Diyabetik Ayak Öz-Bakım Davranış Ölçeğinin Tip 2 Diyabetli Hastalarda Yapı Geçerliliği Ve Madde Ayırt Ediciliği

Öz

Amaç: Bu çalışma, Diyabetik Ayakta Öz Bakım Davranış Ölçeğinin (DAÖD) Türkçe versiyonunun Tip 2 diyabetli hastalarda test edilmesi ve geçerliliğinin sağlanması amacıyla planlanmıştır. Gereç ve Yöntem: Çalışmaya yaşları 53,3±4,7 olan 119 (57 kadın; 62 erkek) Tip-2 diyabetik hasta dahil edilmiştir. DAÖD'ün İngilizce'den Türkçe'ye ileri-geri çevirisi Beaton tarafından belirlenen metodoloji ile yapılmıştır. Katılımcılara DAÖD ile birlikte Dünya Sağlık Örgütü İyilik Hali Ölçeği-22 (İHÖ-22) ve Nottingham Sağlık Profili (NSP) uygulanmıştır. Sonuçlar: Yakınsak yapı geçerlilik analizi için DAÖD puanı ile İHÖ-22 (r=0.639, p<0.001) ve NSP toplam puanı (r=-0.200, p<0.029) arasındaki ilişkiler Pearson korelasyon katsayısı ile hesaplandı. Ayırt edici yapı geçerliği analizi, ölçek puanları açısından kadın ve erkekler arasında fark olmadığını göstermiştir. Açıklayıcı faktör analizi sonuçları, toplam varyansın %75'inin iki faktörle açıklanabileceğini göstermiştir. Doğrulayıcı faktör analizinin de gösterdiği gibi, Türkçe versiyonun faktör yapısı ile orijinal versiyonun faktör yapısı arasındaki uyum yeterli olarak bulunmuştur. Ek olarak, madde ayırt edici güç analizi, tüm maddelerin 'yüksek' ve 'düşük' yanıtları ayırt edebildiğini göstermiştir. Tartışma: DAÖD, diyabet ayak öz-bakım davranışlarını birey merkezli bir yaklaşımla değerlendirebilen ve ölçebilen nadir bir ölçektir. Bu ölçek, diyabetik ayak hastalarında öz-bakım davranışlarını değerlendirmek, müdahale ve eğitim programları planlamak için kullanılabilir.

Anahtar Kelimeler

• diyabetik ayak
• özbakım
• yapı geçerliliği

Construct Validity and Item Discrimination of The Diabetes Foot Self-Care Behavior Scale in Patients with Type-2 Diabetes

Öz

Background: This study was planned to test the construct validity of the Turkish version of the Diabetes Foot Self-Care Behavior Scale (DFSBS) in patients with type-2 diabetes. Method: 119 type-2 diabetic patients (57 women; 62 men) with a mean age of 53.3±4.7 years were included in this study. The forward-backward translation of the DFSBS was conducted for translation from English to Turkish according to the methodology outlined by Beaton. The World Health Organization Well-being Questionnaire-22 (WBQ-22) and Nottingham Health Profile (NHP) were administered to the participants along with the DFSBS. Results: For convergent construct validity analysis, the correlations between the DFSBS score and WBQ-22 (r=0.639, p<0.001) and NHP total score (r=-0.200, p<0.029) were calculated with the Pearson correlation coefficient. The discriminative construct validity analysis showed that there is no difference between men and women in terms of scale scores. The exploratory factor analysis results showed that 75% of the total variance is explainable by two factors. The fit between the factor structure of the Turkish version and the original version was adequate as shown by the confirmatory factor analysis. Additionally, item discriminative power analysis showed that all items were able to discriminate ‘high’ and ‘low’ responses. Conclusion: The DFSBS is a rare scale that can assess and measure diabetic foot self-care behaviors in a person-centered approach with satisfactory construct validity. This scale can be used to assess self-care behaviors, plan interventions and education programs with diabetic foot clients.

