Estudo Fatorial Exploratório das Dimensões Comportamentais de Adesão em Pessoas com Diabetes Mellitus Tipo 1 e Tipo 2

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 Servico de Endocrinologia, Diabetes e Metabolismo of the Centro Hospitalar Universitario de Coimbra and at the Associacao Portuguesa de Diabeticos de Portugal. The self-report instruments were Rosenberg Self-esteem Scale, WHOQOL-Bref, Escala de Satisfacao com o Suporte Social, Medida de Adesao aos Tratamentos, Attitudes Towards Doctors and Medicine, Beck Depression Inventory, Diabetes Health Profile e Questionario 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.