Review of the psychometric properties of the Diabetes Self-Efficacy Scale: Australian longitudinal study

The current paper presents the findings from the reliability and validity testing of an 18-item Diabetes Self-efficacy Scale derived from the 28-item Insulin Management Diabetes Self-efficacy Scale. Testing in the Australian context occurred at three points over 9 months. Diabetes self-efficacy is defined as the individual's judgement of confidence to carry out tasks specific to diabetes management. Data were obtained from an Australian metropolitan sample of adult, English speaking men and women with diabetes (N = 226). Participants were insulin-using and non-insulin-using. Factor analysis indicated five subscales. The data support the construct validity and reliability of the 18-item scale in terms of stability, internal consistency and item-total correlation matrices. This study provides consistent evidence that the Diabetes Self-efficacy Scale is a valid and reliable measure over time when the individual's efficacy beliefs are changing. Hence this instrument should be a useful outcome measure for educational diabetes related interventions.     

Further validation of the Multiple Sclerosis Self-Efficacy Scale

Abstract

Purpose: This study examined the factorial and construct validity of the Multiple Sclerosis Self-Efficacy (MSSE) Scale in two samples of people with multiple sclerosis (MS). Method: Two samples (n's?=?292, 275) of participants with MS were recruited from across the United States. Participants in both studies completed a questionnaire battery that included the MSSE and measures of symptoms, dysfunction, disability, psychosocial aspects, mental/emotional well-being, and quality of life. Factorial validity was tested using confirmatory factor analysis (CFA), whereas construct validity was examined based on bivariate correlations with scores from other measures. Results: The two-factor measurement model provided a poor fit for the 18 items on the MSSE in both the samples. This model provided a good fit for a modified, 10-item scale in both samples. The 10-item version of the MSSE was highly correlated with the original MSSE (r?=?0.97, p?<?0.001) and related constructs (e.g. disability, r?=?0.69, p?<?0.0001). The standardized Cronbach's αs of the two subscales (function and control) of the 10-item version ranged between 0.78 and 0.94 for both samples. Conclusions: Scores from the modified, 10-item version of the MSSE provide a valid and reliable measure of MS-specific self-efficacy among persons with MS.

• Implications for Rehabilitation

• The importance of self-efficacy in managing the consequences of multiple sclerosis (MS) has increased.

• The Multiple Sclerosis Self-Efficacy (MSSE) Scale was developed and validated for measuring self-efficacy in function maintenance and control over MS from patients' perspectives. In the past almost 20 years, this scale has not undergone additional validation of its factor structure and construct validity in large-scale samples of persons with MS.

• The original two-factor construct did not provide a good fit for the 18 items on the MSSE in two independent samples. We modified the MSSE and found the 10 items fitted by the two-factor construct well with one sample and demonstrated cross-validity of the 10 items in the second sample.

• The 10-item version of the MSSE has good reliability and construct validity in both independent samples. Researchers and clinicians should adopt these 10 items when examining MS self-efficacy of patients.

     

2型糖尿病患者恐惧疾病进展与血糖控制水平的关系：自我效能的中介作用

目的探讨2型糖尿病（type 2 diabetes mellitus, T2DM）患者恐惧疾病进展（fear of progression, FOP）与血糖控制水平的关系,分析自我效能在两者间的中介作用,为优化患者血糖控制水平提供参考依据。方法采用便利抽样法选取245例住院的T2DM患者为调查对象,检测患者糖化血红蛋白（glycated hemoglobin, HbA1c）水平,采用一般资料调查表、FOP简化量表、糖尿病自我效能量表（diabetes management self-efficacy scale, DMSES）对患者进行调查。结果 245例患者HbA1c水平为（9.22±1.92）%,72.7%（178/245）的患者血糖控制不理想;FOP总分为（28.02±8.66）分,31.4%（77/245）患者因过度FOP而导致心理功能失调;DMSES总分为（130.85±37.27）分,64.5%（158/245）的患者得分处于中等水平。FOP与血糖控制水平呈正相关（r=0.207,P<0.01）,自我效能与血糖控制水平呈负相关（r=-0.297,P<0.01）,自我效能在FOP及血糖控制水平间存在完全中介作用（P<0.01）。结论 FOP显著影响T2DM患者血糖控制水平,且主要通过自我效能的完全中介作用实现。避免患者产生过度的FOP心理、提高自我效能水平是血糖控制良好的有效措施。     

Evaluation of a Swedish version of the Arthritis Self-Efficacy Scale.

