Conclusão: estudos futuros com ampliação da casuística são necessários para confirmação da nova estrutura de fatores do IDCV.69469770

Factor analysis of an instrument to measure the impact of disease on daily life

Objective: to verify the structure of factors of an instrument to measure the Heart Valve Disease Impact on Daily Life (IDCV) when applied to coronary artery disease patients. Method: the study included 153 coronary artery disease patients undergoing outpatient follow-up care. The IDCV structure of factors was initially assessed by means of confirmatory factor analysis and, subsequently, by exploratory factor analysis. The Varimax rotation method was used to estimate the main components of analysis, eigenvalues greater than one for extraction of factors, and factor loading greater than 0.40 for selection of items. Internal consistency was estimated using Cronbach's alpha coefficient. Results: confirmatory factor analysis did not confirm the original structure of factors of the IDCV. Exploratory factor analysis showed three dimensions, which together explained 78% of the measurement variance. Conclusion: future studies with expansion of case selection are necessary to confirm the IDCV new structure of factors.Objetivo: verificar a estrutura de fatores do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata (IDCV) quando aplicado em coronariopatas. Método: fizeram parte deste estudo 153 coronariopatas em seguimento ambulatorial. A estrutura de fatores do IDCV foi inicialmente avaliada por meio da análise confirmatória de fatores e, subsequentemente, por meio da análise exploratória de fatores. Utilizou-se o método de estimação dos componentes principais de análise com rotação Varimax e eigenvalues acima de um para extração de fatores e carga fatorial superior a 0,40 para seleção dos itens. A consistência interna foi estimada por meio do coeficiente alfa de Cronbach. Resultados: a análise confirmatória não confirmou a estrutura original de fatores do IDCV. A análise exploratória de fatores evidenciou três dimensões que, em conjunto, explicaram 78% da variância da medida. Conclusão: estudos futuros com ampliação da casuística são necessários para confirmação da nova estrutura de fatores do IDCV.69469770

L’activation de l’intention visant à réduire la consommation de sel chez les patients atteints d’insuffisance cardiaque : un essai contrôlé randomisé

Introduction: An Implementation Intention strategy might be effective in transforming a positive intention to reduce salt intake into effective action among heart-failure patients. Objective: To assess the potential efficacy of an Implementation Intention intervention to reduce salt intake among heart-failure patients. Methods: Randomized controlled trial. The 60 heart-failure patients recruited were first randomized into 2 groups: an experimental group (EG) and a control group (CG). The study population was further broken down into 4 groups depending on whether the individuals prepared their own meals: 2 individual groups (EG-Individual and CG-Individual); and 2 collaborative groups, involving the patient and a social referent (EG-Collaborative and CG- Collaborative). The experimental groups developed action and coping plans based on the Implementation Intention. Total salt intake was calculated through discretionary salt, sodium-food frequency questionnaires, and 24-hour recall, obtained at the baseline (T0) and at the 2-month follow-up (T3). Results: 56 patients ended the follow-up. A reduction in the total salt intake was observed in the EGs (Individual and Collaborative) compared to baseline (5.04g/day vs. 12.21g/day for the EG-Individual (p≤0.001); 4.79g/day vs. 11.43g/day for the EG-Collaborative; p≤0.001). The multivariate analysis showed that the 2 EGs had lower salt intake at T3 than the 2 CGs (95% CI 4.19-9.29 for individual groups vs. 95% CI 4.84-10.22 for collaborative groups). There were no differences between the 2 EGs (95% CI –2.77 to 2.41). The total variance explained (R2) by these comparisons was 0.70. Discussion and conclusion: This study suggests that Implementation Intention might be effective in reducing salt intake among heart-failure patients, either individually or collaboratively. Further research testing mediator and moderator effects of the psychosocial variables are recommended.Introduction : La stratégie de l’Activation de l’Intention peut constituer une intervention efficace pour réduire la consommation de sel chez les patients atteints d’insuffisance cardiaque (IC). Objectif : Évaluer l’efficacité potentielle d’une intervention basée sur l’Activation de l’Intention pour réduire la consommation de sel chez les patients atteints d’IC. Méthodes : Essai contrôlé randomisé. Les 60 patients atteints d’IC recrutés ont été randomisés en deux groupes : Expérimental (GE) et Contrôle (GC). Ensuite, selon que les individus préparaient leurs propres repas ou qu’un référent social était responsable de cette préparation, ils ont été répartis en GE-Individuel, GC-Individuel et en GE-Collaboratif, GC-Collaboratif. La consommation de sel a été mesurée à partir du sel discrétionnaire, du questionnaire de fréquence de consommation de sodium et du rappel de 24 heures, et ce au temps de référence (T0) et au suivi à 2 mois (T3). Résultats : 56 patients ont complété le suivi. Une réduction de l’apport total en sel a été observée dans les GE (Individuel et Collaboratif) comparativement à T0 (GE-Individuel : 5,04g/jour vs 12,21g/jour ; GE-Collaboratif : 4,79g/jour vs 11,43g/jour, p≤0.001). L’analyse multivariée a montré que les GE ont présenté une plus faible consommation de sel à T3 que les GC (95% IC 4,19-9,29 pour les groupes individuels vs 95% IC 4,84-10,22 pour les groupes collaboratifs). Aucune différence n’a été constatée entre les GE (95% IC –2,77 à 2,41). La variance totale (R2) expliquée par ces comparaisons était de 0,70. Discussion et conclusion : L’Activation de l’Intention peut être efficace pour réduire la consommation de sel chez les patients atteints d’IC, individuellement ou en collaboration avec un référent social. D’autres recherches testant les effets médiateurs et modérateurs des variables psychosociales sont recommandées

