Diabetes Attitude Scale Research Articles

The diabetes-related attitudes of health care professionals and persons with diabetes in Argentina

To test diabetes-related attitudes of health care team members (HCTMs) and people with diabetes in a developing country, in this case, Argentina. The third version of the Diabetes Attitudes Scale (DAS-3) was randomly administered, in person, to 252 HCTMs (nurses, nutritionists, physicians, podiatrists, and social workers) and 279 people with type 1 or type 2 diabetes mellitus in several provinces of Argentina in 2004. Data from 531 completed questionnaires were included in the study. The data were statistically analyzed using analysis of variance, covariance, chi-square, and t-tests. Although few, the differences in attitudes of HCTMs and people with diabetes were significant. The two groups expressed only slight agreement on DAS-3 statements such as "seriousness of type 2 diabetes," "value of tight control," and "psychosocial impact of diabetes;" and disagreed completely on "patient autonomy." No significant differences were recorded between people with type 1 or type 2 diabetes regarding "seriousness of the disease," but from both groups, those individuals who had previously attended a diabetes education course assigned this statement a higher score (P<0.01). The unfavorable trend among the participants, similar to that recorded in developed countries, would contribute to the poor treatment outcomes observed in people with type 2 diabetes. Changing these attitudes by means of education could contribute to improving the quality of care and of life for people with diabetes and to decreasing the cost of the disease.

Standardized Patients and Multidisciplinary Classroom Instruction for Physical Therapist Students to Improve Interviewing Skills and Attitudes About Diabetes

Background and Purpose. The purpose of this study was to enable physical therapist educators to evaluate the impact of multidisciplinary classroom instruction and a standardized patient interaction on physical therapist students' attitudes towards diabetes, and their confidence and skills in performing a physical examination and communicating with simulated patients. Method/Model Description and Evaluation. All aspects of the module were conducted cooperatively by faculty from physical therapist, nursing, physician assistant, and pharmacy education programs. Instruction covered patient interviewing, physical examination skills, diabetes risk factors, management, and complications, as well as a standardized patient interaction. Study subjects were 29 first-semester Master of Physical Therapy (MPT) students. Pre- and post-module surveys were completed by all subjects. Both surveys included the Diabetes Attitude Scale, 3rd version (DAS-3), and a set of self-perception statements. The postmodule survey included 8 evaluative statements about the education module. Outcomes. Four of the five DAS-3 subscales (need for specialized diabetes training, seriousness of type 2 diabetes, value of tight glucose control, psychosocial impact of diabetes, and patient autonomy) and statements about 5 of the 7 learning objectives showed a statistically significant change from baseline. Student satisfaction with this educational module was very good. Generally, students scored themselves lower than did the patients in regard to their interactions. Discussion and Conclusions. Multidisciplinary diabetes-focused instruction and a standardized patient interaction improved the attitudes about diabetes in these students. This type of education module was well received by students and helped build student confidence, knowledge, and skills related to diabetes, patient interviewing, and physical exam.

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

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.

Attitudes of Internal Medicine Physicians Toward Type 2 Diabetes

This study was designed to identify differences among internists in their attitudes about diabetes and how those attitudes influence practice behavior. A cross-sectional study of 55 internists in an academic medical center was done using the Diabetes Attitude Scale (DAS-3), a valid and reliable measure of attitudes toward diabetes. Most respondents were white (89%), male (65%), and < or = 40 years old (85%). On the need for special training, internists were significantly different from the standardized norm for the DAS-3. Similar differences were observed on the seriousness of type 2 diabetes, the value attached to "tight control," and patient autonomy. Differences by age, sex, and level of training were not significant. Regardless of age, sex, or level of training, internal medicine physicians have negative attitudes toward type 2 diabetes that require future educational interventions.

Pharmacists' attitudes toward diabetes and their involvement in diabetes education.

