Estudo fatorial exploratório das dimensões comportamentais de adesão em pessoas com diabetes mellitus tipo 1 e tipo 2

Ilda Maria Massano-Cardoso; Fernanda Bento Daniel; Vitor Rodrigues; Manuela Carvalheiro

doi:10.7342/ismt.rpics.2017.3.1.47

Authors

Ilda Maria Massano-Cardoso Instituto Superior Miguel Torga; Faculdade de Medicina da Universidade de Coimbra/Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Portugal http://orcid.org/0000-0003-2510-2348
Fernanda Bento Daniel Instituto Superior Miguel Torga; Centro de Estudos e Investigação em Saúde da Universidade de Coimbra; Centro de Investigação e Estudos de Sociologia , Coimbra, Portugal http://orcid.org/0000-0002-2202-1123
Vitor Rodrigues Faculdade de Medicina da Universidade de Coimbra, Portugal
Manuela Carvalheiro Faculdade de Medicina da Universidade de Coimbra, Portugal

DOI:

https://doi.org/10.7342/ismt.rpics.2017.3.1.47

Keywords:

Diabetes mellitus, Factorial analyses, Behavioral dimensions, Adherence

Abstract

Background & Aim: The current study sought out to conduct an exploratory factor analysis in order to examine behavioral dimensions associated with adherence in diabetes mellitus (DM) patients. Additionally, our goal was to test a theoretical model consisting of internal and relational factors. Method: Three hundred and forty-seven patients attending consultations at the Serviço de Endocrinologia, Diabetes e Metabolismo of the Centro Hospitalar Universitário de Coimbra and at the Associação Portuguesa de Diabéticos de Portugal. The self-report instruments were Rosenberg Self-esteem Scale, WHOQOL-Bref, Escala de Satisfação com o Suporte Social, Medida de Adesão aos Tratamentos, Attitudes Towards Doctors and Medicine, Beck Depression Inventory, Diabetes Health Profile e Questionário de Autocuidados da Diabetes. Exploratory factor analysis was used to assess the instrument's dimensionality with Kaiser-Meyer-Olkin and Bartlett’s Sphericity Test. Results: For type 1 DM the factor structure found included six components with a total explained variance of 70.8%. For type 2 DM (insulin treatment) seven components were found explaining a total variance of 74.9%. For type 2 diabetes (oral treatment) six factors accounting for 73.4% of the total explained variance were found. Conclusions: The highest component loadings were found in constructs that should theoretically belong to the corresponding factors. In the case of type 1 DM the therapeutic factor disappears, combining the self-care factor, and in the case of type 2 DM (oral), this component emerged as a dimension. A forced two-dimentional factor analysis indicated that social support load in internal factor. These findings led us to reflect on the suitability of the instrument for the assessment of social support, instead of the model itself. An explanation based on the multidimensionality of therapeutic adherence was achieved considering that internal structure and semantics conditioned our results.

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