中文版糖尿病自护行为量表的信度和效度研究

目的 考察中文版糖尿病自护行为量表(SDSCA)的信度和效度,为我国2型糖尿病患者,自护行为评估提供有效、简便的工具.方法 翻译国外的糖尿病自护行为量表(SDSCA),形成中文版SDSCA,采用随机抽样方法,从内分泌门诊中选取20例2型糖尿病患者,进行中文版糖尿病自护行为量表的重测信度、量表内部一致性和结构效度研究.结果 中文版SDSCA各维度重测信度在0.763～1.000;量表各维度条目间相关系数,具体饮食最低(0.104),其余各维度条目间呈中度至高度相关0.555～0.933;主成分分析共抽取4个因子,解释变异量的67.483%.结论 中文版SDSCA的信效度理想,适合于2型糖尿病患者自护行为评价.

Abstract：

Objective To test the reliability and validity of the Chinese version Diabetea Self-Care Behavior(SDSCA)Questionnaire,and thus to provide an effective and convenient way of self-care behavior assessment for patients with type 2 diabetes.Methods The questionnaire based on the translation of SDSCA wag used in 20 cases of type 2 diabetes patients,in order to analyze the retest rehability,internal consistency and scale construct validity. Results The retest reliability of each dimension wag between 0.763 to 1.000;the scale correlation coeflicients between items in specific diet dimension Wag lowest(0.104),and the others were moderate to high degree of correlation between 0.555～0.933;exploratory factor analysis extracted 4 components,and the percentage of variance explained was 67.483% .Conclusions Chinese version SDSCA has a good reliability and validity,and is good for evaluating the self-care activities in type 2 diabetes patients.     

Psychometric properties of a Korean version of the summary of diabetes self-care activities measure

Background

The summary of diabetes self-care activities (SDSCA) questionnaire is one of the most widely used self-report instruments for measuring diabetes self-management in adults.

Objectives

This study aimed to examine the psychometric properties of a Korean version of the SDSCA questionnaire.

Methods

The 11-item English version of the SDSCA was translated into Korean following the standard translation methodology. The questionnaire was administered to 208 patients with type 2 diabetes. Exploratory and confirmatory factor analyses (EFA and CFA) were carried out for construct validity. Content validity index (CVI), internal consistency and a diabetes management self-efficacy scale (DMSES) were assessed.

Results

The CVI of a Korean version of the SDSCA was .83. The EFA yielded a 9-item measure with a four factor solution with the same labels for original scales. The results of CFA showed the goodness of fit in the 9-item Korean SDSCA version (SDSCA-K). The internal consistency of SDSCA-K was moderate (Cronbach's α = .69) and the positive correlation between the SDSCA-K and the DMSES was identified.

Conclusion

The current study provides the initial psychometric properties of SDSCA-K modified to 9 items and supports SDSCA-K as a reliable and valid measure of diabetes self-management in Korean patients.     

社区2型糖尿病患者自我照顾行为与自我效能的调查研究

目的 了解社区2型糖尿病患者的自我照顾行为与自我效能的现状,探讨存在的问题.方法 采用糖尿病自我照顾量表及糖尿病控制自我效能量表,以方便取样法对北京市海运仓社区的2型糖尿病患者进行调查,共取得85份有效问卷,并对问卷进行分析.结果 社区2型糖尿病患者自我照顾行为与自我效能的平均得分指标为66.98%和69.02%;是否听过糖尿病知识讲座的患者在自我照顾行为方面比较,差异无统计学意义;社区2型糖尿病患者的自我效能与自我照顾行为密切相关.结论 2型糖尿病患者的自我照顾行为和自我效能水平均有待提高,应重视并健全社区糖尿病健康教育.     

