Objective:to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. Method:methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. Results:the model’s goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. Conclusion:the scale’s factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R.

IntroduçãoCom o objetivo de conseguir um bom controle metabólico entre as pessoas com diabetes mellitus, o tratamento substitutivo com insulina exó-gena constitui a opção terapêutica mais eficiente, frente à deficiência parcial ou total da secreção de insulina 1,2 .A terapia com insulina visa a mimetizar, tanto quanto possível, o perfil fisiológico da secreção pancreática de insulina. Dessa forma, múltiplas doses diárias desse hormônio no tecido subcutâneo são necessárias no sentido de proporcionar o controle glicêmico, o qual tem sido demonstrado como condição essencial na prevenção das complicações agudas e crônicas do diabetes mellitus 3 .Mas para que o controle glicêmico seja efetivo com o tratamento insulinoterápico, é necessá-rio que o usuário com diabetes mellitus aprenda vários aspectos sobre como utilizar a insulina exógena, pois a ação deste medicamento está diretamente relacionada a fatores envolvidos desde a sua aquisição até a aplicação 4 e que, para alcançar este objetivo, é necessário tempo, prática e educação permanente para o desenvolvimento de confiança e habilidade técnica 5 .No entanto, estudos têm mostrado que a realidade do cuidado ao usuário com diabetes mellitus continua deficiente, apesar dos avanços do tratamento insulinoterápico nos últimos anos, pois ainda se observa déficit de conhecimento ARTIGO ARTICLE 1314Cad. Saúde Pública, Rio de Janeiro, 24(6)

Objective: To verify the effectiveness of the educational intervention through the evaluation of nurses’ knowledge about prevention of pressure injury. Method: A quasi-experimental study with a single group, carried out with 95 nurses from a teaching hospital in the interior of Minas Gerais, in August and September 2017. As a teaching strategy, the active methodology and hybrid teaching were used, based on the reference of the Method of the Arch of Charles Maguerez. Data were collected from a validated instrument, called the Pieper Knowledge Test, and analyzed by descriptive statistics and Student’s t-test with significance level of p <0.001. Results: The mean number of correct answers obtained by the nurses was 78.8% in the pre-test and 88.8% in the post-test, and the difference was statistically significant (p <0.001). Conclusion: The educational intervention developed was effective, since it contributed to the improvement of nurses’ knowledge.

Objective: Translate, adapt and validate the Appraisal of Self-care Agency Scale-Revised (ASAS-R) for Brazil. Methods: A descriptive method for adapting measurement instruments was used with 150 diabetes mellitus patients. The instrument underwent translation, synthesis of independent translations, evaluation by a committee of judges, back-translation and submittal of back-translation to original authors, semantic validation, submittal of the adapted version to original authors, and pretesting. Results: The ASAS-R maintained semantic, cultural and conceptual equivalence. Cronbach's alpha was 0.74; the intraclass correlation coefficient for test-retest reliability was 0.81; and interobserver agreement was 0.84. Conclusion: The Brazilian-Portuguese version maintained conceptual, semantic and cultural validity, as compared to the original version. In the discriminant validity, there was correlation between capacity for selfcare, depression and perceived health, but not social support. There were significant differences between groups regarding age, education levels and insulin self-application. ResumoObjetivo: Traduzir, adaptar e validar a escala Appraisal of Self Care Agency Scale-Revised (ASAS-R) para o Brasil. Métodos: Utilizou-se o método descritivo de adaptação de instrumentos de medidas, em 150 portadores de diabetes mellitus. As etapas foram: tradução, síntese das traduções independentes, avaliação pelo Comitê de Juízes, retrotradução, submissão das versões retrotraduzidas aos autores da versão original, validação semântica, submissão da versão adaptada aos autores da versão original e pré-teste. Resultados: ASAS-R manteve as equivalências semântica, cultural e conceitual. O alfa de Cronbach foi de 0,74, e o coeficiente de correlação intraclasse, no teste e reteste, foi de 0,81, e na análise interobservadores, de 0,84. Conclusão: A versão manteve as equivalências conceitual, semântica e cultural. Confirmou-se a correlação entre os construtos capacidade de autocuidado, depressão e percepção do estado de saúde, exceto apoio social. Na validade discriminante, observaram-se diferenças significantes entre grupos, quanto à idade, escolaridade e autoaplicação de insulina.

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