There is a great need today for clinically useful instruments in the rehabilitation of chronic pain patients. The Arthritis Self-efficacy Scale measures patients' perceived self-efficacy to cope with the consequences of chronic arthritis. The aim of the present study was to evaluate a Swedish version of the Arthritis Self-efficacy Scale with respect to factor structure and reliability. Twenty-five chronic pain patients and twenty-four rheumatology patients were given a Swedish version of the Arthritis Self-efficacy Scale twice within a three week interval. The three factor structure of the scale was confirmed; Cronbach's alpha for internal consistency ranged between 0.82-0.91 and test-retest correlations ranged between 0.81-0.91, showing that the instrument satisfactorily met psychometric standards.     

Diabetes management in an Australian primary care population

What is known and objective: Worldwide studies have shown that significant proportions of patients with type 2 diabetes (T2DM) do not meet targets for glycaemic control, blood pressure (BP) and lipids, putting them at higher risk of developing complications. However, little is known about medicines management in Australian primary care populations with T2DM. The aim of this study was to (i) describe the management of a large group of patients in primary care, (ii) identify areas for improvement in management and (iii) determine any relationship between adherence and glycaemic, BP and lipid control. Methods: This was a retrospective, epidemiological study of primary care patients with T2DM diabetes, with HbA_1c of >7%, recruited in 90 Australian community pharmacies. Data collected included demographic details, diabetes history, current medication regimen, height, weight, BP, physical activity and smoking status. Results and discussion: Of the 430 patients, 98% used antidiabetics, 80% antihypertensives, 73% lipid lowering drugs and 38% aspirin. BP and all lipid targets were met by only 21% and 14% of the treated patients and 21% and 12% of the untreated patients respectively. Medication adherence was related to better glycaemic control (P = 0·04). What is new and conclusions: An evidence‐base prescribing practice gap was seen in this Australian primary care population of T2DM patients. Patients were undertreated with antihypertensive and lipid lowering medication, and several subgroups with co‐morbidities were not receiving the recommended pharmacotherapy. Interventions are required to redress the current evidence‐base prescribing practice gap in disease management in primary care.     

社区2型糖尿病患者自我效能与心理痛苦相关性分析

目的通过对社区2型糖尿病患者自我效能与心理痛苦的水平及相关性分析,为制定干预对策提供参考依据.方法采用中文版糖尿病自我效能量表和中文版糖尿病痛苦量表,对某社区5个社区卫生站或服务中心的252例2型糖尿病患者进行调查,分析两者的水平及其相关性.结果本组患者的自我效能得分总均分8.25分,属中等偏上水平;糖尿病痛苦量表结果显示,患者因糖尿病导致的与生活规律相关痛苦维度、情感负担维度的表现较明显,其情感负担处于轻中度占29.4%,生活规律相关痛苦处于轻中度者占30.9%;心理痛苦总分及其4个维度得分与自我效能得分呈一定负相关(r=-0.430~-0.230,P<0.01).结论社区2型糖尿病患者的自我效能属中等偏上水平,且自我效能水平越高则心理痛苦程度越轻.提示应侧重对患者加强糖尿病导致的与生活规律相关痛苦、情感方面痛苦的干预;提高患者控制血糖的自信心,以消除负面情绪.     

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.

     

Depression,Self-efficacy,and Adherence in Patients With Type 2 Diabetes

Depression and self-efficacy can be major factors in treatment adherence for patients with type 2 diabetes. Fifty-five adults with diabetes completed a depression inventory, a self-efficacy questionnaire, and a diabetes self-care inventory. As depressive symptoms increased, self-efficacy decreased (P = .000). As depressive symptoms increased, participants reported following the appropriate diet (P = .020) and exercise (P = .034) recommendations less often. Participants with higher self-efficacy were less likely to smoke (P = .031), and were more likely to adhere to diet (P = .000) and exercise (P = .000). Interventions should be multifaceted to address various factors that affect diabetes adherence.     

