Tradução, adaptação cultural para o português do Brasil e validação do DiAbeTes Education Questionnaire (DATE-Q) em adultos com Diabetes Mellitus

Abstract

The use of questionnaires to assess knowledge about diseases in educational programs in the health field allows us to know the needs of the individual and consequently to promote strategies aimed at improving self-care. Since knowledge about Diabetes Mellitus (DM) is fundamental for the development of skills in therapeutic self-management, the DiAbeTes Education Questionnaire (DATE-Q) was developed, which addresses issues related to important components such as the practice of physical exercises and psychosocial well-being to control the disease. In this context, the availability of a validated version of DATE-Q for its use in Brazil can contribute to the implementation of more comprehensive and effective therapeutic approaches for people living with pre-diabetes and diabetes in this country. The objective was translate to Brazilian Portuguese, culturally adapt and validate the DATE-Q for its use in the Brazilian population. This is a methodological study, involving a total sample of 230 adult subjects (age ≥ 18 years old) diagnosed with type 1 or type 2 DM, with thirty participants from the pre-test phase and two hundred from the validation phase. The pre-test phase comprised the questionnaire’s translation and cross-cultural adaptation processes, developed in five stages (initial translation, synthesis of translations, back-translation, expert committee and pre-test). The next phase consisted of validating the questionnaire through: evaluation of internal consistency based on the calculation of Cronbach's alpha; construct validity based on the calculation of the Spearman correlation coefficient between the total score of the questionnaire and the functional capacity assessed by the distance covered in the Incremental Shutte Walking Test (ISWT), the glycated hemoglobin and the total score of another knowledge questionnaire about DM validated for use in Brazil (DKN-A); reproducibility from the calculation of the intraclass correlation coefficient (ICC); and presence of a ceiling and floor effect. The versions of DATE-Q obtained through the translation and back-translation processes did not present discrepant divergences between themselves and with the original questionnaire in English. After analysis by the committee of experts of the entire process of translation and back-translation, a pre-final version of the questionnaire was obtained taking into account the semantic, idiomatic, experiential and conceptual equivalences. The evaluation of the psychometric properties of the final version of DATE-Q in Portuguese revealed satisfactory internal consistency (Cronbach's alpha coefficient = 0.60), moderate reliability (ICC = 0.53) and absence of ceiling and floor effects. A statistically significant, positive and strong correlation (r = 0.66; P <0.001) was found between the total DATE-Q and DKN-A scores. Although statistically significant, the positive correlation found between the total DATE-Q score and the distance covered in the ISWT was weak (r = 0.32; P = 0.014) and there was no correlation between the total DATE-Q score and the values of glycated hemoglobin from the participants' most recent blood test (r = 0.22; P = 0.103). The Portuguese version of DATE-Q had adequate psychometric properties and is a valid instrument for investigating the level of knowledge about disease in people living with DM in Brazil.