To determine the relationship between pharmacists' attitudes toward diabetes and their involvement in diabetes patient education in the community setting. Registered pharmacists in Arizona were mailed surveys regarding their attitudes toward diabetes and their involvement in diabetes patient education. Attitudes were measured using the Diabetes Attitude Scale (DAS); the types of educational skills evaluated were based on those recommended by the American Diabetes Association's Standards of Medical Care. Pharmacists' attitudes were significantly positive toward the need for special training for diabetes care, the importance of tight glycemic control, the team approach to care, and the preference for diabetes education in an outpatient setting (p < 0.001). The majority of the time, pharmacists provided basic patient education (52%) rather than intermediate or advanced patient education (26% and 27%, respectively). There was a negative correlation between the attitude that diabetes is a difficult disease to treat and pharmacists' involvement in diabetes patient education (p < 0.05). This indicates that, although pharmacists believe that diabetes is a treatable disease, they infrequently provide diabetes patient education. Overall, pharmacists had positive attitudes toward diabetes. These attitudes did not correlate with the degree of their involvement in diabetes patent education. More diabetes patient education through community pharmacists is needed.

Pharmacists’ Attitudes Toward Diabetes

ObjectivesTo assess pharmacists’ attitudes toward diabetes, to evaluate the measurement properties of the Diabetes Attitude Scale (DAS) in a sample of pharmacists, and to estimate the number and attitudes of pharmacists certified as diabetes educators (CDE). DesignMail survey. Setting/ParticipantsA systematic sample of 522 hospital, community, and other pharmacists registered with the professional pharmacy association in Alberta, Canada. InterventionsNot applicable. Main Outcome MeasuresThe survey contained the 31 items of the DAS with 4 additional items that addressed attitudes toward the role of the pharmacist. ResultsResponse rate was 65%. Pharmacists’ mean attitude scores were positive to strongly positive toward the Special Training, Control/Complications, Team Care, and Pharmacist’s Role factors and neutral toward the Compliance, NIDDM, Difficult to Treat, and Outpatient Education factors. Pharmacists’ attitudes varied based on practice setting, year of graduation, and whether they had diabetes or a CDE designation. Most factor scores had good reliability. ConclusionPharmacists agree that they should be part of the health care team for managing diabetes, should be required to have specialized training to provide primary diabetes care, and that they have the skills to become diabetes educators.

The short-term impact of a continuing medical education program on providers' attitudes toward treating diabetes.

The objective of this study was to evaluate the short-term impact of a 7-h type 2 diabetes continuing medical education (CME) program. Outcomes included a measure of health care providers' diabetes knowledge and the Diabetes Attitude Scale (DAS), a validated measure of attitudes toward diabetes. A CME program on type 2 diabetes was presented by an expert panel in Chicago during November 1998. A before-after trial with pre- and postintervention measurements of diabetes knowledge and attitudes toward diabetes was administered as part of the program. A convenience sample of the 129 health care providers in attendance resulted in 91 (71%) completed pre- and postintervention surveys. Within-subjects analysis revealed increases in knowledge and more favorable attitudes toward diabetes after the program. Between-subjects analysis revealed that attitude changes differed for physicians as compared with allied health care providers. A CME program was associated with an increase in knowledge of diabetes and more favorable attitudes toward diabetes as measured by the DAS. The DAS changes were subtly different for the physician group as compared with the allied health care provider group. These results suggest that the DAS can be a useful instrument for measuring the short-term impact of educational interventions.

The third version of the Diabetes Attitude Scale.

The objective of this study was to develop a third version of the Diabetes Attitude Scale (DAS-3) that is congruent with current scientific knowledge about diabetes, has improved subscale internal reliability scores, and is shorter than the earlier versions of this instrument. The second DAS was revised and rewritten by a panel of diabetes experts, including patients, associated with the University of Michigan Diabetes Research and Training Center. The revised version of the instrument was sent to physicians, nurses, dietitians, and patients with diabetes. Completed and usable questionnaires were obtained from 384 patients with diabetes, 321 physicians, 540 nurses, and 569 dietitians. The total number of surveys used for these analyses was 1,814. The study resulted in a revised DAS with 33 items and five discrete subscales. The subscales were attitudes toward the following: 1) need for special training to provide diabetes care, 2) seriousness of type 2 diabetes, 3) value of tight glucose control, 4) pyschosocial impact of diabetes, and 5) attitude toward patient autonomy. Overall, the subscale reliabilities of the DAS-3 were superior to the earlier versions of the scale. The DAS-3 is a valid and reliable general measure of diabetes-related attitudes and is most suitable for comparisons across different groups of health care professionals and/or patients. The DAS-3 is also suitable for the evaluation of patient and/or professional education programs if those programs focus on the specific topic areas measured by the five DAS-3 subscales.

