Tradução, adaptação transcultural e testes das propriedades de medidas da EPAD (Escala de Percepção da Atividade Física em Dialise) para o português do Brasil

Abstract

Introduction: Chronic Kidney Disease (CKD) requiring dialysis impacts the musculoskeletal health of patients, leading to reduced physical activity. The Short Form Health Survey - 36 (SF-36) is an instrument used to assess aspects related to the physical health of these patients. However, this questionnaire is not specific to the dialysis population and does not aim to identify and understand the potential barriers these patients face in engaging in physical activity. The Dialysis Patient-Perceived Exercise Benefits and Barriers Scale (DPEBBS) was developed with the purpose of specifically evaluating patients with CKD on dialysis, facilitating the understanding of the perceived barriers and benefits related to physical activity. Objective: The objective of the study was to translate, culturally adapt, and perform measurement tests on the Brazilian version of the DPEBBS for its application in adult dialysis patients. Methods: The study was a measurement properties test based on the application of the Brazilian version of the DPEBBS, SF-36, and an anthropometric assessment. The COSMIN guidelines were followed to ensure a reliable measurement of the scale’s properties. Participants were recruited from the Hemodialysis Department of a university hospital, and to be eligible, they had to have a diagnosis of CKD on dialysis, be ≥ 18 years old, and have clinical stability. After applying the instruments, descriptive and statistical analyses were performed to evaluate the validity and reliability of the scale. Results: Study 1: Data analysis indicates that the test demonstrates high stability and consistency, with similar average scores on test and retest. Internal consistency is robust, and reliability is confirmed by a low Minimal Detectable Difference (MDD) and a strong Intraclass Correlation Coefficient (ICC). Convergent validity was significant (p = 0.001), though divergent validity was marginally non-significant (p = 0.052). Study 2: Analysis showed a gender-balanced sample with an average age of 54.42 years and a mean BMI of 24.05. The average scores on the EPAD, SF-36, and DASI scales were 67.54, 42.21, and 29.00, respectively. A significant negative correlation was found between physical capacity (DASI) and psychological well-being (EPAD) (R = -0.313; p = 0.013), suggesting that higher physical capacity may be associated with better psychological health. No significant correlations were found between SF-36 and the other scales, indicating that general quality of life may be influenced by distinct factors. These findings highlight the specific relationship between psychological well-being and physical capacity in adults. Study 3: *Ebook: Quick Guide to Physiotherapy in Dialysis. Conclusion: The results of this study provide strong evidence for the reliability and validity of the DPEBBS for use in CKD patients on dialysis in Brazil. The validation of the scale fills a gap in the literature, providing a reliable instrument to assess perceived benefits and barriers to physical activity in this population. These results have important clinical and research implications, enabling the development of targeted interventions to promote participation in physical activities and improve health outcomes in this vulnerable population.