Abstract
ObjectiveThe aim of the paper is to report the development and psychometric testing of Diabetes Attitude Scale.MethodA prospective study was performed. The cultural equivalency and content validity of the Diabetes Attitude Scale were determined by panels of endocrinologists, physiologists, nurses and dieticians. An accurate and usable translation was obtained for each of five subscales examining attitudes on need for special training, the seriousness of type-2 diabetes, the need for controlling the condition, its psychosocial impact and the degree of autonomy given to patients in decision making. The validation was derived from 5961 patients with type-2 diabetes, recruited from 50 centers in 29 provinces throughout China between March 1st and September 30th, 2010.ResultsThe modified Diabetes Attitude Scale showed an acceptable level of internal consistency. The strength of the inter-correlations among the domains of five subscales suggests that the instrument measures related but separate domains of patients' attitudes toward diabetes. Moreover, the test-retest intraclass correlation coefficients were high enough to support the stability of the Chinese version of the third version of the scale.ConclusionsThe psychometric properties of the Chinese version of Diabetes Attitude Scale demonstrated satisfactory validity and reliability and appeared to effectively evaluate attitudes toward diabetes in patients with type-2 diabetes.
Highlights
Successful control of diabetes greatly depends on patients being able to manage their disease [1]
Many studies focusing on the effects of psychological problems on diabetes reveal that psychological factors have an impact on diabetes control [4,5,6]
Increasing evidence suggests that improving patient educations is the most effective way to lessen the complications and costs associated with diabetes and its management [43]; targeted and culturally sensitive patient education programs are not possible without improved understanding of diabetic patient attitudes in these developing regions
Summary
Demographic and Clinical Data Eighty two of the initial 6043 questionnaires had missing data, and questionnaires from the remaining 5961 patients (98.6%, male 3233 and female 2728) were included in the analysis. The reliability (internal consistency) of the subscales based on Cronbach’s alpha statistic ranged from 0.654 for subscale 5 (‘patient autonomy’) to 0.848 for subscale 4 (‘psychosocial impact of diabetes’). Subscale inter-correlations ranged from 0.836 for subscale 1 (‘need for special training’) versus subscale 5 (‘patient autonomy’) to 0.497 for subscale 1 (‘need for special training’) versus subscale 2 (‘seriousness of type-2 diabetes’). This high correlation between the subscales maybe partially due to the fact that the items of the subscales did not load in different factors. The correlation coefficient between the total Chinese version of Diabetes Attitude Scale score and HbA1c was 20.040 (p = 0.018), and weak correlations between 4 subscales (subscale 1,subscale 4) and A1c were found. There were correlations between the C-DAS score and age, education level, duration of diabetes, presence of complications, and accepted diabetes education, but there was no association between the Chinese DAS score and gender, insulin treatment, and BMI. (Table 3)
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