Reliability and construct validity of the instrument to measure the impact of valve heart disease on the patient's daily life

Avaliar a praticabilidade, aceitabilidade e os efeitos teto e chão, estimar a confiabilidade e verificar a validade de construto convergente do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata em pacientes com valvopatia mitral e/ou aórtica. Método: dados foram obtidos junto a 86 pacientes valvopatas por meio de três etapas: uma entrevista presencial para caracterização sociodemográfica e clínica e as duas outras realizadas por meio de contato telefônico para as aplicações do instrumento (Teste e teste de repetição). Resultados: quanto à praticabilidade e aceitabilidade, o instrumento foi aplicado com tempo médio de 9,9 minutos e com 110% de respostas, respectivamente. Constatados efeitos teto e chão para todos os domínios, principalmente efeito chão. A confiabilidade foi testada por meio do teste-teste de repetição, obtendo-se evidências de estabilidade temporal da medida. Foram constatadas correlações negativas significantes de moderada a forte magnitude entre o escore da questão genérica sobre o impacto da doença e os escores do IDCV, o que aponta para validade de construto convergente do instrumento. Conclusão: o Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata apresentou evidências de confiabilidade e validade quando aplicado em pacientes com valvopatia2419Evaluate the practicality, acceptability and the floor and ceiling effects, estimate the reliability and verify the convergent construct's validity with the instrument called the Heart Valve Disease Impact on daily life (IDCV) of the valve disease in patients with mitral and or aortic heart valve disease. Method: data was obtained from 86 heart valve disease patients through 3 phases: a face to face interview for a socio-demographic and clinic characterization and then other two done through phone calls of the interviewed patients for application of the instrument (test and repeat test). Results: as for the practicality and acceptability, the instrument was applied with an average time of 9,9 minutes and with 110% of responses, respectively. Ceiling and floor effects observed for all domains, especially floor effect. Reliability was tested using the test - repeating pattern to give evidence of temporal stability of the measurement. Significant negative correlations with moderate to strong magnitude were found between the score of the generic question about the impact of the disease and the scores of IDCV, which points to the validity of the instrument convergent construct. Conclusion: the instrument to measure the impact of valve heart disease on the patient's daily life showed evidence of reliability and validity when applied to patients with heart valve diseas

Psychometric performance of the Brazilian version the “Insulin Management Diabetes Self-Efficacy Scale” for patient with Type 2 Diabetes Mellitus

Modelo de estudo: estudo de validação. Objetivo: Avaliar o desempenho psicométrico da versão brasileira “Escala de Auto-eficácia no manejo da insulina” - IMDSES. Metodologia: A confiabilidade (consistência interna - α Cronbach), a validade convergente e a validade de critério foram avaliadas. Os dados foram coletados de 127 pacientes com diabetes mellitus tipo 2 (DM2) em uso de insulina por meio da aplicação de instrumentos sociodemográficos e clínicos e as versões brasileiras “Summary of Diabetes Self-Care Activities Measures” - SDSCA and the IMDSES. Resultados: Observou-se “efeito de teto” no domínio da insulina. A confiabilidade foi confirmada em todos os domínios do IMDSES obtendo pontuação total satisfatória (α=0,87). A validade convergente de constructo foi confirmada por correlações negativas significativas de magnitude moderada a fraca entre os escores dos domínios do IMDSES e os escores de domínio da SDSCA. A validade de critério foi parcialmente confimada por correlação de magnitude fraca entre o domínio de Gerenciamento Geral e o escore total do IMDSES e níveis de hemoglobina glicada (r=0.22; p=0.02). Conclusão: A versão brasileira do IMDSES apresentou medidas psicométricas satisfatórias e pode ser útil para avaliar a efetividade das intervenções de enfermagem que visam otimizar a autoeficácia do paciente com DM2 no manejo do tratamento.Model of study: Validation study. Objective: To evaluate the psychometric performance of the Brazilian version of the Insulin Management Diabetes Self-Efficacy Scale - IMDSES. Methodology: Reliability (internal consistency - Cronbach’s α), convergent and criterion validity were assessed. Data were gathered from 127 patients with type 2 diabetes mellitus (T2DM) in use of insulin through the application of sociodemographic and clinical instruments and the Brazilian versions of the Summary of Diabetes Self-Care Activities Measures - SDSCA and the IMDSES. Results: It was observed “ceiling effect” in Insulin domain. Reliability was confirmed in all IMDSES domains and Total Score (α=0.87). The convergent construct validity was supported by significant negative moderate to weak magnitude correlations between the scores of IMDSES domains and the scores of SDSCA domains. Criterion validity was partially supported by the weak magnitude correlation between the General Managements domain and the Total Score of IMDSES and serum levels of glycated hemoglobin (r=0.22; p=0.02). Conclusion: The Brazilian version of IMDSES presented satisfactory psychometric measures and may be useful to evaluate the effectiveness of nursing interventions aimed at optimizing the selfefficacy of the T2DM patient in the management of his treatment