Anahtar Kelimeler

• Diabetic foot
• self care
• construct validity

Kaynakça

1. Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: a multinational investigation. Plos one, 14(6), e0217771. https://doi.org/10.1371/journal.pone.0217771
2. American Diabetes Association Professional Practice Committee (ADAPPC). (2021). 5. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes—2022. Diabetes Care, 45(1), 60-82. https://doi.org/10.2337/dc22-S005
3. Akoglu, H. (2018). User’s guide to correlation coefficients. Turk. J. Emerg. Med., 18(3), 91-93. https://doi.org/10.1016/j.tjem.2018.08.001
4. Baker, E. L. (1996). Introduction to theme ıssue on educational assessment. J Educ Res, 89(4), 194-196. https://doi.org/10.1080/00220671.1996.9941204
5. Bakır, E., & Samancıoglu, S. (2021). Diyabetik Ayakta Öz Bakım Davranışı Ölçeği’nin Türkçe geçerlilik ve güvenilirliği. Karya Journal of Health Science, 2(2), 39-43. http://dx.doi.org/10.52831/kjhs.894403
6. Bandyk, D. F. (2018). The diabetic foot: pathophysiology, evaluation, and treatment. Semin Vasc Surg, 1(2-4), 43–48. https://doi.org/10.1053/j.semvascsurg.2019.02.001
7. Beaton, D., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2002). Recommendations for the cross-cultural adaptation of health status measures. New York: American Academy of Orthopaedic Surgeons, 12, 1-9.
8. Bell, R. A., Arcury, T. A., Snively, B. M., Smith, S. L., Stafford, J. M., Dohanish, R., et al. (2005). Diabetes foot self-care practices in a rural, triethnic population. Diabetes Educ., 31(1), 75-83. https://doi.org/10.1177/0145721704272859

