Construction and validation of the Self-care Assessment Instrument for patients with type 2 diabetes mellitus

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

BACKGROUND

The management of diabetes is complex. There is growing recognition of the use of patient-reported outcome measures (PROMs) as a standardized method of obtaining an outlook on patients' functional status and well-being. However, no systematic reviews have summarized the studies that investigate the measurement properties of diabetes PROMs.

OBJECTIVE

Our aims were to conduct a systematic review of studies investigating the measurement properties of diabetes PROMs by evaluating the methodological quality and overall level of evidence of these PROMs and to categorize them based on the outcome measures assessed.

METHODS

This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the Embase, PubMed, and PsychINFO databases. The PROMs were evaluated with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines.

RESULTS

A total of 363 articles evaluating the measurement properties of PROMs for diabetes in the adult population were identified, of which 238 unique PROMs from 248 studies reported in 209 articles were validated in the type 2 diabetes population. PROMs with at least a moderate level of evidence for ≥5 of 9 measurement properties include the Chinese version of the Personal Diabetes Questionnaire (C-PDQ), Diabetes Self-Management Instrument Short Form (DSMI-20), and Insulin Treatment Appraisal Scale in Hong Kong primary care patients (C-ITAS-HK), of which the C-PDQ has a "sufficient (+)" rating for >4 measurement properties. A total of 43 PROMs meet the COSMIN guidelines for recommendation for use.

CONCLUSIONS

This study identified and synthesized evidence for the measurement properties of 238 unique PROMs for patients with type 2 diabetes and categorized the PROMs according to their outcome measures. These findings may assist clinicians and researchers in selecting appropriate high-quality PROMs for clinical practice and research.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42020180978; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180978.

Aplicação da teoria de Orem no âmbito das feridas: uma revisão integrativa

Objetivos: Caracterizar a produção científica sobre a aplicação da teoria do autocuidado no âmbito das feridas. Método: Revisão integrativa da literatura com os artigos disponíveis na íntegra que evidenciem a temática. Foram utilizados os seguintes recursos informacionais: BVS, CINAHL, Scopus, Cochrane, PubMed e SciELO. Foram elencados os seguintes descritores: Autocuidado, Teoria de enfermagem, Ferida e Úlcera, em suas versões em inglês e português. A amostra final constou de 10 publicações. Os dados foram coletados utilizando um instrumento validado. A avaliação e a síntese dos dados foram produzidas através de descrição e avaliações estatísticas simples. Resultados: Os estudos analisados foram desenvolvidos em quatro países, o idioma inglês predominou e as publicações tiveram início em 2004. A teoria foi aplicada na sistematização da assistência de enfermagem como estratégia de ensino para o autocuidado e como referencial teórico. Os artigos relacionaram a teoria com pé diabético, úlcera venosa, úlceras de perna/ membros inferiores (sem especificar o tipo), queimaduras e lesão por pressão. Conclusão: A teoria de Orem foi aplicada a uma diversidade de sujeitos e contextos, sua aplicabilidade no âmbito das feridas é algo concreto, independentemente do tipo de lesão.

Application of Orem’s theory on wounds: an integrative review

Objective: To characterize the scientific production on the application of Orem’s self-care theory in the scope of wounds. Method: Integrative literature review with the available articles that highlight the theme. The following informational resources were used: VHL, CINAHL, Scopus, Cochrane, PubMed and SciELO. The following descriptors were listed: Self Care, Nursing Theory, Wound and Ulcer, in their English and Portuguese versions. The final sample consisted of 10 publications. Data were collected using a validated tool. Evaluation and data synthesis were produced through description and simple statistical evaluations. Results: The analyzed researches were developed in four countries; English language was predominant; publications began in 2004. The theory was applied in nursing care systematization, as a teaching strategy for self-care and as a theoretical framework. The articles linked the theory to diabetic foot, venous ulcer, leg/lower limb ulcers (no specification of type), burns and pressure injury. Conclusion: Orem’s theory was applied to a variety of individuals and contexts, its applicability within the scope of wounds is something concrete, regardless of the type of injury.

Good Practices in Home Kitchens: Construction and Validation of an Instrument for Household Food-Borne Disease Assessment and Prevention

This study aimed to develop and validate an instrument to evaluate Brazilian home kitchens’ good practices. We elaborated on the preliminary version of the check-list based on the Brazilian resolution for food safety Collegiate Board Resolution 216 (RDC 216), Collegiate Board Resolution 275 (RDC 275), the standard 22000 from the International Organization for Standardization (ISO 22000) and Codex Alimentarius. Seven experts with experience in the area participated in the check-list validation and semantic evaluation. The criteria used for the approval of the items, as to their importance for the prevention of food contamination and clarity of the wording, was the achievement of a minimum of five out of seven of agreement among the experts (W-values ≥ 0.7). Moreover, items should have a mean ≥3 for the evaluation of importance (content validation) and clarity (semantic evaluation) to be maintained in the instrument. After the expert phase, we conducted another semantic evaluation of the check-list with a focus group composed of 13 undergraduate students, one moderator, and one observer of the process, to evaluate each item regarding its clarity, considering their level of understanding of the item. The final version of the check-list was composed of 77 items, divided into four blocks. The check-list developed was validated with respect to content with a W-value of 0.86 and approved in the semantic evaluation.

Aspects that influence the self-care of patients living with human immunodeficiency virus

Objective:

to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service.

Method:

analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem’s Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software.

Results:

most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (β = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015).

Conclusion:

aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.