Turkish validity and reliability of the Diabetes Self-Efficacy Scale

PurposeThe aim of this methodological study was to determine the validity and reliability of the Diabetes Self-Efficacy Scale adapted to the Turkish community.MethodsThe study sample was completed with 319 patients who had been diagnosed at least 1 year before and hospitalized in the Malatya Turgut Ozal Health Center and Malatya State Hospital in Turkey. A questionnaire that consists of items on sociodemographic characteristics, drug use and information about the disease of patients and the Diabetes Self-Efficacy Scale were used for data collection in the study. In reliability analysis of the scale, the Cronbach's α coefficient was calculated and item analysis method was utilized. Factor analysis was used for the construct validity, and Principal Component Analysis and Varimax Rotation method were used for analyzing the factor structures.ResultsAccording to data obtained in the study, item-total correlation of the items of the scale was found to be at an adequate level (0.297–0.803). The scale's Cronbach's α reliability coefficient was found to be 0.86, and there was one factor that explains 52.38% of the total variance with an eigenvalue was greater than 1.0. As a result of the analysis, the factor loadings of the items of the scale were found to be between 0.59 and 0.81.ConclusionDiabetes Self-Efficacy Scale is a valid and reliable instrument for determining the self-efficacy of patients and providing a proper care. It can be suggested to investigate and evaluate the consistency of the scale by applying it to broader sample groups representing different socioeconomic levels.     

Reliability and validity of the Icelandic version of the Problem Area in Diabetes (PAID) Scale

BACKGROUND: Diabetes is a burdensome disease that increases distress among people with diabetes. OBJECTIVES: To test the validity and reliability of an Icelandic version of the problem area in diabetes scale (PAID) and to assess the hitherto unknown distress level of Icelandic people with insulin requiring diabetes. DESIGN: Methodological research design. SETTING: Diabetes clinics. PARTICIPANTS: People with insulin-dependent diabetes, between 18 and 61 years. METHODS: All instruments were translated using a back-translation technique. Participants answered three consecutive questionnaires in succession, the PAID scale, the diabetes empowerment scale (DES) and the diabetes knowledge test (DKT). Principical component analysis with varimax rotation was conducted on the PAID scale to identify latent factors. RESULTS: Factor analysis revealed two factors: (a) distress in relation to life with diabetes, with Cronbach alpha coefficient of 0.93 and (b) distress in relation to management of diabetes, with Cronbach alpha coefficient of 0.88, for PAID overall Cronbach alpha coefficient was 0.94. PAID showed neither floor nor ceilings effects. Propositions set to indicate validity were generally met. However, PAID's factor structure and predictive validity needs to be tested further. CONCLUSIONS: The Icelandic version of PAID is sufficiently psychometrically robust. PAID is simple to administer and by using the scale clinicians can identify people at risk for developing diabetes-related distress. The results are comparable to results from studies in other countries using the PAID scale.     

手机互动管理模式在糖尿病俱乐部教育的应用效果

目的探索基于手机的互动管理模式在糖尿病俱乐部教育的应用效果,以期为临床提供参考。方法 2014年1-6月,采用便利抽样法在德清县人民医院举办的糖尿病俱乐部中选取86例2型糖尿病患者为研究对象,采用抛硬币法将其分为观察组和对照组,每组43例。观察组患者给予短信或电话互动式管理教育、常规健康教育,而对照组患者仅给予常规健康教育。干预6个月,比较两组患者的糖尿病相关知识掌握情况及实验室检查[如空腹血糖浓度(fasting blood glucose,FBG)、餐后2h血糖浓度(postprandial blood glucose,PBG)、糖化血红蛋白浓度(glycosylated hemoglobin,HbA1c)等]结果。结果经过6个月干预后,两组患者糖尿病相关知识评分均明显升高,与干预前相比,差异均有统计学意义(均P0.05);观察组患者糖尿病相关知识评分高于对照组,差异有统计学意义(P0.05);两组患者FBG、PBG、HbA1c检测结果明显降低,与干预前比较,差异均有统计学意义(均P0.05),且观察组患者的检测结果明显低于对照组,差异均有统计学意义(均P0.05)。结论在糖尿病俱乐部教育中应用手机互动管理模式有利于提高患者对糖尿病的认知水平,提高患者自我控制能力。     

The Diagnosis and Management of Atypical Types of Diabetes

In addition to type 1 and type 2 diabetes, there are other types of diabetes that can present diagnostic challenges for nurse practitioners. This article reviews the more unusual types of diabetes, including latent autoimmune diabetes in adults, maturity-onset diabetes of the young, and type 3c diabetes. To promote optimal patient outcomes, nurse practitioners should be aware of evidence-based management principles for less common types of diabetes.     

