J. Paulo Almeida (*)

M. Graça Pereira (**)

RESUMO

A Diabetes Tipo 1 é uma doença crónica complexa e de difícil controlo. Esta dificuldade é mais notória na adolescência, período em que a problemática que envolve a transição da dependência parental para uma vida mais autónoma. A adolescência caracteriza-se também por alterações nas características psicossociais que se podem repercutir na adesão ao tratamento, no controlo metabólico da Diabetes e na qualidade de vida.

O objectivo da presente investigação é adaptar um questionário de avaliação da qualidade de vida para adolescentes.

A amostra que constituiu o presente estudo foi composta por 256 adolescentes, com idades compreendidas entre os dez e os dezoito anos. O diagnóstico foi efectuado pelo menos um ano antes da colheita de dados. A versão portuguesa do DQOL apresenta-se com um número total de itens mais reduzido que a versão original os quais se agrupam em três factores que avaliam o IMPACTO da diabetes na vida actual do adolescente, a SATISFAÇÃO com o tratamento e a vida e a PREOCUPAÇÃO quanto ao futuro. Revela uma consistência interna excelente. A intercorrelação entre as sub-escalas que a compõem é também boa. Duas das subescalas revelam um poder discriminante heterogéneo quanto ao género e nas diversas faixas etárias da adolescência. Por fim apresenta uma elevada validade convergente, correlacionando-se de forma significativa com um questionário de ansiedade face à Diabetes.

Palavras-chave: Qualidade de vida, adolescentes, Diabetes Tipo 1.

ABSTRACT

Diabetes Type 1 is a complex chronic disease that is difficult to control specially during adolescence. This is due in part to the developmental transition of adolescence from dependency on parents to a more autonomous lifestyle. Adolescence is also marked by a change in psychosocial characteristics that have an impact on adherence to treatment, metabolic control and quality of life in diabetics.

The purpose of this study is to adapt a questionnaire of quality of life for adolescents with diabetes Type 1. The research included 256 adolescents, aged 10 to 18 years from the Pediatric Department of Hospital S. João – Porto. Diabetes was diagnosed at least a year prior to data collection.

The Portuguese version of DQOL has a smaller number of items than the original version gathered in 3 factors that assess IMPACT of Diabetes in the adolescent day to day life (13 itens), SATISFACTION with treatment and life (17 itens) and WORRY towards the future (6 itens). The scale shows an excellente internal consistency. The intercorrelation between the subscales is also good. The scale is able to descriminate between gender and age according to three phases of adolescence in two of the subscales. It also shows an excellent convergent validity being highly correlated with a questionnaire of anxiety towards diabetes.

Key words: Life quality, adolescents, Diabetes Type 1.

Texto completo disponível apenas em PDF.

Full text only available in PDF format.

Aaronson, N. K. (1988). Quality of Life: What is it? How Should be Measured? Oncology, 2, 69-74.         [ Links ]

Bradley, C. (1996). Translaction of Questionnaires for Use in Different Languages and Cultures. In Claire Bradley (Ed.), Handbook of Psychology and Diabetes. A Guide to Psychological Measurement in Diabetes Research and Practice. London: Harwood Academic Publishers.

Bradlyn, A. S. et al. (1996). Quality of Life Research in Pediatric Oncology. Research Methods and Barriers. Cancer, 78, 1333-1339.

Eiser, C., Patterson, D., & Tripp, J. H. (1984). Diabetes and Developing Knowledge of the Body. Archives of Disease in Childhood, 59, 167-169.

Eiser, C. (1985). The Psychology of Childhood Illness. New York: Spriger-Verlag.

Eiser, C. (1995). Concepts of Stress and Coping. In C. Eiser (Ed.), Growing up with a Chronic Disease. New York: Spriger-Verlag.

Eiser, C. (1997). Children’s Quality of Life Measures. Archives of Disease in Childhood, 77, 350-354.

Eiser, C., Vance, Y. H., & Seamark, D. (2000). The Development of a Theoretically Driven Generic Measure of Quality of Life for Children aged 6-12 Years: a Preliminary Report. Child Health, Care and Development, 26 (6), 445-456.

