Evidências de validade da escala de atenção e consciência plenas (MAAS) e do questionário das facetas de mindfulness (FFMQ-BR) entre usuários de tabaco e população geral

Abstract

Introduction: Mindfulness refers to a metacognitive skill, defined by Jon Kabat-Zinn as "paying attention in a particular way, intentionally, in the present moment and non judgmentally" The Mindfulness-based interventions have proven effective for many health problems, especially for depression, stress, chronic disease and relapse prevention among substance users. Objective: To translate, adapt and present evidence of validity of the Mindful Attention Awareness Scale (MAAS) and the Five Facet Mindfulness Questionnaire (FFMQ) to the Brazilian Portuguese language. Methods: The validation of the MAAS and FFMQ was performed through a cross-sectional and correlational study using a quantitative methodology, with a total sample of 395 participants, composed by patients of a public institution of treatment for tobacco dependence, a Unit of Primary Health (UAP) in Juiz de Fora, university students and meditators. The instruments used were: socio-demographic questionnaire, Fagerström Test for Nicotine Dependence, MAAS, FFMQ and Subjective Well-Being Scale (EBES). This study was divided into two phases. The first was the process of translation and cultural adaptation of instruments that consisted of five steps - translation, synthesis, back translation, expert committee review and pretesting. After the necessary adjustments, we proceeded to the second phase of the study that consisted of the evaluation of the psychometric properties of the instruments. We analyzed the construct and criterion validity and its reliability. Results: From the exploratory factor analysis, the unidimensional structure of the MAAS explained 31.98% of the total variance of the scale. The FFMQ was composed of 7 factors due to the division of the factors “describe” and “act with awareness” in two new factors, different from the original scale. As expected, the total score of the MAAS and the FFMQ-BR positively

correlated with all factors and the overall score of the EBES (p <0.001). In criterion validity evaluation, we observed a significant difference regarding the meditators and non meditators scores for all facets of FFMQ and its total score. However, for the MAAS there was not a significant difference between the groups. In the MAAS reliability analysis, Cronbach's alpha of the total scale considering its 15 items was 0.83 and the Spearman Brown coefficient (split half) was 0.67. In the test-retest reliability, the Pearson coefficient was 0.80 (p <0.001). In FFMQ, Cronbach's alpha of the total scale was 0.81 and the values of the alphas of the facets were: “Nonjudging the Internal Experience” (α = 0.78), “Acting with Awareness – Autopilot” (α = 0.79), “Observe” (α = 0.76), “Describe - positive items” (α = 0.76), “Describe – items with negative formulation” (α = 0.75), “Nonreact to Internal Experience” (α = 0.68) and “Act with awareness- distraction” (α = 0.63). The values of all correlations for test-retest were significant, with p values <0.001: FFMQ total (0.90), Nonjudging the Inner Experience (0.80), Act with Awareness - Autopilot (0.67 ), Observe (0.83), Describe - items with positive formulation (0.85), Describe - items with negative formulation (0.71), Nonreact to Internal Experience (0.72) and Act with Awareness - distraction (0.80). Conclusions: These data confirm the existence of evidence of construct validity and reliability for both scales and criterion validity for FFMQ.