Measuring diabetes-related attitudes: the use of a USA-developed instrument with Australian nurses

The revised Diabetes Attitudes Scale (DAS) was completed by nearly 1000 nurses and nursing students in South Australia. Confirmatory factor analysis was used to compare the factor structure with that previously obtained in the USA with patients with diabetes. The instrument was found to be robust. It was concluded that only one item of the 50-item scale is unsuitable for inclusion in studies which aim to compare patient and health professional attitudes.

Measuring the Attitudes and Beliefs of American Indian Patients With Diabetes

Diabetes is recognized as a major health problem for American Indians. This study examined the attitudes and beliefs of American Indian patients with diabetes using the revised Diabetes Attitude Scale (DAS). Revised DAS factors represent patients'attitudes toward the need for special training to provide diabetes care, patient compliance, the seriousness of non-insulin-dependent diabetes mellitus (NIDDM), the relationship between blood glucose levels and complications, the impact of diabetes on the patient's life, patient autonomy, and team care. Data were collected from subjects at Indian Health Service hospitals on two American Indian reservations in northern Minnesota. Results of the analysis indicated significant differences in attitudes related to seriousness of the disease and autonomy in care decisions, after controlling for sex and educational level of the respondents.

A comparison of the diabetes-related attitudes of health care professionals and patients

The following study compares the diabetesrelated attitudes of sampled health care professionals and patients with diabetes. Attitudes were measured with a revised version of the Diabetes Attitude Scale (DAS) which includes seven factors representing attitudes towards: (1) the need for special training in order to provide diabetes care; (2) patient compliance; (3) the seriousness of noninsulin-dependent diabetes (NIDDM); (4) the relationship between blood glucose levels and the complications of diabetes; (5) the impact of diabetes on the patient's life; (6) patient autonomy; and (7) team care. The highest levels of agreement among patients and professionals concerned the seriousness of NIDDM and the relationship between blood glucose control and the development of the complications of diabetes. The most striking finding of the study was that patients tended to express a significantly more judgmental, moralistic attitude toward patient behavior than did health care professionals.

Measuring the attitudes of patients towards diabetes and its treatment

The following is a study of the general diabetes-related attitudes of 1202 patients with diabetes in Michigan. The instrument used to measure attitudes was a revised version of the Diabetes Attitude Scale (DAS) designed to measure the attitudes of health care professionals. A factor analysis of the revised DAS yielded seven diabetes attitude factors. These factors represented patients' attitude toward: (1) the need for special training in order to provide diabetes care; (2) patient compliance; (3) the seriousness of noninsulin-dependent diabetes (NIDDM); (4) the relationship between blood glucose levels and complications; (5) the impact of diabetes on the patient's life; (6) patient autonomy; (7) team care. Overall, the respondents to this survey displayed attitudes consistent with the current recommendations of health care professionals in the field of diabetes. The revised DAS is an instrument that can be used to measure and compare the attitudes of both health care professionals and patients on a variety of diabetes-related issues.

Development of Diabetes Attitude Scale for Health-Care Professionals

This article describes the development of a diabetes attitude scale (DAS) that was designed to measure the attitudes of health-care professionals (HCPs). The DAS was developed through the efforts of a national panel of diabetes experts. The panel developed a 60-item scale that was pilot tested and reduced to a 50-item scale. The 50-item scale was then mailed to a national sample of HCPs with an interest in diabetes. The surveys were returned by 633 nurses, 322 dietitians, 116 physicians, and 67 others totaling 1138 returns (a return rate of 54%). The returned surveys were analyzed, and a 31-item DAS composed of 8 subscales resulted. Evidence for the reliability and validity of the 31-item DAS along with the instrument itself are included in this study.