The confidence in diabetes self-care scale: psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and US patients with type 1 diabetes

OBJECTIVE: To examine psychometric properties of the Confidence in Diabetes Self-Care (CIDS) scale, a newly developed instrument assessing diabetes-specific self-efficacy in Dutch and U.S. patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Reliability and validity of the CIDS scale were evaluated in Dutch (n = 151) and U.S. (n = 190) outpatients with type 1 diabetes. In addition to the CIDS scale, assessment included HbA(1c), emotional distress, fear of hypoglycemia, self-esteem, anxiety, depression, and self-care behavior. The Dutch sample completed additional measures on perceived burden and importance of self-care. Test-retest reliability was established in a second Dutch sample (n = 62). RESULTS: Internal consistency (Cronbach's alpha = 0.86 for Dutch patients and 0.90 U.S. patients) and test-retest reliability (Spearman's r = 0.85, P < 0.0001) of the CIDS scale were high. Exploratory factor analysis showed one strong general factor. Spearman's correlations between the CIDS scale and other measures were moderate and in the expected directions, and high HbA(1c) levels were associated with low CIDS scores in the U.S. sample only. Low CIDS scores were positively associated with self-care but not with glycemic control in the original samples. CIDS scores in the U.S. and Dutch samples did not show any statistically significant differences. U.S. men had higher CIDS scores than U.S. women. CONCLUSIONS: The CIDS scale is a reliable and valid measure of diabetes-specific self-efficacy for use in patients with type 1 diabetes. High psychometric similarity allows for cross-cultural comparisons.     

Psychometric evaluation of the Thai translation of the Diabetes Self-management Questionnaire in type 2 diabetes

ObjectivesTo explore the content validity and the internal consistency of the diabetes Self-management Questionnaire (DSMQ) for persons with T2DM in Thailand.MethodsDiabetes Self-management Questionnaire (DSMQ) was developed in English. The translation of DSMQ into Thai language was performed by native Thai translators. A panel of five experts in Thailand evaluated the translation. Content validity was quantified by the content validity index (CVI). A cross-sectional design was used to test internal consistency by calculating Cronbach’s alpha.ResultsThe DSMQ contains 16 items. There are eleven items (69%) which showed excellent CVI; two items (12.5%) showed good CVI and three items showed acceptable CVI. The average scale of CVI was 0.90. The internal consistency of the DSMQ was 0.73.ConclusionThe Thai version of DSMQ showed excellent content validity; good internal consistency. The instruments can be used among Thai adults with DM in future research studies.     

社区2型糖尿病患者自我效能及自护行为对其生活质量的影响

目的：了解2型糖尿病患者自我效能及自护行为对其生活质量的影响。方法：采用自我效能量表（DSES）和自护行为量表（DSCS）和生活质量综合评定问卷（GQOLI-74）,以目的抽样法,调查了214例大庆社区2型糖尿病患者,了解社区2型糖尿病患者自我效能的水平、自护行为的执行情况和生活质量,并采用专家授课、多媒体健康教育、护理技能培训等集体指导方法和个体针对性指导相结合方式,实施社区护理干预半年。结果：2型糖尿病患者自我效能感和自护行为能力干预前、后比较有统计学差异（P〈0.001）;生活质量的躯体功能、心理功能、社会功能和生活总分,干预前后有统计学差异（P〈0.05）,物质生活状态干预前后无统计学差异（P〉0.05）。结论：通过社区护理干预,可以增强2型糖尿病患者的自我效能感、自护行为能力,提高其生活质量。     

2型糖尿病患者自我管理行为量表的信、效度研究

目的 了解糖尿病自我管理行为量表修订版(SDSCA)在国内2型糖尿病患者中应用的信、效度.方法 按方便取样的方法,对符合条件的2型糖尿病患者80例进行问卷调查,并于2周后选择其中10例患者进行再次调查. 结果量表整体的Cronbach's α为0.62,重测信度为0.83(P<0.01);采用主成分分析法、方差最大正交旋转后,共提取因子8个,累计贡献率为0.92,各因子负荷系数均大于0.80.结论 SDSCA中文版具有较好的信、效度,适宜作为国内2型糖尿病患者自我管理行为的评估工具.     

