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Almeida DM, Santos-de-Araújo AD, Júnior JMCB, Cacere M, Pontes-Silva A, Costa CP, Gonçalves MC, Leite JMS, Dibai-Filho AV, Bassi-Dibai D. The best internal structure of the Diabetes Quality of Life Measure (DQOL) in Brazilian patients. BMC Public Health 2024; 24:580. [PMID: 38395813 PMCID: PMC10885374 DOI: 10.1186/s12889-024-18090-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is considered a chronic disease with numerous secondary complications that negatively affect the quality of life of patients. However, the specific, known and validated instruments for Brazilian Portuguese are too extensive, which often makes their use infeasible. OBJECTIVE To validate the internal structure of the Brazilian version of the Diabetes Quality of Life (DQOL) measure. METHODOLOGY Patients with DM type 1 or 2, between the ages of 18 and 76, were evaluated between April 2022 and May 2022. The survey was conducted online using the Google Forms platform. The original DQOL contains 46 multiple-choice questions organized into four domains. For structural validity, confirmatory factor analysis (CFA) was performed using RStudio software (Boston, MA, USA) with the packages lavaan and semPlot. RESULTS A total of 354 subjects were evaluated. The 3-domain, 24-item version of the DQOL was the most adequate, with acceptable values for all fit indices (chi-square/GL < 3, TLI and CFI > 0.90, and RMSEA and SRMR < 0.08). CONCLUSION The structure with three domains and 24 items is the most appropriate based on factor analysis. The Brazilian version of the DQOL with a structure of 3 domains and 24 items has adequate measurement properties that support its use in the clinical and scientific context in patients with DM.
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Affiliation(s)
- Denilson Menezes Almeida
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil
| | | | | | - Marcela Cacere
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, Brazil
| | | | - Maria Cláudia Gonçalves
- Department of Physical Therapy, Universidade Ceuma, São Luís, Brazil
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Brazil
| | - José Márcio Soares Leite
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil
- Department of Medicine, Universidade Ceuma, São Luís, Brazil
| | | | - Daniela Bassi-Dibai
- Postgraduate Program in Management of Health Programs and Services, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. Zip Code, 65075-120, São Luís, Brazil.
- Department of Physical Therapy, Universidade Ceuma, São Luís, Brazil.
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, Brazil.
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Brazil.
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Pereira FHF, Santos-de-Araújo AD, Pontes-Silva A, Marinho RS, Garcia-Araújo AS, Borghi-Silva A, Gonçalves MC, de Cássia Mendonça de Miranda R, Protazio JB, Pinheiro CAB, Dibai-Filho AV, Bassi-Dibai D. Regular Physical Exercise Adherence Scale (REPEAS): a new instrument to measure environmental and personal barriers to adherence to regular physical exercise. BMC Public Health 2023; 23:2491. [PMID: 38093228 PMCID: PMC10717144 DOI: 10.1186/s12889-023-17438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE To create, develop, and validate a scale that identifies the environmental and personal barriers that make it difficult to adhere to the practice of physical exercise on a regular basis in a population of Brazilian adults. METHODS We include adult individuals, aged 18-59 years, practitioners or former practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In the development and validation phases of the process, 6 specialists in the field of the health assessed the content validity: firstly, the specialists were asked to freely list the questions they would ask to investigate the barriers to adherence to regulating physical activity. Secondly, after compiling all the suggestions listed and eliminating suggestions with similar content, the items suggested in the first round were sent to the specialists so that an evaluation of all questions using a 5-point Likert scale and the content validity coefficient was calculated. We then evaluated the structural validity, construct validity, reliability, internal consistency, and ceiling and floor effects of the Regular Physical Exercise Adherence Scale (REPEAS). RESULTS Sixteen items were proposed to measure the factors that make it difficult to adhere to the regular practice of physical exercise. The internal structure of the REPEAS initially tested was based on the theoretical proposal of creating the instrument with two domains. After the structural analysis, we used the modification indices to identify the redundant items of the instrument. Consequently, the final version of the REPEAS after factor analysis had 12 items. Thus, the structure with 2 domains and 12 items presented adequate fit indices. With regard to construct validity, the REPEAS scores were compared in two distinct groups: irregular practitioners/ex-practitioners versus regular practitioners of physical exercise, in which a significant difference could be observed between groups (p < 0.001) for both the domains. Acceptable reliability was observed for the environment and personal domains, with ICC values of 0.86 and 0.94, in the same order. For internal consistency, Cronbach's alpha value was 0.908 (environmental domain) and 0.915 (personal domain), these values being adequate for the REPEAS. CONCLUSION The REPEAS is a scale with a valid two-dimensional internal structure, consisting of 12 items, reliable and with a valid construct, which supports its use in the clinical, epidemiological, and research contexts in Brazil.
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Affiliation(s)
| | - Aldair Darlan Santos-de-Araújo
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Renan Shida Marinho
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Adriana Sanches Garcia-Araújo
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | | | | | - Jhonata Botelho Protazio
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Postgraduate Program in Management of Health Services and Programs, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Departament of Physical Therapy, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Programa de Pós-Graduação em Meio Ambiente, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. CEP 65075-120, São Luís, Maranhão, Brazil.
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