Erling, A. (1999). Methodological Considerations in the Assessment of Health-Related Quality of Life in Children. Acta Pediatrica (Suppl 428), 106-107.

Herschbach, P., Duran, G., Waadt, S., Zetler, A., Amm, C., & Marten-Mittag, B. (1997). Psychometric Properties of the Questionnaire on Stress in Patients with Diabetes-Revised (QSD-R). Health Psychology, 16 (2), 171-174.

Ingersoll, G., & Marrero, D. (1991). A Modified Quality-of Life Measure for Youths: Psychometric Properties. The Diabetes Educator, 17 (2), 114-118.

ISPAD, IDF & WHO (St. Vincent & Kos Declarations) (1995). Consensus Guidelines for the Management of Insulin-Dependent (Type 1) Diabetes Mellitus (IDDM) In Childhood And Adolescence. London: Freund Publishing House.

ISPAD & IDF (2000). ISPAD Consensus Guidelines for the Management of Type 1 Diabetes Mellitus in Children and Adolescents. Medical Forum International, The Neederlands.

Jenney, E. M., & Campbell, S. (1997). Measuring Quality of Life. Archives of Disease in Childhood, 77, 347-354.

Levi, R., & Drotat, D. (1998). Critical Issues and Needs in Health-Related Quality of Life Assessment of Children and Adolescents with Chronic Health Conditions. In Dennis Drotar (Ed.), Measuring Health-Related Quality of Life in Children and Adolescents – Implication for Research and Practice. Mahwah, NJ: Lawrence Erlbaum Publishers.

Manificat, S., Dazord, A., Cochat, P., & Nicolas, J. (1997). Évaluation de la Qualité de Vie en Pediatrie: Comment Recueillir le Point de Vue de l’Enfant. Archives de Pediatrie, 4, 1238-1246.

McGee, H. M. (1997). Quality of Life: Assessment Issues for Children with Chronic Illness and their Families. In M. Christie, & A. West (Ed.), Assessment of Quality of Life in Childhood Asthma. Chichester: Carden.

Ribeiro, J. L. P. (1994). Reconstrução de uma Escala de Locus de Controlo de Saúde. Psiquiatria Clínica, 15 (4), 207-214.

Ribeiro, J. L., Meneses, R. F., Meneses, I., & GRUPOQVD (1998). Avaliação da Qualidade de Vida em Crianças com Diabetes Tipo 1. Análise Psicológica, 16 (1), 91-100.

Rodrigues, F. J. C., Costa, F. G., Moura, L. S., Pinto, B., Gomes, L., Carvalheiro, M., & Ruas (1997). Incidence of Childhood Type 1 (Insulin-Dependent) Diabetes In Coimbra, Portugal, 1987-94. Diabetes Nutrition & Metabolism, 10, Suppl. 1, 14-17.

Rosenbaum, P., Cadman, D., & Kirpalani, H. (1990). Pediatrics: Assessing Quality of Life. In Bert Spilker (Ed.), Quality of Life Assessment in Clinical Trials. New York: Raven Press.

Schor, E. L. (1998). Children’s Health and the assessment of Health-Related Quality of Life. In Dennis Drotar (Ed.), Measuring Health-Related Quality of Life in Children and Adolescents – Implication for Research and Practice. Mahwah, NJ: Lawrence Erlbaum Publishers.

Shumaker, A. S., Anderson, R. T., & Czajkowski, S. M. (1990). Psychological Tests and Scales. In Bert Spilker (Ed.), Quality of Life Assessment in Clinical Trials. New York: Raven Press.

Sperling, A. M. (1996). Diabetes Mellitus. In W. E. Nelson, R. M. Behrman, & A. M. Arvin (Ed.), Nelson Textbook of Pediatrics (15.ª ed.). Philadelphia: W. B. Sanders.

Spieth, L. E., & Harris, C. V. (1996). Assessment of Health-Related Quality of Life in Children and Adolescents: An Integrative Review. Journal of Pediatric Psychology, 21, 175-193.

(*) Psicólogo Clínico, UAG da Mulher e da Criança, Hospital S. João – Porto. E-mail: jpaulo.c.almeida@gmail.com