Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Portuguese Version of the Depressive Cognition Scale in Brazilian Adults with Diabetes Mellitus

Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Portuguese Version of the Depressive Cognition Scale in Brazilian Adults with Diabetes Mellitus

Article excerpt

Identifying depressive cognitions in Brazilians with diabetes can be important step to prevent the development of clinical depression, which is negatively associated with diabetes self-management. This study focused on the psychometric testing of the Portuguese version of the Depressive Cognition Scale, the Escala Cognitiva de Depressão (ECD), among 82 Brazilian adults with diabetes mellitus. The questionnaire was assessed for internal consistency, homogeneity, and construct validity using factor analysis and convergent validity assessment with the Portuguese version of the Beck Depression Inventory, the Inventário de Depressão Beck (IDB). Cronbach's alpha for the ECD was .88. The homogeneity of the instrument was supported by item-to-total correlations between .30 and .70. Factor extraction generated only one factor with eigenvalues greater than 1, which is consistent with the English version. The ECD's total score had a weak but significant correlation with the IDB's total score (r = .24, p < .05), indicating convergent validity. Evidence for the reliability and construct validity of the ECD was provided by this study. This scale has the potential to become a useful screening tool for depressive cognitions among Brazilians with diabetes.

Keywords: depression; depressive cognition; diabetes; Escala Cognitiva de Depressão (ECD)

Detecting and treating early depressive cognitions in Brazilians with diabetes can be an important step in preventing the development of clinical depression. Studies conducted in the United States have suggested that individuals with diabetes with depression may not properly engage in diabetes self-management (Carnethon, Kinder, Fair, Stafford, & Fortmann, 2003; Lustman, Williams, Sayuk, Nix, & Clouse, 2007). When depression was treated, those individuals showed an improvement in glycemic control, which in turn decreased their risks for disease-related medical complications (Lustman et al., 2007; Lustman, Freedland, Griffith, & Clouse, 2000; Lustman, Griffith, Freedland, Kissel, & Clouse, 1998) and delayed their diabetes-related mortality (Bogner, Morales, Post, & Bruce, 2007). Although not yet reported among the Brazilian population, these outcomes observed among Americans with diabetes when depression was treated may also apply to Brazilians with diabetes. Therefore, a reliable and valid measure of depression, particularly cognitions that may precede the development of clinical depression, which can be used with adults in Brazil, is needed. This article reports the psychometric evaluation of the Portuguese version of the Depressive Cognition Scale (the Escala Cognitiva de Depressão [ECD]) among adults with diabetes mellitus from Southern Brazil.

BACKGROUND

Diabetes in the Brazilian Population

Diabetes affects approximately 11 to 12 million people in Brazil (Cambri & Santos, 2005; Clavijo, Carvalho, Rios, & Oliveira, 2006; Melo et al., 2003; Sociedade Brasileira de Diabetes [SBD], 2007). This represents approximately 8% to 10% of the Brazilian population (International Federation of Diabetes [IFD], 2007; SBD, 2007). As in the United States, where diabetes is also reaching epidemic proportions (American Diabetes Association [ADA], 2007; Centers for Disease Control and Prevention [CDC], 2005), diabetes-related complications among Brazilians are consequences of inadequate diabetes control; they include blindness, neuropathies and peripheral vascular diseases (leading to ulcerations and limb amputation), chronic renal failure, coronary artery disease, and cerebral vascular disease (CDC, 2005; Expert Committee on the Diagnosis and Classification of Diabetes Mellitus [ECDCDM], 2003; SBD, 2007). As suggested by studies conducted in the United States, these complications may be prevented or delayed if Brazilians with diabetes engage in proper disease self-management, including blood glucose monitoring, meal and exercise planning, and medication (oral hypoglycemic and/or insulin) adherence (Lustman et al. …

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