Validation of the Greek Version of the Diabetes Management Self-Efficacy Scale (GR-DMSES)

Introduction

Self-efficacy has been found to have a direct relation with self-care in diabetes. Several tools have been developed and used for evaluating self-efficacy of diabetic patients, the most widely used being the Diabetes Management Self-Efficacy Scale (DMSES). The aim of the present study was to translate, culturally adapt, and validate the Greek DMSES (GR-DMSES) in order for it to be used in the ATTICA pilot study of the SmartCare EU-funded project.

Methods

Using standard procedures, the original version of DMSES was translated and culturally adapted into Greek. Content validity was assessed by an expert panel with the calculation of a content validity index of the overall scale. Α convenient sample was recruited to complete the questionnaire. Psychometric testing of the produced instrument included internal consistency test (Cronbach’s alpha), construct validity (factor analysis), and stability (intraclass correlation coefficient).

Results

One hundred and sixteen patients, aged 36–86 years, with type 2 diabetes (T2D) participated in the study. There were no items excluded from the original scale after the content validity procedure. The coefficient Cronbach's alpha for the internal consistency was 0.93 and the intraclass correlation coefficient for the stability with a 5-week time interval was 0.87 (P < 0.001). Factor analysis yielded four factors related to diet, medical therapy, medication and feet check, and physical activity.

Conclusion

The findings supported that the GR-DMSES was reliable and valid in measuring self-efficacy related to diabetes self-management, thus providing a quick and easy-to-use tool for health professionals dealing with Greek adults with T2D.

     

Cross-cultural adaptation of the Diabetes Management Self-Efficacy Scale for patients with type 2 diabetes mellitus: scale development

Background: As a profession, nurses are particularly concerned with cross-cultural influences that affect the health practices of populations. Although the international literature describes questionnaires and specific scales in health and disease behaviours, adequate Turkish-language instruments are scarce. Therefore, suitable Turkish-language instruments need to be developed or adapted for the Turkish population.Objectives: Study aim was to adapt a Dutch/English version of the diabetes management self-efficacy (SE) scale for use with a Turkish population and evaluate its psychometric properties.Design: Methodological research design.Settings: Attendants of an outpatient clinic of a university hospital in Turkey.Participants: A convenience sample of 110 patients with type 2 diabetes mellitus (DM).Methods: Translation and back-translation of the original English instrument and content validation through a expert panel were the first two steps of the study. Third step was the psychometric testing of the adapted instrument by establishing internal consistency (Cronbach's α), stability (test-retest reliability), and construct validity (factor analysis).Results: Content validity procedure resulted in a final scale that consisted of 20 items. Internal consistency of the total scale was coefficient α=0.88, and test-retest reliability with a 4-week time interval was r=0.91 (p<0.001). Factor analysis yielded three factors related to diet, exercise and medical treatment. Two relevant items of the scale, weight control and blood sugar control, however, had low reliability and validity scores.Conclusions: Although acceptable levels of reliability and validity of the Turkish version of the diabetes management SE scale for people with type 2 DM were reached, cultural factors appeared to play a role in the applicability of some items of the scale.     

社区护理干预对提高糖尿病患者生活质量的作用

目的探讨社区护理干预对提高社区2型糖尿病患者生活质量的作用。方法采用自我效能量表、自护行为量表和生活质量综合评定问卷,调查214例社区2型糖尿病患者,了解社区2型糖尿病患者自我效能的水平、自护行为的执行情况和生活质量;并采用专家授课、多媒体健康教育、护理技能培训等集体指导方法和个体针对性指导相结合方式,实施社区护理干预半年。结果2型糖尿病患者自我效能感和自护行为能力干预前、后比较差异有统计学意义（P〈0．01）;生活质量的躯体功能、心理功能、社会功能和生活总分干预前后差异有统计学意义（P〈0．05）,物质生活状态干预前后无统计学意义（P〉0．05）。结论通过社区护理干预,可以增强2型糖尿病患者的自我效能感、自护行为能力,进而提高其生活质量。     

Self-efficacy in children with diabetes mellitus: testing of a measurement instrument

