Transcultural adaptation and validation of the spanish version of the treatment burden questionnaire for people with mellitus type 2 diabetes that attend to primary health care centers within the public health care system. San Juan
DOI:
https://doi.org/10.47196/diab.v57i2.626Keywords:
diabetes mellitus type 2, validation study, surveys and questionnaires, quality of life, workloadAbstract
Introduction: the Treatment Burden Questionnaire (TBQ) assess the load that implies the self-care for people with chronic diseases and the impact that medical assistance produce in their quality of life.
Objectives: to adapt and psychometrically validate the spanish version of the TBQ-multiple sclerosis questionnaire to the diabetes mellitus (DM) context in patients treated in the Argentinian public health sector.
Materials and methods: analytic study of transcultural adaptation and psychometric validation of a questionnaire. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were performed. Concurrent criterion validity was evaluated through Pearson correlation with three scales (WHO-5, PHQ-9, Morisky-Green Test). Reliability was evaluated through Cronbach's alpha coefficient, composite reliability, and average variance extracted.
Results: 256 people participated. The adapted version was adequately understood by the target population. EFA (n=100) allowed for the hypothesis of four domains: 1) pharmacological treatment; 2) healthcare/health system; 3) maintenance of a lifestyle and its economic impact; 4) psychosocial sphere. In the CFA (n=156), the factor loadings of 87.5% (14/16) of the items were greater than 0.5 with statistical significance. An inverse correlation (-0.46; p=0.0002) with the WHO-5 index and a direct correlation (0.36; p=0.0046) with the PHQ-9 scale were documented. Patients categorized as “non-adherent” by the Morisky-Green-Levine scale had a TBQ-DM score of 16.99 (95% CI: 0.95 to 33.03) points higher than patients categorized as “adherent” (p=0.0383). The internal consistency of the questionnaire was very good (Cronbach's alpha: 0.87), its composite reliability was acceptable, and its divergent validity was low.
Conclusions: the spanish TBQ adapted to DM2 has acceptable pyshcometric properties. Its implementation can help offer a person-centered care.
References
I. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA 2005 Aug 10;294(6):716-24. doi: 10.1001/jama.294.6.716. PMID: 16091574.
II. Safford MM, Russell L, Suh DC, Roman S, Pogach L. How much time do patients with diabetes spend on self-care? J Am Board Fam Pract 2005 Jul-Aug;18(4):262-70. doi: 10.3122/jabfm.18.4.262. PMID: 15994472.
III. Eton DT, Elraiyah TA, Yost KJ, Ridgeway JL, Johnson A, Egginton JS, Mullan RJ, Murad MH, Erwin PJ, Montori VM. A systematic review of patient-reported measures of burden of treatment in three chronic diseases. Patient Relat Outcome Meas 2013 Jun 5;4:7-20. doi: 10.2147/PROM.S44694. PMID: 23833553; PMCID: PMC3699294.
IV. Tran VT, Montori VM, Eton DT, Baruch D, Falissard B, Ravaud P. Development and description of measurement properties of an instrument to assess treatment burden among patients with multiple chronic conditions. BMC Med 2012 Jul 4;10:68. doi: 10.1186/1741-7015-10-68. PMID: 22762722; PMCID: PMC3402984.
V. Tran VT, Harrington M, Montori VM, Barnes C, Wicks P, Ravaud P. Adaptation and validation of the Treatment Burden Questionnaire (TBQ) in English using an internet platform. BMC Med 2014 Jul 2;12:109. doi: 10.1186/1741-7015-12-109. PMID: 24989988; PMCID: PMC4098922.
VI. Ysrraelit MC, Fiol MP, Peña FV, Vanotti S, Terrasa SA, Tran VT, Montori VM, Correale J. Adaptation and validation of a Spanish version of the treatment burden questionnaire in patients with multiple sclerosis. BMC Neurol 2019 Aug 27;19(1):209. doi: 10.1186/s12883-019-1441-0. PMID: 31455235; PMCID: PMC6710872.
VII. Ramada-Rodilla JM, Serra-Pujadas C, Delclós-Clanchet GL. Adaptación cultural y validación de cuestionarios de salud: revisión y recomendaciones metodológicas. Salud Publica Mex 2013 Jan-Feb;55(1):57-66. Spanish. doi: 10.1590/s0036-36342013000100009. PMID: 23370259.
VIII. Pérez ER, Medrano LA. Análisis factorial exploratorio: bases conceptuales y metodológicas. Rev Argent Cienc Comport 2010; 2(1):58-66.
IX. Martínez CM, Sepúlveda MA. Introducción al análisis factorial exploratorio. Rev Colomb Psiquiatr 2012 Mar;41(1):197-207. Spanish. doi: 10.1016/S0034-7450(14)60077-9. Epub 2014 May 10. PMID: 26573478.
X. Streiner DL. Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry 1994 Apr;39(3):135-40. doi: 10.1177/070674379403900303. PMID: 8033017.
XI. Jöreskog KG, Sörbom D, Du Toit SHC, Universitet U. LISREL 8: New Statistical Features. Scientific Software International 2001;248.
XII. Streiner DL. A checklist for evaluating the usefulness of rating scales. Can J Psychiatry 1993 Mar; 38(2):140-8. doi: 10.1177/070674379303800214. PMID: 8467441.
XIII. Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom 2015;84(3):167-76. doi: 10.1159/000376585. Epub 2015 Mar 28. PMID: 25831962.
XIV. Baader MT, Molina FJL, Venezian BS, Rojas CC, Farías SR, Fierro-Freixenet C, Mundt C. Validación y utilidad de la encuesta PHQ-9 (Patient Health Questionnaire) en el diagnóstico de depresión en pacientes usuarios de atención primaria en Chile. Revista Chilena de Neuro-Psiquiatría 2012; 50(1):10-22. doi: 10.4067/s0717-92272012000100002.
XV. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986 Jan;24(1):67-74. doi: 10.1097/00005650-198601000-00007. PMID: 3945130.
XVI. Chin WW. The partial least squares approach to structural equation modelling. In G. A. Marcoulides (Ed.) Modern methods for business research 1998;295-336. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
XVII. Hair JF, Black WC, Babin B, Anderson RE. Multivariate data analysis. 8° Ed. Cengage. 2018.
XVIII. Fornell C, Larcker D.F. Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research1981;18:39-50.
XIX. Finney SJ, DiStefano C. Non-normal and categorical data in structural equation modeling. Structural equation modeling: a second course. 2006;10:269-314.
XX. Hu LT, Bentler PM. Cutoff criteria for fit indixes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling 1999;6:1-55.
XXI. Ubel PA, Abernethy AP, Zafar SY. Full disclosure out of pocket costs as side effects. N Engl J Med 2013 Oct 17;369 (16):1484-6. doi: 10.1056/NEJMp1306826. PMID: 24131175.
XXII. Shippee ND, Shah ND, May CR, Mair FS, Montori VM. Cumulative complexity: a functional, patient-centered model of patient complexity can improve research and practice. J Clin Epidemiol 2012 Oct;65(10):1041-51. doi: 10.1016/j.jclinepi.2012.05.005. PMID: 22910536.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 on behalf of the authors. Reproduction rights: Argentine Diabetes Society
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.