Skindex 17: validação da versão brasileira e comparação do desempenho psicométrico com Skindex-16 e DLQI-BRA.
Carregando...
Arquivos
Data
2021-06-10
Autores
Jorge, Marilia Formentini Scotton [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Qualidade de vida (QV) relacionada a doença compreende as dimensões associadas a condições de saúde e como essas afetam a vida cotidiana. Há diversos instrumentos genéricos para avaliação de QV em dermatologia. Em 1996, Chren et al. desenvolveram a primeira versão do Skindex, com estrutura multidimensional, objetivando englobar aspectos psicológicos e psicossociais ainda não abordados por outros instrumentos. Existem três versões posteriores ao estudo original que são utilizadas na prática clínica - Skindex-29, 16 e 17. O Skindex-17 não foi validado no Brasil, e tal processo apresenta grande valor para prática, assim como sua comparação com outros instrumentos disponíveis. Não há também estudos comparativos dos desempenhos entre as versões mais recentes – Skindex-16 e Skindex-17. Este estudo objetivou a validação do instrumento Skindex-17 e sua comparação com Skindex-16 e DLQI-BRA através da avaliação das suas propriedades psicométricas, em uma amostra de pacientes dermatológicos, do Brasil. Foi realizado estudo metodológico transversal, prospectivo, com pacientes atendidos no ambulatório de dermatologia da Faculdade de Medicina de Botucatu-Unesp, no período de dezembro de 2017 a outubro de 2019. Foram avaliadas a correlação entre os instrumentos, consistência interna, estrutura fatorial, estabilidade temporal, e responsividade. A amostra foi composta de 229 pacientes, sendo 71% do sexo feminino, idade adulta, fototipos intermediários e pacientes casados. Foram avaliados 271 questionários no total por conta dos pacientes entrevistados pela segunda vez para avaliação de estabilidade temporal e responsividade. Houve adequada consistência interna do Skindex-17 (Cronbach-α>0,8 para cada dimensão), assim como sua validação concorrente e discriminante. Foi confirmada a estrutura bidimensional do instrumento através da análise fatorial confirmatória. A análise pela teoria de resposta ao item mostrou boa discriminação e ordenação adequada de itens; dois itens apenas não aderiram ao modelo (p<0,01). Skindex-17 se mostrou factível na prática clínica pela avaliação de conteúdo, assim como pelo baixo tempo dispendido para resposta. A comparação dos três instrumentos DLQI-BRA, Skindex16 e Skindex-17, revelou maior sensibilidade discriminatória pelas versões do Skindex. Concluímos que o Skindex-17 é um instrumento válido para uso entre portadores de doenças dermatológicas no Brasil. O DLQI-BRA e o Skindex-16 também se mostraram adequados na amostra estudada. As versões do Skindex, por sua estrutura multidimensional, proporcionam uma avaliação pormenorizada da qualidade de vida, mesmo em situações de impacto leve.
Health-related quality of life (HQOL) comprises the dimensions associated with health conditions and how they affect everyday life. There are several generic instruments for evaluating HQOL in dermatology. In 1996, Chren et al. developed the first version of Skindex, with a multidimensional structure, aiming to encompass psychological and psychosocial aspects not yet addressed by other instruments. There are three versions after the original study that are used in clinical practice - Skindex-29, 16 and 17. The Skindex-17 has not been validated in Brazil, and this process is of great value for practice, as well as its comparison with other available instruments. There are also no comparative studies of performances between the most recent versions - Skindex-16 and Skindex-17. This study aimed at the validation of the Skindex-17 instrument and its comparison with Skindex-16 and DLQI-BRA through the evaluation of its psychometric properties, in a sample of dermatological patients, from Brazil. A prospective, cross-sectional methodological study was carried out with patients seen at the dermatology outpatient clinic of the Faculty of Medicine of Botucatu-Unesp, from December 2017 to October 2019. The correlation between the instruments, internal consistency, factor structure, stability was evaluated temporal, and responsiveness. The sample consisted of 229 patients, the proportion of woman was 71%, with a predominance of adulthood, intermediate phototypes and married patients. A total of 271 questionnaires were evaluated on account of the patients interviewed for the second time to assess temporal stability and responsiveness. There was adequate internal consistency of Skindex-17 (Cronbach-α> 0.8 for each dimension), as well as its concurrent and discriminating validation. The instrument's two-dimensional structure was confirmed through confirmatory factor analysis. The analysis by the Item Response Theory showed good discrimination and proper ordering of items; two items did not fit to the model (p <0.01). Skindex-17 proved to be feasible in clinical practice due to content evaluation, as well as due to the low time spent to respond. The comparison of the three DLQI-BRA instruments, Skindex16 and Skindex-17, revealed greater discriminatory sensitivity by the Skindex versions. We conclude that Skindex-17 is a valid instrument for use among patients with dermatological diseases in Brazil. DLQI-BRA and Skindex-16 were also shown to be adequate in the studied sample. The Skindex versions, due to their multidimensional structure, provide a detailed assessment of the quality of life, even in mild impact situations.
Health-related quality of life (HQOL) comprises the dimensions associated with health conditions and how they affect everyday life. There are several generic instruments for evaluating HQOL in dermatology. In 1996, Chren et al. developed the first version of Skindex, with a multidimensional structure, aiming to encompass psychological and psychosocial aspects not yet addressed by other instruments. There are three versions after the original study that are used in clinical practice - Skindex-29, 16 and 17. The Skindex-17 has not been validated in Brazil, and this process is of great value for practice, as well as its comparison with other available instruments. There are also no comparative studies of performances between the most recent versions - Skindex-16 and Skindex-17. This study aimed at the validation of the Skindex-17 instrument and its comparison with Skindex-16 and DLQI-BRA through the evaluation of its psychometric properties, in a sample of dermatological patients, from Brazil. A prospective, cross-sectional methodological study was carried out with patients seen at the dermatology outpatient clinic of the Faculty of Medicine of Botucatu-Unesp, from December 2017 to October 2019. The correlation between the instruments, internal consistency, factor structure, stability was evaluated temporal, and responsiveness. The sample consisted of 229 patients, the proportion of woman was 71%, with a predominance of adulthood, intermediate phototypes and married patients. A total of 271 questionnaires were evaluated on account of the patients interviewed for the second time to assess temporal stability and responsiveness. There was adequate internal consistency of Skindex-17 (Cronbach-α> 0.8 for each dimension), as well as its concurrent and discriminating validation. The instrument's two-dimensional structure was confirmed through confirmatory factor analysis. The analysis by the Item Response Theory showed good discrimination and proper ordering of items; two items did not fit to the model (p <0.01). Skindex-17 proved to be feasible in clinical practice due to content evaluation, as well as due to the low time spent to respond. The comparison of the three DLQI-BRA instruments, Skindex16 and Skindex-17, revealed greater discriminatory sensitivity by the Skindex versions. We conclude that Skindex-17 is a valid instrument for use among patients with dermatological diseases in Brazil. DLQI-BRA and Skindex-16 were also shown to be adequate in the studied sample. The Skindex versions, due to their multidimensional structure, provide a detailed assessment of the quality of life, even in mild impact situations.
Descrição
Palavras-chave
Qualidade de vida, Dermatologia, Psicometria, Dermatopatias, Psychometrics, Quality of life, Dermatology, Quality indicators, Health care