The study reported here assessed the psychometric properties of an instrument to measure diabetes management self-efficacy in Dutch children, ages 8 to 12. Content validity of the item list was tested by consulting an expert panel of diabetes nurse specialists and a child-oriented rating scale was developed. A pretest was conducted to assess whether the instrument was clear and comprehensible for children. Then the instrument was tested in children with diabetes at the outpatient diabetes clinics for children at three Dutch hospitals. Reliability and criterion-related validity of the instrument were assessed. The instrument was judged content valid by the expert panel of diabetes nurse specialists, and the language of the instructions, the items and the rating scale was found to be clear and understandable for children of this age group. The study yielded only a moderate internal consistency estimate (Cronbach's = 0.71) and limited support for criterion-related validity. Several useful theoretical and methodological issues were identified.     

A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties

PurposePatients with diabetes frequently need to perform certain numeric tasks such as interpreting blood glucose levels. However, there is no psychometrically sound instrument for objectively measuring diabetes-specific health numeracy. This study aimed to develop a new objective diabetes health numeracy test (DHNT) and evaluate its psychometric properties in adult patients with type 2 diabetes.MethodsAn instrument development study was conducted. Initial items were evaluated by six experts for content validity. After a pilot test, a convenience sample of 257 participants with type 2 diabetes was recruited at 2 university hospitals from May to September 2018. The structural, convergent, and criteria validity, and internal consistency of the DHNT with binary item responses were evaluated. Data were analyzed using exploratory factor analysis, Rasch analysis, tetrachoric correlation, Spearman's correlation, and the Kuder–Richardson-20 formula.ResultsExploratory factor analysis yielded a single-factor solution comprising seven items. Rasch analysis confirmed that no item did not fit with the single factor and identified that the item difficulty parameters had moderate values. The convergent and criterion validity of the instrument were demonstrated, with diabetes knowledge and subjective diabetes numeracy, respectively, as was its acceptable internal consistency, by a Kuder–Richardson-20 coefficient of .81.ConclusionThe DHNT demonstrated satisfactory psychometric properties. The instrument with moderate levels of item difficulty may have a lower cognitive burden. The developed instrument can be applied in practice to tailor the education of diabetes self-management as per the levels of health numeracy of specific patients.     

Promoting foot self-care in type 2 diabetes mellitus patients receiving hemodialysis based on the information-motivation-behavioral skills model

This study develops and verifies the use of the foot self-care behavioral model in patients with type 2 diabetes mellitus (T2DM) receiving hemodialysis (HD) based on the information-motivation-behavioral skills model. Data were collected between June and August 2021 from 156 outpatients with type 2 diabetes who were receiving regular HD. A structured questionnaire and electronic medical records were used to collect demographic and disease-related data along with Foot Care Knowledge Questionnaires, third version of Diabetes Attitude Scale, Multidimensional Scale of Perceived Social Support, Foot Care Confidence Scale, and Foot Self-care Behavior Scale. Age, diabetic foot care knowledge, social support, and foot care self-efficacy had a direct effect on foot self-care behavior. Foot care self-efficacy had a mediating effect on foot care knowledge, diabetes-related attitudes, social support, and foot self-care behavior. The information-motivation-behavioral skills model was suitable as a foot self-care behavioral model for patients with T2DM receiving HD. Additionally, these findings suggest that it is crucial to improve foot self-care behavior through increased foot care knowledge, diabetes-related attitudes, and social support, which could contribute to enhancing foot care self-efficacy.     

