Abstract
ABSTRACTThe aims of this study were to translate and culturally adapt the UK English Audit of Diabetes-Dependent Quality of Life version 19 (ADDQOL-19) into Bulgarian and explore the psychometric properties of the ADDQoL-19 BUL. The formalized linguistic procedure was used to develop the Bulgarian version of the ADDQoL-19 BUL. The ADDQoL was assessed for the following: internal consistency (Cronbach's alpha); test--retest reliability (intraclass correlation coefficient (ICC)); factor structure and known-groups validity (insulin requiring vs. non-insulin requiring, with vs. without diabetes-related complications, overweight/obese vs. not overweight/obese). A total of 423 adults with type 2 diabetes mellitus (T2DM) participated in the study. The mean age was 59.92 years (standard deviation (SD) 11.60, range 28–88 years), and 52.6% were male. Internal consistency (α = 0.922) and the 3-week test–retest stability (intraclass correlation = 0.99) were high. Confirmatory factor analysis indicated that the one-factor structure of the ADDQoL-19 fits moderately (χ2 = 230.63, df = 136, p < 0.001, SRMR (Standardized Root Mean Square Residual) of 0.05, RMSEA (Root Mean Square Error of Approximation) of 0.06, CFI (Comparative Fit Index) of 0.95). Standardized coefficients showed that all domains loaded 0.4, except for one item. The total score was negatively associated with HbA1c (r = −0.10; p < 0.05), indicating that lower scores were related to poorer glycaemic control. In conclusion, the Bulgarian version of the ADDQoL-19 has good psychometric properties and provides clinicians and researchers with a useful tool for comprehensive assessment of the quality of life in adults with diabetes mellitus.
Highlights
Diabetes mellitus (DM) is a global public health problem
The Audit of Diabetes-Dependent Quality of Life (ADDQoL) begins with two items, assessing "present Quality of Life (QoL)" and "diabetesdependent QoL"
The mean age was 59.92 years (standard deviation (SD) 11.60, range 28–88 years), 53% were males, 72% Bulgarian ethnic group, 59% were with diabetes duration of over 5 years, the mean HbA1c was 8.1 (SD 0.85) and 38% used insulin
Summary
The world is facing an epidemic of type 2 diabetes mellitus (T2DM): 382 million people have diabetes and the disease is set to rise beyond 592 million in fewer than 25 years [1]. The rates of DM increased from 8.36% in 2006 up to 9.6% in 2014 (population >20 years of age) as patients with T2DM were 90.4% of all [3,4,5]. Diabetes has a profound impact on the quality of life (QOL) of patients in terms of physical, social and psychological well-being [6]. QoL issues are considered important, because they may powerfully predict an individual's capacity to manage his/her conditions and maintain long-term health and well-being. QoL is increasingly recognized as an important health outcome in its own right, representing the ultimate goal of all health interventions [8,9]
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