Proposta de uma versão longa da escala de avaliação de incapacidade na demência (DAD-Br)

• Autor(a) principal: Canon, Mariana Boaro Fernandez [UNIFESP]
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=2479235; https://repositorio.unifesp.br/handle/11600/46781
• topic: Evaluation; Activities of daily living; Aged; Dementia; Reproducibility of results; Validity of tests; Avaliação; Atividades cotidianas; Idoso; Demência; Reprodutibilidade dos testes; Validade dos testes

Introduction: There are not available in the national literature any functional assessment tools for elderly with dementia that assess all Occupations. Objective: To develop a long version of Disability Assessment for Dementia (DAD-Br), covering all Occupations provided by the American Association of Occupational Therapy (AOTA) and the activities that compose them, which can be inserted into the daily life of elderly with dementia and analyze its psychometric properties. Methodology: The main author of the original version of DAD, Isabelle Gèlinas, PhD, authorized the development of the long version, called in this study as DADL-Br. The new items were developed based on the classification proposed by AOTA for Occupations and were analyzed and modified through the reviews of Cultural and Conceptual Equivalence answered by the Expert Committee and Multidisciplinary Committee. Then, 3 pre-tests were performed and analysis of the final version by the main author of DAD. The DADL-Br was applied in a total sample of 58 caregivers/family of elderly with dementia, the inter-examiner (n=30) intra-examiner (n=28) reliability was assessed using the Kappa?s test and Pearson Correlation Index, the internal consistency was assessed using Cronbach's Alpha and the construct validity (n=48), by hypothesis analysis, was performed comparing the DADL-Br with the MMSE. Results: The process that extended the elaboration of the items, equivalence assessments with consequent formulation of 5 versions of the instrument, pretests and analysis of the final version, conferred the content validity to DADL-Br. The mean agreement for Cultural Equivalence for the items was 89.2% and the Conceptual Equivalence was 81.2%. This analysis resulted in the addition of 12 items and the exclusion of 7 items, the final version consists of 20 fields and 109 items. Psychometric analysis conferred good inter and intra-examiner reliability (0.72 and 0.74 p<0.01), as well as the correlation was almost perfect (0.99 p<0.01 for both inter and intra-examiner). The Cronbach's Alpha presented an excellent result (0.87). The construct validity was given to the instrument by good correlation (0.74 p <0.01), confirming the hypothesis that the less cognitive impairment better is the occupational performance of elderly with dementia. Socio-demographic factors (age, education and gender) both elderly with dementia and their respective caregivers/family did not influence in the performance evaluated by DADL-Br. Conclusions: The final version of DADL-Br contemplates all Occupations proposed by AOTA, showed good results for the psychometric analysis and is considered a reliable instrument and it could constitute a useful tool for assessing the occupational performance profile of older people with dementia.