A new comprehensive diabetes health literacy scale: Development and psychometric evaluation

BackgroundThe prevalence of diabetes is close to reaching an epidemic level, and health literacy has recently emerged as a concept that can influence the health outcomes of patients with diabetes. Health literacy was once defined from the perspective of basic reading and understanding skills, but this has now become more comprehensive to include the abilities and skills to assess, understand, appraise, communicate, and use health information. Nevertheless, there is no instrument reflecting the comprehensive health literacy relevant to diabetes.ObjectivesThe aims of this study were to develop a comprehensive Diabetes Health Literacy Scale and to evaluate its psychometric properties.DesignAn instrument-development study was applied that comprised three steps: conceptualization, item generation and content validity, and field testing of the psychometric properties.SettingsA convenience sample of 462 participants was recruited from December 2016 to September of 2017 at outpatient clinics in 2 Korean university hospitals.ParticipantsThe inclusion criteria for participants were being aged at least 19 years, articulate in the Korean language, and diagnosed with diabetes, while the presence of gestational diabetes was applied as an exclusion criterion. Approximately half of the participants were female (51.1%). The participants were aged 54.5 (SD, 11.0) years, 67.1% of them were taking an oral hypoglycemic agent, and 21.9% of them had well-controlled blood-glucose levels.MethodsThe content validity, factorial structure validity, convergent validity, criterion validity, internal consistent reliability, and test–retest reliability of the Diabetes Health Literacy Scale were evaluated. Data were analyzed using exploratory and confirmatory factor analyses, Pearson’s correlation, Cronbach’s alpha, and the intraclass correlation coefficient.ResultsThe content validity was assessed by five experts. Exploratory and confirmatory factor analyses yielded a three-factor solution. Convergent validity was demonstrated using measures of diabetes knowledge and self-efficacy. Criterion validity was demonstrated with generic health-literacy questions. Internal consistency reliability and test–retest reliability were found to be acceptable, as indicated by a Cronbach’s alpha of 0.91 and an intraclass correlation coefficient of 0.89, respectively.ConclusionsThe Diabetes Health Literacy Scale is a new instrument that measures comprehensive aspects of informational, numeracy, and communicative health literacy. It is a short instrument, comprising only 14 items scored on a 5-point Likert scale. The instrument exhibits good psychometric properties for four validity metrics (content, structural, convergent, and criterion validity) and two reliability metrics (internal consistency and test–retest reliability). These findings indicate that the instrument can be applied in both research and clinical practice.     

Measuring diabetes self-care: a psychometric analysis of the Self-Care Inventory-Revised with adults

OBJECTIVE: To examine psychometric properties of the Self-Care Inventory-revised (SCI-R), a self-report measure of perceived adherence to diabetes self-care recommendations, among adults with diabetes. RESEARCH DESIGN AND METHODS: We used three data sets of adult type 1 and type 2 diabetic patients to examine psychometric properties of the SCI-R. Principal component and factor analyses examined whether a general factor or common factors were present. Associations with measures of theoretically related concepts were examined to assess SCI-R concurrent and convergent validity. Internal reliability coefficients were calculated. Responsiveness was assessed using paired t tests, effect size, and Guyatt's statistic for type 1 patients who completed psychoeducation. RESULTS: Principal component and factor analyses identified a general factor but no consistent common factors. Internal consistency of the SCI-R was alpha = 0.87. Correlation with a measure of frequency of diabetes self-care behaviors was r = 0.63, providing evidence for SCI-R concurrent validity. The SCI-R correlated with diabetes-related distress (r = -0.36), self-esteem (r = 0.25), self-efficacy (r = 0.47), depression (r = -0.22), anxiety (r = -0.24), and HbA(1c) (r = -0.37), supporting construct validity. Responsiveness analyses showed SCI-R scores improved with diabetes psychoeducation with a medium effect size of 0.62 and a Guyatt's statistic of 0.85. CONCLUSIONS: The SCI-R is a brief, psychometrically sound measure of perceptions of adherence to recommended diabetes self-care behaviors of adults with type 1 or type 2 diabetes.     

