Avaliação do conhecimento dos pacientes ambulatoriais com artrite reumatoide: validade e confiabilidade do Methotrexate Questionnaire (MTXQ) traduzido (adaptado) para a língua portuguesa

Abstract

The objective was to carry out the translation and cross-cultural adaptation of the Methotrexate Questionnaire (MTXQ) for use in Brazil and to verify the psychometric properties of the Brazilian version of the MTXQ. For this, prior authorization was obtained from the author of the original version of the instrument. A methodological study was developed with a quantitative approach carried out in an Outpatient Pharmacy in Fortaleza. The five steps recommended by Beaton for cross-cultural adaptation were carried out: initial translation, synthesis of translations, back- translation, evaluation by a committee of judges and pre-test. The sample used was for convenience, totaling 30 patients with rheumatoid arthritis using methotrexate. Data collection took place from January to February 2022, and in addition to the Brazilian version MTXQ, a form with sociodemographic information prepared by the authors was used. A confirmatory factor analysis was performed in order to assess the unidimensionality of the MTXQ. The analysis was implemented using the Robust Diagonally Weighted Least Squares (RDWLS) estimation method, suitable for categorical data. The adjustment indices used were: 2 which should not be significant; 2/gl that values ​​should be < than 5 or, preferably, < than 3; Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) that values ​​must be > 0.90 and preferably above 0.95; Root Mean Square Error of Approximation (RMSEA) that values ​​should be < 0.08 or, preferably < 0.06, with a confidence interval (upper limit) < 0.10. Internal consistency was measured using Cronbach's Alpha. Data were analyzed using the JASP 0.16.1 statistical program. Despite the suggested model excluding some items from the scale and having several items with low factor loading, all fit indices and Cronbach's alpha were satisfactory. We chose to include as many items as possible in the model, as it is assumed that in future applications of the scale, with a larger sample size, there will be an increase in factor loadings. It is noteworthy that for future applications, MTXQ should be applied in its entirety and not just the model suggested by the confirmatory factor analysis, as more items can be added to the model, giving greater robustness to the scale, in addition to possible qualitative analyzes that indicate which information should be worked out better with patients.