Introduction
Comprehensive regular foot self-care is one of the most critical self-management behaviors for people with diabetes to prevent foot ulcer development and related complications. Yet, adequate foot self-care is only practiced by very few of those affected. To improve diabetic foot syndrome prevention, a valid and reliable instrument for measuring daily foot-care routines in patients with diabetes is needed. However, no such instrument is currently available in the German language. This study, therefore, aims to translate and cross-culturally adapt the "Diabetic Foot Self-Care Behavior Scale" (DFSBS) into German (DFSBS-D) and evaluate its validity and reliability.
Material and methods
The DFSBS was translated from English into German using a forward-backward procedure as per previous recommendations. Factor analysis was used to study structural validity. To establish construct validity, 21 a priori hypotheses were defined regarding the expected correlation between scores on the new German version (i.e., DFSBS-D) and those of the following questionnaires measuring related constructs: (1) German version "Diabetes Self-Care Activities Measure" (SDSCA-G), (2) "Frankfurter Catalogue of Foot Self-Care" (FCFSP), and (3) "Short Form 36" (SF-36) and tested in 82 patients. To assess test-retest reliability, patients completed the DFSBS-D again after a 2-week interval. Test-retest reliability was assessed from stable patients’ data (n = 48) by calculating two-way random-effects absolute agreement ICCs with 95% CI and Bland and Altman analyses. In addition, Cronbach’s alpha was calculated as internal consistency measure.
Results
The 7-item DFSBS-D showed good structural validity. Its single factor explains 57% of the total sample variance. Of the 21 predefined hypotheses, 13 (62%) were confirmed. The DFSBS-D’s internal consistency was good (Cronbach’s alpha = 0.87). Test-retest reliability over a 2-week interval was also good (ICC 0.76).
Conclusion
The DFSBS was successfully translated into German. Statistical analyses showed good DFSBS-D structural validity, test-retest reliability, and internal consistency. Yet, construct validity may be debated.
In diesem kurzen Übersichtsartikel soll auf die Bedeutung der antihyperglykämischen Therapie beim Typ-2-Diabetes eingegangen werden. Insbesondere stehen dabei die Ergebnisse der großen Diabetes-Endpunktstudien der letzten Jahre sowie die neue evidenzbasierte Leitlinie der Deutschen Diabetes-Gesellschaft im Fokus, die eine sichere Therapiezielerreichung unter Vermeidung von Hypoglykämien sowie einer ausgeprägten Gewichtszunahme anstreben.Der Typ-2-Diabetes stellt eine zunehmende Epidemie dar, von der zurzeit etwa 246 Millionen Menschen weltweit betroff en sind. Die International Diabetes Federation (IDF) vermutet, dass im Jahr 2030 ca. 440 Millionen Menschen von der Erkrankung betroff en sein werden. In Deutschland leben z. Zt. etwa 8 Millionen Pa tienten mit Typ-2-Diabetes, die Kosten für die Erkrankung betrugen, den Ergebnissen der CODE-2-Studie zufolge, im Jahr 2002 bereits 16 Milliarden Euro pro Jahr. Etwa die Hälfte der Kosten sind bedingt durch die Diabeteskomplikationen, wie Schlaganfall, Herzinfarkt, Dialysepfl ichtigkeit etc., also infolge der unzureichenden Therapiezielerreichung während der letzten Jahre bzw. Jahrzehnte. Durch eine multifaktorielle Therapie, die das Erreichen der Zielwerte für HbA 1c , Blutdruck sowie der Lipidparameter anstrebt, gelingt es eindrucksvoll das Risiko zur Entwicklung von sowohl makro-wie auch mikrovaskulären Folgeerkrankungen zu reduzieren, wie die Steno-2-Studie überzeugend belegt hat [1].
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