Development and validation of the Chinese version of the Diabetes Management Self-efficacy Scale

OBJECTIVE: The purpose of this study was to translate the Diabetes Management Self-Efficacy Scale (DMSES) into Chinese and test the validity and reliability of the instrument within a Taiwanese population. RESEARCH DESIGN AND METHODS: A two-stage design was used for this study. Stage I consisted of a multi-stepped process of forward and backward translation, using focus groups and consensus meetings to translate the 20-item Australia/English version DMSES to Chinese and test content validity. Stage II established the psychometric properties of the Chinese version DMSES (C-DMSES) by examining the criterion, convergent and construct validity, internal consistency and stability testing. The sample for Stage II comprised 230 patients with type 2 diabetes aged 30 years or more from a diabetes outpatient clinic in Taiwan. RESULTS: Three items were modified to better reflect Chinese practice. The C-DMSES obtained a total average CVI score of .86.The convergent validity of the C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale in measuring self-efficacy (r=.55; p<.01). Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities scores (Beta=.58; t=10.75, p<.01). Factor analysis supported the C-DMSES being composed of four subscales. Good internal consistency (Cronbach's alpha=.77 to .93) and test-retest reliability (Pearson correlation coefficient r=.86, p<.01) were found. CONCLUSIONS: The C-DMSES is a brief and psychometrically sound measure for evaluation of self-efficacy towards management of diabetes by persons with type 2 diabetes in Chinese populations.     

基于Barthel指数和疾病自我效能联合评估的主动式护理在2型糖尿病住院患者中的应用

目的 探讨基于Barthel指数和疾病管理自我效能联合评估的主动式护理在2型糖尿病住院患者中的应用价值.方法 该院自2016年4月起开始实施基于Barthel指数和疾病管理自我效能联合评估的主动式护理模式,选择实施前(2016年1~3月)和实施后(2016年4~5月)于该院接受住院治疗的2型糖尿病患者各66例作为研究对象,实施前后病例组分别设为对照组和实验组,比较两组干预后各相关观察指标的差异性.结果 实施后糖尿病住院病例组干预后的自护能力评分、治疗总有效率和医护患三方护理满意度评分均显著高于对照组,差异有统计学意义(P<0.05).结论 采用基于Barthel指数和疾病管理自我效能联合评估的主动式护理对2型糖尿病住院患者实施干预,可显著提高其糖尿病自护能力,获得积极的疾病控制效果,提高医护患三方护理满意度.     

中青年2型糖尿病患者自护行为的调查分析

目的 通过对中青年2型糖尿病自护行为调查,了解其现状。 方法 采用糖尿病患者自护行为量表对94例患者的饮食控制、运动锻炼、遵医嘱服药、血糖监测、足部护理、高血糖与低血糖的预防处理6个方面进行问卷调查。 结果 总体自护行为良好的20例,一般的有51例,较差的有23例。 结论 中青年2型糖尿病患者总体自护行为较差,加强对中青年2型糖尿病患者的健康教育刻不容缓。     

Testing a conceptual framework for diabetes self-care management

Diabetes is a major source of morbidity, mortality, and economic expense in the United States. The majority of researchers and clinicians believe that diabetes is a self-care management disease, and that patients should be reliable, capable, and sufficiently responsible to take care of themselves. However, individuals with diabetes may or may not have diabetes knowledge, social support, self-care agency (an individual's capability to perform self-care actions), and self-efficacy (an individual's beliefs in his or her capability to perform self-care actions) that would help them to engage in diabetes self-care management. Therefore, this study examined the relationship among those factors using a cross-sectional model testing design. A convenient sample of 141 insulin-requiring individuals with either diabetes type 1 or type 2, 21 years old and over, was recruited from an outpatient diabetes care center located in a Southeast region of the United States. Simple linear regression, multiple standard regression, and multiple hierarchical regression were used to analyze the data. Individuals with greater diabetes knowledge had greater self-care agency and self-efficacy. Those with a higher score in social support had greater self-care agency and better diabetes self-care management, and those with greater self-efficacy had better diabetes self-care management. In addition, self-care agency mediated the effects of diabetes knowledge on self-efficacy and the effects of social support on diabetes self-care management. Self-efficacy mediated the effects of self-care agency on diabetes self-care management. Furthermore, the linear combination of diabetes knowledge, social support, self-care agency, and self-efficacy, taken together, positively affected diabetes self-care management. Enhancing an individual's diabetes knowledge, social support, self-care agency, and self-efficacy may be a strategy which can promote better engagement in diabetes self-care.