Evaluation of the FD-66 Scale as a tool for predicting treatment adherence in patients with chronic non-communicable diseases/Evaluacion de la Escala EFD-66 como herramienta para predecir la adherencia al tratamiento en pacientes con enfermedades cronicas no transmisibles/Avaliacao da escala EFD-66 como instrumento para predizer a adesao ao tratamento em pacientes com doencas cronicas nao transmissiveis

Objective. The objectives of this study are to validate the construct of the stages of grief scale (FD-66) as an instrument for measuring the stages of grief and to evaluate its usefulness in discriminating among patients with chronic non-communicable diseases in terms of adherence to the pharmacological treatment prescribed. Methods. A cross-sectional study was conducted from April to October 2015 to determine the association between the stages of grief and treatment adherence. Data were collected using a prolective design. Three instruments were applied: a sociodemographic document, the FD-66 scale, and the Morisky-Green questionnaire. Patients with a history of CNCDs were recruited from the Gustavo A. Madero Family Medicine Clinic in Mexico City. The data were analyzed using the appropriate statistical tests. Results. A total of 165 patients were included. It was observed that high scores on the subscales of denial (odds ratio [OR]: 1.124; confidence interval of 95% [CI95%]: 1.066-1.186; P < 0,001); anger (OR: 1.157; CI95%: 1.080-1.240; P < 0.001), and depression (OR: 1.071; CI95%: 1.029-1.116; P = 0.001) are associated with poor treatment adherence; however, a high score on the acceptance subscale (OR: 0.913; CI95%: 0.880-0.948; P < 0.001) is associated with good treatment adherence. The greatest sensitivity among the subscales was observed in the denial and anger stages (area under the [ABC] curve: 0.597 in both). Conclusions. The FD-66 is an instrument with good construct validity as a tool for measuring the stages of grief and makes it possible to identify patients with CNCD that will adhere to treatment. We therefore recommend its use in outpatient medical consultations. Furthermore, our findings indicate that grief is a risk factor that increases poor treatment adherence. Keywords Grief; medication adherence; primary care, health services, health promotion. Objetivo. Los objetivos del presente estudio son validar la construccion de la escala de fases de duelo (EFD-66) como instrumento para medir las etapas de duelo (ED) y evaluar su utilidad para discriminar entre pacientes con enfermedad cronica no transmisible (ECNT) que cumplen con adherencia al tratamiento farmacologico (ATF) en la consulta medica ambulatoria. Metodos. Se realizo un estudio transversal para determinar la asociacion entre las ED y la ATF, en los meses de abril a octubre de 2015. La recogida de datos se realizo mediante un diseno prolectivo. Se aplicaron tres instrumentos: una c