Desempenho psicométrico do DLQI-BRA e Skindex-16 na avaliação da qualidade de vida em pacientes com doenças dermatológicas.
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Data
2020-02-28
Autores
Matos, Ticiane Dionizio de Sousa
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Universidade Estadual Paulista (Unesp)
Resumo
Muitas doenças dermatológicas não ameaçam diretamente a vida, mas podem causar desconforto físico e psicológico por afetar a percepção da imagem corporal e causar sintomas desconfortáveis, que podem interferir na percepção de qualidade de vida dos indivíduos acometidos. Objetivos: Comparar o desempenho psicométrico dos instrumentos Dermatology Life Quality Index (DLQI-BRA) e Skindex-16 na avaliação da qualidade de vida (QV) de pacientes com doenças dermatológicas. Mais especificamente os objetivos foram: avaliar a QV de pacientes com doenças dermatológicas; realizar reteste do DLQI-BRA e do Skindex-16 para avaliar a estabilidade nos casos em que não houve alteração da doença; avaliar a reprodutibilidade teste-reteste do DLQI-BRA e do Skindex-16; avaliar a informatividade dos itens segundo a psicometria clássica e Teoria de Resposta ao Item. Métodos: Estudo transversal, realizado no ambulatório e enfermaria de dermatologia de hospital público do interior de SP, com 188 pacientes portadores de dermatoses cutâneas. Para a coleta dos dados foi utilizado instrumento constituído de dados sociodemográficos. DLQI-BRA, Skindex-16 e escala visual de incômodo para avaliação de QV. Resultados: Prevaleceram participantes do sexo masculino 95 (51%), com companheiro 129 (69%), menos instruídos 102 (54%) e com renda de até R$ 3.000,00. Para a análise da confiabilidade e a estabilidade temporal, utilizou-se o alfa de Cronbach e a Correlação Intra-Classe para Perfeita Concordância (ICC) respectivamente, ambos com resultados satisfatórios (>0,7). Correlação positiva foi identificada entre: o Skindex-16 total e o DLQI-BRA (0,75), o escore total do Skindex-16e sua dimensão emoção com a escala visual de incômodo (0,64 e 0,63, respectivamente). Na análise de responsividade os instrumentos apresentaram redução da pontuação estatisticamente significante (p< 0,01). Conclusão: Na comparação dos dois instrumentos destinados à avaliação de QV em pacientes portadores de dermatoses cutâneas ambos apresentaram bom desempenho psicométrico. Um instrumento multidimensional, como o Skindex-16 conseguiu identificar o comprometimento de outros domínios de qualidade de vida, além do físico somente, como o DLQI-BRA.
Introduction: Many dermatological diseases do not directly threaten life, but they can cause physical and psychological discomfort as they affect the perception of body image and cause uncomfortable symptoms, which can interfere with the perception of quality of life of the affected individuals. Objectives: To compare the psychometric performance of the Dermatology Life Quality Index (DLQI-BRA) and Skindex-16 instruments in the assessment of quality of life (QoL) of patients with dermatological diseases. More specifically, the objectives were: to assess the QOL of patients with dermatological diseases; perform DLQI-BRA and Skindex-16 retest to assess stability in cases where there was no change in the disease; to evaluate the test-retest reproducibility of DLQI-BRA and Skindex-16; evaluate the informativeness of the items according to classical psychometry and Item Response Theory. Methods: This was a cross-sectional study, carried out at the dermatology ward and outpatient ward of a public hospital in the interior of São Paulo, Brazil, with 188 patients with cutaneous dermatoses. For data collection, an instrument consisting of sociodemographic data, DLQI-BRA, Skindex-16 and visual nuisance scale was used to assess QoL. Results: There were 95 male participants (51%), one partner 129 (69%) and less educated 102 (54%) and up to R $ 3,000.00. The internal consistency of both instruments was greater than 0.7. Positive correlation was identified between the domains that deal with emotional and functional issues of dermatological instruments. Regarding temporal stability, both presented satisfactory values with intraclass correlation coefficient> 0.7, since there was no clinical change. In the responsiveness analysis the instruments showed a statistically significant reduction of p <0.01, demonstrating that the instruments were sensitive to detect QoL changes in cases where there was clinical modification. Conclusion: In the comparison of the instruments both showed good psychometric performance. The internal consistency of both was satisfactory, as well as the temporal stability. Regarding responsiveness, both instruments were sensitive to detect QoL alterations in cases where there was clinical modification of the disease.
Introduction: Many dermatological diseases do not directly threaten life, but they can cause physical and psychological discomfort as they affect the perception of body image and cause uncomfortable symptoms, which can interfere with the perception of quality of life of the affected individuals. Objectives: To compare the psychometric performance of the Dermatology Life Quality Index (DLQI-BRA) and Skindex-16 instruments in the assessment of quality of life (QoL) of patients with dermatological diseases. More specifically, the objectives were: to assess the QOL of patients with dermatological diseases; perform DLQI-BRA and Skindex-16 retest to assess stability in cases where there was no change in the disease; to evaluate the test-retest reproducibility of DLQI-BRA and Skindex-16; evaluate the informativeness of the items according to classical psychometry and Item Response Theory. Methods: This was a cross-sectional study, carried out at the dermatology ward and outpatient ward of a public hospital in the interior of São Paulo, Brazil, with 188 patients with cutaneous dermatoses. For data collection, an instrument consisting of sociodemographic data, DLQI-BRA, Skindex-16 and visual nuisance scale was used to assess QoL. Results: There were 95 male participants (51%), one partner 129 (69%) and less educated 102 (54%) and up to R $ 3,000.00. The internal consistency of both instruments was greater than 0.7. Positive correlation was identified between the domains that deal with emotional and functional issues of dermatological instruments. Regarding temporal stability, both presented satisfactory values with intraclass correlation coefficient> 0.7, since there was no clinical change. In the responsiveness analysis the instruments showed a statistically significant reduction of p <0.01, demonstrating that the instruments were sensitive to detect QoL changes in cases where there was clinical modification. Conclusion: In the comparison of the instruments both showed good psychometric performance. The internal consistency of both was satisfactory, as well as the temporal stability. Regarding responsiveness, both instruments were sensitive to detect QoL alterations in cases where there was clinical modification of the disease.
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Palavras-chave
Psicometria, Doenças dermatológicas, Qualidade de vida, Enfermagem, Psychometrics, Dermatological diseases, Quality of life, Nursing