Psychometric properties of the Thai version of the Diabetes Distress Scale in diabetic seniors

Abstract

BackgroundThe Diabetes Distress Scale (DDS) is an important measure of diabetes-related emotional distress that has been widely used in the Western world. In Thailand, there is a lack of reliable and valid scales for assessing distress levels in diabetes patients, specifically in older adults.ObjectivesThe main objectives of this study were to adapt the DDS for use in Thai diabetic elderly and to evaluate its psychometric properties.MethodsThe 17-item DDS was linguistically adapted using forward–backward translation and administered to 170 diabetic patients ≥60 years selected from diabetes outpatient clinics of four hospitals in Buriram, Thailand. Statistical analyses included exploratory factor analysis, internal consistency, convergent validity, and test–retest reliability.ResultsDuring factor analysis, a three-factor solution was found to be reasonable for the sub-dimensions of emotional and regimen-related burden (ten items), physician- and nurse-related distress (four items), and diabetes-related interpersonal distress (three items). The Cronbach’s alpha coefficient for the total score was 0.95 and varied between 0.85 and 0.96 in the three subscales. The results provided evidence that supports the convergent validity of the Thai version of the DDS as well as its stability.ConclusionThe Thai version of the DDS has acceptable psychometric properties. It enables assessment of diabetes-specific distress in elderly patients and has the advantage of being easy to use in both clinical and research settings.

Longitudinal relationship between diabetes‐specific emotional distress and follow‐up HbA1c in adults with Type 1 diabetes mellitus

“… proposed that the DDS2 is suitable for an initial screening of high diabetes‐specific emotional distress in clinical consultations, and showed that DDS2 was significantly associated with HbA 1c levels. The DDS2 consists of items from the regimen‐related distress and emotional burden subscales and a recent study found that items of regimen‐related distress and emotional burden loaded on the same factor . In the present study the DDS2 showed a significant relationship with follow‐up HbA 1c , but not when adjusting for baseline glycaemic control.…”

Type 2 Diabetes Mellitus Related Distress in Thailand

“…Total DRD, EB, and RD were found to be associated with both HbA1C and co-morbidity. EB includes a variety of negative emotions such as despair, conflict and fear-induced anger that result from thinking about the prospect of a lifetime of living with diabetes, and feeling overwhelmed by the many resulting demands [20]. Type D personality [46] and alexithymia [47] have been reported to adversely affect outcomes in patients with T2DM.…”

“…The Diabetes Distress Scale (DDS-17) questionnaire for assessing DRD developed by Polonsky et al [37] was translated into the Thai language by Kattika [20]. The alpha coefficient of the questionnaire was 0.95.…”

“…Diabetes-related distress (DRD) is a syndrome comprised of multidimensional components including worry, conflict, frustration, and discouragement that can accompany living with diabetes. Negative physical and psychological effects can be directly attributable to long-term suffering from diabetes-related emotional distress [19,20]. Sixty percent of patients with diabetes who have high levels of negative mood and/or psychological distress display a high level of distress [21].…”

Depression, distress and self-efficacy: The impact on diabetes self-care practices

“…Diabetes distress, an affective disorder, is a syndrome comprised of a multidimensional component, such as worry, conflict, frustration, and discouragement that can accompany living with diabetes, and is closely related to depression [5]. Majority of people with diabetes who were depressed experienced diabetes distress, however, most of those experiencing diabetes distress were not depressed [6].…”