RCMAR Measurement Tools

Appraisal of Diabetes Scale (ADS)

Authors:

M.O. Carey, R.S. Jorgensen, R.S. Weinstock, R.P. Sprafkin, L.J. Lantinga, C.L.M. Carnrike Jr., M.T. Baker, SA.W. Meisler (1991)

Background and Development:

The ADS is a brief self-reported questionnaire containing seven items designed to assess an individual’s appraisal of his or her diabetes. It was developed and tested with 200 male subjects, 66% of whom were on insulin treatment with an average age of 58.4 years. All subjects provided blood for routine monitoring of HbA1c, half the subjects completed the ADS in addition to five other questionnaires, and the other half completed the ADS on three occasions over the course of 1 week. No significant difference was observed between ADS scores for insulin-dependent and non-insulin-dependent subjects. The scale is internally reliable as measured by Cronbach’s ? (0.73) and principle components analysis. Pearson product-moment correlation of the test-retest data show the ADS to be stable for both the 1-hour and 1-week retests. As measures of validity, correlation analyses of the ADS to other questionnaires indicate modest to strong relationships. Correlation between the ADS and HbA1c was modest. In general, ADS scores correlated well with measures of psychological adjustment and current stress, and moderately with health beliefs and perceived diabetes complications and susceptibility.

Assessment in Elderly Populations:

The ADS has not been specifically tested in elderly populations.

Assessment in Minority Populations:

The ADS has not been tested in minority populations.

Subsequent Studies:

The ADS has been used to assess the effects of family environment (Trief et al. 1998) and work environment (Trief et al. 1999) on glycemic control and psychosocial adaptation in adults with diabetes.

Design Strengths and Weaknesses:

The authors state that the ADS can be useful as a quick (5 minute) screening tool to assess a patient’s adjustment to diabetes or risk for noncompliance with a care regimen. The test is easy to administer (in either written or oral form) and is easy to score. In a review of health outcome measures for diabetes Garratt et al. (2002) state that this instrument shows good reliability, validity, and test-retest analysis results. But, having been developed without patient input brings into question the content validity as a measure that is relevant to the recipients of care.

Contact Information:

The ADS is printed as an appendix to Carey et al. (1991).

References:

Carey, M.O., R.S. Jorgensen, R.S. Weinstock, R.P. Sprafkin, L.J. Lantinga, C.L.M. Carnrike Jr., M.T. Baker, SA.W. Meisler (1991) Reliability and validity of the appraisal of diabetes scale. J. Behav. Med. 14, 43-51.

Garratt, A.M., L. Schmidt, and R. Fitzpatrick (2002) Patient-assessed health outcome measures for diabetes: a structured review. Diabetic Med., 19, 1-11.

Trief, P.M., W. Grant, K. Elbert, and R.S. Weinstock (1998) Family environment, glycemic control, and the psychosocial adaptation of adults with diabetes. Diabetes Care 21, 241-245.

Trief, P.M., C. Aquilino, K. Paradies, and R.S. Weinstock (1999) Impact of the work environment on glycemic control and adaptation to diabetes. Diabetes Care 22, 569-574.