Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis

Fenwick, Eva; Xie, Jing; Rees, Gwyn; Finger, Robert P.; Lamoureux, Ecosse L.

doi:10.1371/journal.pone.0080593

Cited by 48 publications

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“…No entanto, quanto ao conjunto das 23 questões não existe relação entre o conhecimento e os anos de diabetes, o que vai ao encontro do trabalho de Fenwick et al 7 Segundo este, o desempenho no DKT não está associado à duração da patologia.…”

Section: H3: Anos De Diagnóstico De Dm2unclassified

“…Embora Fenwick et al, 7 Moodley et al 15 e Schillinger et al 14 defendessem que o aumento da idade estava associado a um pior conhecimento sobre a DM2, neste estudo apenas verificamos que a idade não tinha impacto nos resultados alcançados no DKT. As possíveis explicações passam pelo facto de a capacidade de assimilação de informação pelos mais novos poder ser equilibrada por um maior enfoque educacional, por parte dos profissionais de saúde, nos grupos etários mais avançados dada a sua assumida vulnerabilidade.…”

Section: H5: Idadeunclassified

“…Contudo, o fator responsável por esta disparidade de resultados pode assentar no pressuposto de que os residentes em zonas urbanas têm um maior grau de educação e um maior acesso à informação, sendo negligenciada a sua formação por parte dos profissionais de saúde. 7,14,15 H8: estado civil Face à variável 'estado civil', a maioria dos participantes apresenta valores de HbA1c dentro da normalidade, independentemente do seu estado civil. Contudo, a nível de conhecimento sobre a patologia, o grupo dos viúvos destaca-se ao apresentar um pior desempenho no inquérito, enquanto os restantes demonstram um nível de conhecimento moderado sobre a DM, de encontro com os resultados obtidos por Jackson et al 16 Apesar de não ter repercussões a nível metabólico, o pouco conhecimento por parte dos viúvos poderá dever--se à vulnerabilidade característica deste grupo, que pode levar a um simples cumprimento da terapêutica e das recomendações médicas gerais para a patologia, sem procurar conhecer o porquê das suas limitações.…”

Section: H6: Naturalidadeunclassified

“…Dada a sua crescente incidência, e tendo em consideração que 95% do seu controlo se deve à atitude do paciente face à sua doença, assomou-se a necessidade de munir os profissionais de saúde de ferramentas capazes de determinar as carências educacionais dos seus utentes. [2][3][4][5][6][7] e manuseio da terapêutica. 2 Ao identificar as necessidades educativas dos diabéticos nestas temáticas, o DKT permitirá aos profissionais de saúde delinear uma estratégia interventiva mais personalizada, dirigindo a informação transmitida às reais dificuldades do doente.…”

Section: Introductionunclassified

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Fiabilidade da Escala de Conhecimento da Diabetes em Portugal

Azevedo

Santiago

2016

Acta Med Port

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RESUMOIntrodução: Dada a crescente incidência da diabetes tipo 2 e considerando que parte do seu controlo se deve à atitude do paciente face à doença, torna-se importante munir os profissionais de saúde com ferramentas capazes de determinar as carências educacionais dos utentes, permitindo uma intervenção mais personalizada na correção de hábitos nocivos. Conclusão: Demonstrou-se a fidelidade psicométrica moderada a elevada do teste, assim como uma correlação positiva entre o controlo da diabetes e o desempenho no inquérito. Espera-se que a sua futura aplicação possibilite identificar as razões do descontrolo dos diabéticos, permitindo uma atuação mais individualizada pelos profissionais de saúde.Palavras-chave: Avaliação Educacional; Conhecimentos, Atitudes e Prática em Saúde; Diabetes Mellitus; Portugal; Psicometria.ABSTRACT Introduction: Given the rising incidence of type 2 diabetes and taking into account that much of its control depends on the patient's attitude towards his illness, loomed the need to equip health professionals with capable tools to determine the educational needs of their patients, allowing a more personalized intervention to correct habits that could be harmful to the diabetics' health.Objective: Verify the Diabetes Knowledge Test reliability in Portugal. Analysis of socio-demographic and pathologic variables' correlation with the number of correct answers in the test. Material and Methods:Application of the translated version of Diabetes Knowledge Test to a convenience sample of a primary care center in Covilhã. Results:In general, the questions obtained a Cronbach's alpha > 0.800. Diabetics with better results in the survey proved to be more compliant, with a positive relationship between knowledge and diabetes' control. However, only 9.2% of diabetics have good knowledge about their disease, and the majority (65.8%) shows an average one. The insulin treated patients show the worst results (77.6% with low knowledge). The variables 'treatment route' and 'complications' show statistical impact on the level of knowledge that diabetics have about their pathology (p values 0.00 and 0.048, respectively). Inhabitants of rural areas, without complications secondary to diabetes and treated orally, proved to be more compliant and to have better knowledge about the disease.Discussion: Contrary to previous studies, variables such as age and educational level showed no relation with the performance in the survey. Inhabitants of the rural area and diabetics treated orally obtained better results than what had been previously advocated. Conclusion:It has been proved the moderate to high psychometric reliability of the test, as its value establishing a correlation between diabetes knowledge and control. It is expected that its future application will help identifying the reasons for uncontrolled diabetics, allowing a more individualized intervention by the health professionals.Keywords: Diabetes Mellitus; Educational Measurement; Health Knowledge, Attitudes, Practice; Portugal; Psychometrics. INTRODUÇÃ...