Ramping Glucosuria for Management of Type 2 Diabetes Mellitus: An Emerging Cynosure

Chronic hyperglycemia is a characteristic feature of type 2 diabetes mellitus (T2DM). The kidney plays a vital role in maintaining blood glucose homeostasis by recovering glucose from glomerular filtrate which is controlled by SGLT2 cotransporters expressed mainly in proximal tubule. In T2DM patients, inhibition of SGLT2 normalizes glycemic levels by preventing glucose from being reabsorbed through SGLT2 and re‐entering the circulation. Thus, SGLT2 inhibition seems to be a logical approach and pose a novel insulin‐independent mechanism of action for management of T2DM by promoting urinary glucose excretion in the body. Canagliflozin is the first SGLT2 inhibitor approved by US Food and Drug Administration (US FDA) followed by dapagliflozin while empagliflozin is under FDA review. Various other drug candidates in late‐stage clinical developments are also expected to hit the global markets in the coming years. In this review, studies on various early‐ and late‐stage SGLT2 inhibitors have been investigated and recent clinical developments summarized.     

高同型半胱氨酸血症与2型糖尿病视网膜病变的关系

目的 探讨2型糖尿病患者血浆同型半胱氨酸（homocysteine, Hcy）水平与糖尿病视网膜病变之间的关系. 方法 测定45例2型糖尿病（DM）患者及19例健康对照者（CON）血浆同型半胱氨酸水平,45例2型糖尿病患者分为糖尿病视网膜病变（DR）组（17例）与无视网膜病变（NDR）组（28例）,比较各组间血浆总Hcy的水平;再将17例DR组分为增殖期糖尿病视网膜病变（PDR）组（9例）和背景期糖尿病视网膜病变（BDR）组（8例）,比较两组间血浆总Hcy的水平. 结果 2型糖尿病患者中DR组的血浆总Hcy水平高于NDR组及CON组（P＜0.01）,NDR与CON组比较则无显著性差异.在DR组,PDR组的血浆总Hcy水平显著高于BDR组（P＜0.01）,以正常对照组的血浆Hcy均数＋2个标准差作为高Hcy血症的诊断标准,PDR组高Hcy血症的发生率高于BDR组（P＜0.05）. 结论 2型糖尿病患者伴有视网膜病变者血浆总Hcy水平升高,其中PDR组的血浆总Hcy又高于BDR组.血浆总Hcy水平升高,可能是2型糖尿病视网膜病变的危险因素之一.     

Translation and Validation of the Condom Self-Efficacy Scale With Thai Adolescents and Young Adults

PURPOSE: To translate the 14-item Condom Self-Efficacy Scale (CSES) into Thai and to validate the Thai version of the Condom Self-efficacy Scale (CSES-T) among Thai adolescents and young adults. METHODS: The CSES was translated using a back-translation technique and validated with a cluster-based sample of 425 participants aged 18 to 22 years from eight randomly selected private vocational schools in Bangkok. Participants completed anonymous self-administered scales. Principal component analysis with varimax rotation was conducted to identify latent factors. RESULTS: Factor analysis indicated three factors: communication, correct use, and consistent use. Items loading on the original CSES also loaded on the same factors of the CSES-T except one item. The Cronbach's alpha coefficients were .85 for the total scale, .70 for consistent use, .79 for correct use, and .80 for communication. CONCLUSIONS: Based on psychometric properties, the CSES-T is a valid and reliable tool. It is culturally appropriate for Thai young adults. Thai researchers and health care providers can use the CSES-T to assess adolescents' and young adults' self-efficacy to use condoms as well as to further develop and evaluate interventions to increase condom use.