9. Biçer, E., & Enç, N. (2014). Validity and reliability study of the diabetic foot care self efficacy scale. Diyabet, Obezite ve Hipertansiyonda Hemşirelik Forumu, 6(2), 40-45.
10. Boyko, E. J., Seelig, A. D., & Ahroni, J. H. (2018). Limb-and person-level risk factors for lower-limb amputation in the prospective Seattle diabetic foot study. Diabetes Care, 41(4), 891-898. https://doi.org/10.2337/dc17-2210
11. Bradley, C. (1994). Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practice. UK: Routledge. https://doi.org/10.4324/9781315077369
12. Chin, Y. F., & Huang, T. T. (2013). Development and validation of a diabetes foot self-care behavior scale. J Nurs Res., 21(1), 19-25. https://doi.org./10.1097/jnr.0b013e3182828e59
13. Cook, D. A., Zendejas, B., Hamstra, S. J., Hatala, R., & Brydges, R. (2014). What counts as validity evidence? Examples and prevalence in a systematic review of simulation-based assessment. Advances in Health Sciences Education, 19, 233-250. https://doi.org/10.1007/s10459-013-9458-4
14. Curry, L., & Nunez-Smith, M. (2014). Mixed methods in health sciences research: A practical primer (First edition). USA: Sage Publications.
15. De Vet, H. C., Terwee, C. B., Mokkink, L. B., & Knol, D. L. (2011). Measurement in medicine: a practical guide. https://doi.org/10.1017/CBO9780511996214
16. Emerging Risk Factors Collaboration (ERFC). (2010). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 375(9733), 2215-2222. https://doi.org/10.1016/S0140-6736(10)60484-9
17. Eroğlu, N. (2018). Diyabetli hastalarda diyabetik ayak sorunlarının yaşam kalitesine etkisi: sistematik inceleme. Hemşirelik Bilimi Dergisi, 1(2), 19-22.
18. Hasanpour Dehkordi, A., Chin, Y. F., Huang, T. T., Ebadi, A., & Ghanei Gheshlagh, R. (2020). Psychometric evaluation of the Farsi version of the diabetes foot self-care bahavior scale. J Foot Ankle Res., 13(1), 1-6. https://doi.org/10.1186/s13047-020-00437-5.
19. Hunt, S. M., McKenna, S. P., McEwen, J., Williams, J., & Papp, E. (1981). The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A, 15(3), 221-229. https://doi.org/10.1016/0271-7123(81)90005-5
20. International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas 10th edition. Retrieved from the Web. https://diabetesatlas.org/atlas/tenth-edition/
21. Jeffcoate, W., Gooday, C., Harrington, A., Lewis, J., Cawley, S., & Young, B. (2020). The national diabetes foot care audit of England and Wales: achievements and challenges. Diabetic Foot, 23(1), 71.
22. Kalayci, Ö., Açikgöz, B., Bayraktaroğlu, T., & Ayoğlu, F. N. (2020). Diyabetli hastaların ayak bakımı ve diyabetik ayak hakkındaki bilgi, tutum ve davranışlarının değerlendirilmesi. Turk J Diab Obes., 4(2), 98-107. https://doi.org/10.25048/tudod.622852
23. Kücükdeveci, A. A., McKenna, S. P., Kutlay, S., Gürsel, Y., Whalley, D., & Arasil, T. (2000). The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res, 23(1), 31-38. https://doi.org/10.1097/00004356-200023010-00004
24. Lecker, L., Stevens, M., Thienel, F., Lazovic, D., Van den Akker-Scheek, I., & Seeber, G. H. (2022). Validity and reliability of the German translation of the Diabetes Foot Self-Care Behavior Scale (DFSBS-D). Plos one, 17(6), e0269395. https://doi.org/10.1371/journal.pone.0269395
25. Mokkink, L. B., Terwee, C. B., Knol, D. L., Stratford, P. W., Alonso, J., Patrick, D. et al. (2010). The COSMIN checklist for evaluating the methodological quality of studies on measurement properties: a clarification of its content. BMC Med Res Methodol. 10(1), 1-8. https://doi.org/10.1186/1471-2288-10-22
26. Polikandrioti, M., Vasilopoulos, G., Koutelekos, I., Panoutsopoulos, G., Gerogianni, G., Babatsikou, F., et al. (2020). Quality of life in diabetic foot ulcer: associated factors and the impact of anxiety/depression and adherence to self-care. Int J Low Extrem Wounds. 19(2), 165-179. https://doi.org/10.1177/1534734619900415
27. Pollock, R., Unwin, N., & Connolly, V. (2004). Knowledge and practice of foot care in people with diabetes. Diabetes Res Clin Pract., 64(2), 117-122. https://doi.org/10.1016/j.diabres.2003.10.014
28. Sarouphim, K. M. (2001). DISCOVER: Concurrent validity, gender differences, and identification of minority students. Gift Child Q, 45(2), 130-138.
29. Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinccag, N., et al. (2013). Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur. J. Epidemiol. 28(2), 169-180. https://doi.org/10.1007/s10654-013-9771-5
30. Savli, H., & Sevinc, A. (2005). The evaluation of the Turkish version of the Well-being Questionnaire (WBQ-22) in patients with Type 2 diabetes: the effects of diabetic complications. J Endocrinol Invest. 28(10), 683-691. https://doi.org/10.1007/BF03347550
31. Terrin, N., Schmid, C. H., & Lau, J. (2005). In an empirical evaluation of the funnel plot, researchers could not visually identify publication bias. J Clin Epidemiol., 58(9), 894-901. https://doi.org/10.1016/j.jclinepi.2005.01.006
32. Terwee, C. B., Mokkink, L. B., Knol, D. L., Ostelo, R. W., Bouter, L. M., & de Vet, H. C. (2012). Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res, 21(4), 651-657. https://doi.org/10.1007/s11136-011-9960-1
33. van Netten, J. J., Raspovic, A., Lavery, L. A., Monteiro‐Soares, M., Rasmussen, A., Sacco, I. C., et al. (2020). Prevention of foot ulcers in the at‐risk patient with diabetes: a systematic review. Diabetes Metab Res Rev., 36, e3270. https://doi.org/10.1002/dmrr.3270
34. Vileikyte, L., Gonzalez, J. S., Leventhal, H., Peyrot, M. F., Rubin, R. R., Garrow, A., et al. (2006). Patient Interpretation of Neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care, 29(12), 2617-2624. https://doi.org/10.2337/dc06-1550
35. Wachid, N., Gayatri, D., & Pujasari, H. (2019). Correlation between sleep quality with diabetes self-care management on diabetes mellitus type 2 patients. AIP Conference Proceedings, 2092(1), 040018. https://doi.org/10.1063/1.5096751.
36. Yalçın, M., & Yetkin, İ. (2022). Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2022. Retrieved from the Web. https://temd.org.tr/yayinlar/kilavuzlar