School of Nursing, University of Campinas, Campinas, Brazil.
Int Wound J. 2020 Jun;17(3):670-682. doi: 10.1111/iwj.13310. Epub 2020 Feb 17.
The purpose of this paper is to provide measurement properties evaluation and factor analysis of the Brazilian version of the diabetic foot ulcer scale-short form (DFS-SF). This methodological study evaluated the measurement properties of the DFS-SF by ceiling and floor effect reliability, responsiveness, and structural construct validity. The study included 290 people with diabetic foot under regular follow-up in a specialised outpatient clinic in inland São Paulo. Reliability was assessed by internal consistency using Cronbach's alpha and composite reliability. Ceiling and floor effects were assessed by the percentage of participants who scored the 15% worst (floor) and 15% best (ceiling) possible scale results. Validity was tested by correlating the instrument values with the domains of the Brazilian version of the Short Form Health Survey (SF-36). Responsiveness (n = 34) was accessed through the wound area obtained by photography and evaluated by the Image J Features program and the DFS-SF score at two moments, with a 4-week interval between them. The instrument had good evidence of reliability, shown by adequate internal consistency (Cronbach's alpha in domains >0.70) and compound reliability (0.84 > CC > 0.92); and of convergent validity, by significant positive correlations of moderate to strong magnitude with SF-36. Structural construct validity was examined by applying the DFS-SF confirmatory factor analysis, which indicated that the Brazilian version of the instrument is properly fitted to the original dimensional structure. The ceiling and floor effect analysis showed no ceiling or floor effects. Responsiveness was observed in the wound area, but not in the DFS-SF scores in the times. The Brazilian version of the DFS-SF presented evidence of validity and reliability, suggesting that this instrument is a valid tool for assessing the quality of life of people with diabetic foot in the Brazilian population.
本文旨在评估巴西版糖尿病足溃疡量表简表（DFS-SF）的测量性能。该方法学研究通过天花板和地板效应的可靠性、反应度以及结构构念效度来评估 DFS-SF 的测量性能。该研究纳入了在巴西内陆圣保罗一家专科门诊接受常规随访的 290 名糖尿病足患者。采用 Cronbach's alpha 和综合可靠性评估内部一致性来评估可靠性。通过评估得分最差（地板）和最好（天花板）的 15%的患者比例来评估天花板和地板效应。通过与巴西版健康调查简表（SF-36）的各个领域相关联来检验效度。通过摄影获得的创面面积评估反应度（n=34），并用 Image J Features 程序和 DFS-SF 得分进行评估，两次评估之间间隔 4 周。该工具具有良好的可靠性证据，表现为各领域适当的内部一致性（Cronbach's alpha >0.70）和综合可靠性（0.84 > CC > 0.92）；具有良好的聚合效度，与 SF-36 呈显著正相关，相关程度从中等到较强。结构构念效度通过应用 DFS-SF 验证性因子分析进行检验，结果表明该工具与原始维度结构适配良好。天花板和地板效应分析未发现天花板或地板效应。在创面面积方面观察到反应度，但在两次评估的 DFS-SF 得分中未观察到。巴西版 DFS-SF 具有有效性和可靠性的证据，表明该工具是评估巴西人群糖尿病足患者生活质量的有效工具。
