Avaliação das propriedades psicométricas de um aplicativo para o exame dos pés da pessoa com Diabetes Mellitus

Abstract

Considered a public health problem of high prevalence in the world, Diabetes Mellitus is characterized by elevated levels of serum glucose. Due to its chronicity, it predisposes the person to irreversible complications, among them, the diabetic foot; a serious problem that is characterized by lesions in the feet with loss of epithelium, which can reach the dermis to deeper tissues making it the main cause of amputations in the lower limbs. This highlights the need for health professionals to provide adequate assistance to people with Diabetes Mellitus through periodic foot assessments using reliable innovative methodologies that combine science and technology to accurately measure the risk of developing diabetic foot and intervene early in the problem. The objective of this study was to evaluate the psychometric properties of a foot evaluation of the person with Type 2 Diabetes Mellitus in a municipality in the south of Minas Gerais. This is a quantitative methodological study in which the validation process was carried out through the following steps: application content analysis; inter-examiner and intra-examiner reliability and concurrent criterion validity. The content analysis was performed by a committee with 15 judges from different professional categories that through a form evaluated the application as to its functionality and applicability. At the end of this phase, data were collected from April to June 2017 with volunteers with Type 2 Diabetes Mellitus. The inter-rater reliability was performed by two different evaluators at the same time who used the application in a sample of 100 volunteers. Intra-examiner reliability was performed by the same investigator at different times with 67 volunteers. In the criterion validity 100 volunteers were evaluated by means of a printed instrument with evaluation items recommended by the Ministry of Health and concomitantly by the application. Kappa statistical coefficient was used to analyze the data. The data evidenced, in the content analysis of the application, excellent agreement among judges. In the inter-examiner and intra-examiner reliability analyzes, more than 90% of diabetic foot evaluation indicators expressed satisfactory and excellent reliability and only the items: "already had feet evaluated", "knows foot care" and "xeroderma / dry ", Presented low reliability in the intra-examiner analysis, but, although they are important to complement the evaluation, these do not constitute indicators that score for risk classification of the diabetic foot. In the criterion validity, there was no low level of agreement and for most of the items, the reliability was excellent, noting that the application generates answers similar to the answers of the printed instrument and still has advantages, since it offers the possibilities of digital technology, besides features such as photos, videos, and help screens. It was concluded that the study allowed the evaluation of content and psychometric properties of the "Caring for the Foot" application, which proved to be a reliable tool to guide the health professional in the process of assessing the feet of the person with DM and measurement of the risk of diabetic foot.