Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G).

Martina Kamradt,Werner Besier,Johannes Krisam,Dominik Ose,Sarah Berger,Tobias Freund,Marion Kiel,Joachim Szecsenyi,Kayvan Bozorgmehr,Elisabeth Flum,Markus Qreini

doi:10.1186/s12955-014-0185-1

Abstract

BackgroundOne of the most widely used self-reporting tools assessing diabetes self-management in English is the Summary of Diabetes Self-Care Activities (SDSCA) measure. To date there is no psychometric validated instrument in German to assess self-management in patients with diabetes mellitus. Therefore, this study aimed to translate the SDSCA into German and examine its psychometric properties.MethodsThe English version of the SDSCA was translated into German following the guidelines for cultural adaptation. The German version of the SDSCA (SDSCA-G) was administered to a random sample of 315 patients with diabetes mellitus type 2. Reliability was analyzed using Cronbach’s alpha coefficient and item characteristics were assessed. Exploratory and confirmatory factor analysis (EFA and CFA) were carried out to explore the construct validity. A multivariable linear regression model was used to identify the influence of predictor variables on the SDSCA-G sum score.ResultsThe Cronbach’s alpha for the SDSCA-G (all items) was α = 0.618 and an acceptable correlation between the SDSCA-G and Self-management Diabetes Mellitus-Questionnaire (SDQ) (ρ = 0.664) was identified. The EFA suggested a four factor construct as did the postulated model. The CFA showed the goodness of fit of the SDSCA-G. However, item 4 was found to be problematic regarding the analysis of psychometric properties. The omission of item 4 yielded an increase in Cronbach’s alpha (α = 0.631) and improvements of the factor structure and model fit. No statistically significant influences of predictor variables on the SDSCA-G sum score were observed.ConclusionThe revised German version of the SDSCA (SDSCA-G) is a reliable and valid tool assessing self-management in adults with type 2 diabetes in Germany.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0185-1) contains supplementary material, which is available to authorized users.

Highlights

One of the most widely used self-reporting tools assessing diabetes self-management in English is the Summary of Diabetes Self-Care Activities (SDSCA) measure
The mean age of the population was 71.6 ± 9.2 years, 41.2% of the patients were female, 33.6% were treated with insulin and the mean number of comorbidities was 2.8 ± 1.6. 36.2% of the patients were enrolled in a Disease management program (DMP) and 14.3% had a migration background
These findings suggest that the SDSCA-G is suitable for assessing self-management in patients with diabetes mellitus type 2 in Germany

Summary

Introduction

One of the most widely used self-reporting tools assessing diabetes self-management in English is the Summary of Diabetes Self-Care Activities (SDSCA) measure. To date there is no psychometric validated instrument in German to assess self-management in patients with diabetes mellitus. Care for people with chronic diseases is shifting away from patients as passive recipients to patients with active involvement in their everyday health care. To accomplish this change strengthening self-management has become a major task in the health care sector [8,9,10,11], which is Kamradt et al Health and Quality of Life Outcomes (2014) 12:185 necessary to meet the needs of chronically ill people and achieve better health care outcomes [9,10,11]. Concepts like self-efficiency or empowerment are strongly related with self-management and self-care because attributes related with these concepts influence patients’ behavior as well as enables patients to be actively involved in their daily care [9,12,15]

Objectives

Methods

Results

Discussion

Conclusion