Evidências de validade do Millon Behavioral Medicine Diagnostic (MBMD) na avaliação psicológica de candidatos à cirurgia bariátrica

the Millon Behavioral Medicine Diagnostic is an instrument, developed from a consensus among health professionals, to identify psychological factors that may compromise the conducting of medical treatment in order to allow a better adhesion. As it has been one of the most used tools to assess bariatric surgery, the objective of this research is to verify the evidence validity of Millon Behavioral Medicine Diagnostic (MBMD) for psychological assessment of candidates for bariatric surgery. Method: males and females volunteers, aged 18 to 70, grouped in 150 patients admitted for surgical procedures or suffering from chronic diseases (control group) and 426 patients candidates for bariatric surgery, contacted in person or by the internet. For the study in the face group were also administered Millon Index of Personality Styles (MIPS), the Millon Clinical Multiaxial Inventory-III (MCMI-III) and the General Health Questionnaire of Goldberg, just in bariatric surgery patients. Results: there are indicators of semantic adaptation of the instrument, with 27 factors in five areas of the instrument, all with satisfactory levels of validity. The reliabitity indicators were satisfactory in 18 of the 32 scales that comprise the MBMD, while relations with the other three instruments showed significant variations compared to the original indicators. The MBMD was sensitive to differences between groups about gender, age, education, marital status, body mass index, comorbidities and chronic disease patients and with or without obesity. The use of this instrument in the assessment of candidates for bariatric surgery presents indicators of validity in view the limitations as to the realiability of certain scales

Evidências de validade do Millon Behavioral Medicine Diagnostic: avaliação de indicadores de adesão ao tratamento em pacientes com hipertensão

Systemic Arterial Hypertension – SAH – is defined as the syndrome which its main feature is the presence of high tensional levels, associated with alterations of functional or structural levels in the organs that it strikes. Its specific causes are not very well bounded and have an asymptomatic character. Due to its chronicity it requires adherence to the treatment plan in a systematic and permanent manner, implicating in lifestyle changes, combined or not with the use of medication. The personality inventories have been largely used in the lineation of indicative traits of difficulties with the adherence to the treatment. In this sense, developed by Theodore Millon, the Millon Behavioural Medicine Diagnostic – MBMD is an instrument made from the consensus among healthcare professionals, aiming at identifying psychological factors that may compromise medical treatment so that they can be conducted in a way to enable a better adherence. Objective: evaluation of the evidence of validity of the Millon Behavioural Medicine Diagnostic – MBMD for a public of patients with hypertension, aiming at investigating the indicators implicated in the adherence or not to the anti-hypertensive treatment. Method: there was a group of 200 participants in a university hospital in the city of Natal/RN, males and females, ranging from 20 to 70 years old. An interview protocol was administered in order to obtain information about socio-demographic data, clinical history, healthcare habits and way of conducting treatment, and after, the administration of the MBMD followed. Results: by means of Factor Analysis it was verified that the organization proposed by the factors is favorable and it adjusts to the theory, allowing the visualization of other underlying constructs to the scales, with adequate adjustment indexes and satisfactory Cronbach’s alpha indicators. Besides, the MBMD revealed itself sensitive to the intragroup differences relative to the sex, age, schooling, marital status, profession, income, SAH history, diagnostic time, medication use, comorbidity presence, hyposodic diet, social support and adherence criteria variables. The utilization of such instrument in the evaluation of the adherence to the anti-hypertensive treatment show, therefore, indicators of validity.