Several instruments have been developed for the assessment of emotional distress in patients with diabetes. The Problem Areas in Diabetes Scale (PAID) is a brief self-report scale that evaluates diabetes-related distress. There is a lack of validated instruments for the evaluation of psychological aspects in patients with diabetes in Greek language. The current study was conducted to translate and adapt the PAID scale in Greek language and to evaluate the psychometric properties in two different study populations of patients with diabetes. The aim of this study was to translate the Problem Areas in Diabetes (PAID) scale into Greek, adapt it culturally to Greece and determine its psychometric properties. The translation process included two forward translations, reconciliation, backward translation and pre-testing steps. The validation incorporated the exploration of internal consistency (Cronbach's alpha), test-retest reliability (interclass correlation coefficient), construct validity (exploratory factor analysis) and responsiveness (Spearman correlation coefficient). Participants included 101 consecutive patients from a rural primary healthcare centre and 101 patients from an urban hospital. All patients completed the PAID scale and the Short Form-36 (SF-36) version 2. Internal consistency considered good (Cronbach's alpha = 0.948). Interclass correlation coefficient was 0.942 (95% CI 0.915-0.961). Factor analysis yielded three factors: 'Diabetes-related emotional problems' (51.79% variance, Cronbach's alpha = 0.910), 'Food-related problems' (9.55% variance, Cronbach's alpha = 0.824) and 'Social support-related problems' (5.96% variance, Cronbach's alpha = 0.704). Screen plot test and conceptual congruency of items supported a three-factor solution. Total PAID showed a negative correlation with both SF-36 mental component summary (r = -0.733, P < 0.0001) and SF-36 physical component summary (r = -0.594, P < 0.0001). Our findings indicate that the Greek version of the PAID questionnaire is reliable and valid for patients with diabetes mellitus in Greece.

BackgroundSelf-management of long term conditions can promote quality of life whilst delivering benefits to the financing of health care systems. However, rarely are the meso-level influences, likely to be of direct relevance to these desired outcomes, systematically explored. No specific international guidelines exist suggesting the features of the most appropriate structure and organisation of health care systems within which to situate self-management approaches and practices. This review aimed to identify the quantitative literature with regard to diabetes self-management arrangements currently in place within the health care systems of six countries (The United Kingdom, The Netherlands, Norway, Spain, Bulgaria, and Greece) and explore how these are integrated into the broader health care and welfare systems in each country.MethodsThe methodology for a realist review was followed. Publications of interest dating from 2000 to 2013 were identified through appropriate MeSH terms by a systematic search in six bibliographic databases. A search diary was maintained and the studies were assessed for their quality and risk of bias.ResultsFollowing the multi-step search strategy, 56 studies were included in the final review (the majority from the UK) reporting design methods and findings on 21 interventions and programmes for diabetes and chronic disease self-management. Most (11/21, 52%) of the interventions were designed to fit within the context of primary care. The majority (11/21, 52%) highlighted behavioural change as an important goal. Finally, some (5/21, 24%) referred explicitly to Internet-based tools.ConclusionsThis review is based on results which are derived from a total of at least 5,500 individuals residing in the six participating countries. It indicates a policy shift towards patient-centred self-management of diabetes in a primary care context. The professional role of diabetes specialist nurses, the need for multidisciplinary approaches and a focus on patient education emerge as fundamental principles in the design of relevant programmes. Socio-economic circumstances are relevant to the capacity to self-manage and suggest that any gains and progress will be hard to maintain during economic austerity. This realist review should be interpreted within the wider context of a whole systems approach regarding self-care support and chronic illness management.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6963-14-453) contains supplementary material, which is available to authorized users.

No abstract

No abstract