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Section: H3: Anos De Diagnóstico De Dm2unclassified

Section: H5: Idadeunclassified

Section: H6: Naturalidadeunclassified

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Fiabilidade da Escala de Conhecimento da Diabetes em Portugal

Azevedo

Santiago

2016

Acta Med Port

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“…It has been reported that low-income diabetes patients have low levels of diabetes knowledge and the levels of diabetes knowledge are directly related to glucose control capabilities in this population. Therefore, developing effective strategies to provide health information and improve knowledge levels in this vulnerable population of low-income elderly patients with diabetes is necessary [5,8,9].…”

Section: Introductionmentioning

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The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes

Jihye

Park

Shin

2014

J Korean Acad Community Health Nurs

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Purpose: This study aimed to assess the levels of and relationships among health literacy, knowledge about diabetes, and self-care activities in the Korean low-income elderly with diabetes and to identify factors influencing the self-care activities of this vulnerable population. Methods: This study surveyed a total of 151 low-income elderly patients with diabetes registered at 16 Visiting Health Care Services in B City, Korea. Health literacy was measured with the Newest Vital Sign. Diabetes knowledge was measured with the Diabetes Knowledge Test. The Summary of Diabetes Self-care Activities Questionnaire was used to assess diabetes self-care activities. A stepwise multiple regression analysis was conducted to identify significant factors influencing diabetes self-care activities in these patients. Results: In the regression model, diabetes knowledge (β=.322, p<.001), exercise (β=.337, p<.001), and experiences of diabetes education (β=.241, p=.001) were significantly associated with increased diabetes self-care activities in low-income elderly patients with diabetes when gender, education, health literacy, and subjective health state were controlled. Conclusion: To improve diabetes self-care activities in the low-income elderly with diabetes, it is important to develop a customized program considering their knowledge, exercise, and diabetes education experience.

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Association Between Diabetes-Related Eye Complications and Symptoms of Anxiety and Depression

et al. 2016

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IMPORTANCE This study is needed to clarify inconsistent findings regarding the association between diabetes-related eye complications and psychological well-being. OBJECTIVE To examine the association between severity of diabetic retinopathy (DR) and diabetic macular edema (DME) with symptoms of depression and anxiety in adults with diabetes. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study was conducted in a tertiary eye hospital in Melbourne, Australia. The study comprised 519 participants with diabetes. The median duration of diabetes was 13.0 (interquartile range, 14.0) years. The study was conducted from March 1, 2009, to December 24, 2010. EXPOSURES Patients underwent a comprehensive eye examination in which dilated fundus photographs (disc and macula centered) were obtained and graded for the presence and severity of DR and DME. Presenting distance uniocular and binocular visual acuity were assessed using a 3-m logMAR chart. MAIN OUTCOMES AND MEASURES Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS), which comprises 7 questions specific to anxiety and 7 specific to depression with scores ranging from 0 to 21; scores higher than 8 signify possible anxiety or depression. The ordinal raw scores of the HADS questionnaire were transformed to estimates of interval measure using Rasch analysis and evaluated as continuous variables. Participants also completed standardized interview-administered questionnaires. Blood samples were assessed for hemoglobin A 1c , fasting blood glucose, and serum lipids. Multiple linear regression models were used to determine the associations between the severity of DR and DME with symptoms of anxiety and depression and commonality analysis was used to quantify the unique variance explained. RESULTS Of the 519 participants in the study, 170 individuals (32.8%) were female; mean (SD) age was 64.9 (11.6) years. Raw scores indicated that 80 individuals (15.4%) screened positive for depressive symptoms and 118 persons (22.7%) screened positive for symptoms of anxiety. In multivariate analysis using Rasch scores, severe nonproliferative DR (NPDR)/PDR was independently associated with greater depressive symptoms (regression coefficient [β] = 0.69; 95% CI, 0.03-1.34) after controlling for sociodemographic factors and clinical characteristics, including visual acuity. A history of depression or anxiety accounted for 60.6% (95% CI, 23.9%-83.2%) of the unique variance in depressive symptoms, and severe NPDR or PDR contributed to 19.1% (95% CI, 1.7%-44.4%) of the total explained variance of depressive symptoms. Diabetic macular edema was not associated with depressive symptoms. No association between DR and symptoms of anxiety was identified. CONCLUSIONS AND RELEVANCE Severe NPDR or PDR, but not DME, was independently associated with depressive symptoms. The severity of DR could be an indicator to prompt monitoring of depression in at-risk individuals with diabetes. Further work is required to replicate these findings and determine...

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Factors Associated with Knowledge of Diabetes in Patients with Type 2 Diabetes Using the Diabetes Knowledge Test Validated with Rasch Analysis

Cited by 48 publications

References 32 publications

Fiabilidade da Escala de Conhecimento da Diabetes em Portugal

Fiabilidade da Escala de Conhecimento da Diabetes em Portugal

The Influence of Health Literacy and Diabetes Knowledge on Diabetes Self-care Activities in Korean Low-income Elders with Diabetes

Association Between Diabetes-Related Eye Complications and Symptoms of Anxiety and Depression

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