La importancia de la adaptación transcultural y la validación de la DAS-3 (Diabetes Attitude Scale) a la lengua vernácula (DAS-3cat): la versión catalana de un instrumento de medición de actitudes y motivaciones en la diabetes mellitus

Abstract

Background The third version of the Diabetes Attitude Scale (DAS-3)1 and its Spanish language version (DAS-3sp), which was recently published in this journal2, has been shown to be a valid and reliable general measure of diabetesrelated attitudes. It is most suitable for comparing different groups of healthcare professionals and/or patients and for evaluating education programs on diabetes3,4. This study presents the results of the process of translation and adaptation of the DAS-3 to our reference population (Catalan-speaking). Method The validation process followed the translation/back-translation method. Throughout the process, several meetings were organized to contrast the opinions of translators, investigators, health professionals and diabetic patients. A series of pilot tests was carried out to produce successive versions and to finally obtain a definitive instrument: the DAS-3 questionnaire in Catalan (DAS-3cat). This was administered to 71 health care professionals (35 doctors and 36 nurses) and to 67 diabetic patients twice within an interval of 3-6 weeks. Internal consistency was analyzed using Cronbach's alpha and reproducibility was evaluated by the testretest method. Results The global Cronbach's alpha of the DAS-3cat was 0.68, and for the subscales it was 0.50 for need of special training, 0.73 for perception of the severity of diabetes mellitus, 0.72 for evaluation of strict control, 0.49 for the psychosocial impact of diabetes mellitus and 0.45 for patient autonomy. Globally, Cronbach's alpha was 0.52 in doctors, 0.57 in nurses, and 0.66 in diabetic patients. The intraclass correlation coefficient between the two questionnaires administered ranged from 0.49 to 0.74. This coefficient ranged from 0.34 to 0.73 in doctors, from 0.47 to 0.63 in nurses and from 0.54 to 0.75 in diabetic Conclusions The translation and cross-cultural adaptation of the DAS-3 to Catalan achieved acceptable reliability and reproducibility and allowed us to have an instrument similar to the original adapted to the local population.