RCMAR Measurement Tools
Diabetes Health Profile (DHP-1 and DHP-18)
K. Meadows, N. Steen, E. McColl, M. Eccles, C. Shiels, J. Hewison, and A. Hutchinson (1996)
Background and Development:
The DHP-1 was developed specifically for insulin-dependent diabetics
(type 1) following in-depth interviews with patients, reviews of relevant
literature, and discussions with health care professionals. Initially,
a 43-item version was tested, but, after a factor analysis, 11 items
with high cross-factor loading or low single factor loadings were
dropped. Factor analysis of the resulting 32-item survey resulted
in the identification of three subscales: Psychological Distress,
Barriers to Activity, and Disinhibited Eating. The internal reliabilities
of these subscales (as measured by Cronbach's alpha) were good (0.86,
0.82, and 0.77, respectively). Discriminant validity was assessed
by comparing scores between men and women. Women younger than 40 scored
significantly higher on the Psychological Distress subscale and women
younger than 65 scored significantly higher on the Disinhibited Eating
subscale. Convergent validity was measured by comparisons with individual
dimensions of the Hospital Anxiety and Depression scale (HAD) and
the SF-36. Strong correlations were found between these scales and
the Psychological Distress and Barriers to Activity subscales.
Assessment in Elderly Populations:
No assessment has been conducted specifically in elderly populations.
Assessment in Minority Populations:
No assessment has been conducted specifically in minority populations, although a Danish translation (the DHP-18) has been tested.
No reports of subsequent studies using this measure have been published.
Design Strengths and Weaknesses:
In a review of health outcome measures for diabetes Garratt et al. (2002) state that both of these instruments have good evidence for reliability, and internal and external construct validity. The three subscales measure psychosocial attributes not generally found in other scales. No validation studies with independent outcome measures (e.g. glycaemic control) have been performed. No test-retest validation studies have been performed.
Dr. Keith A. Meadows
Garratt, A.M., L. Schmidt, and R. Fitzpatrick (2002) Patient-assessed health outcome measures for diabetes: a structured review. Diabetic Med., 19, 1-11.
Meadows, K., N. Steen, E. McColl, M. Eccles, C. Shiels, J. Hewison, and A. Hutchinson (1996) The diabetes health profile (DHP): A new instrument for assessing the psychosocial profile of insulin requiring patients -- Development and psychometric evaluation. Qual. Life Res. 5, 242-254.
Meadows, K., S. Abrams, A. Sandback (2000) Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison. Diabet. Med. 17, 572-580.
© 2006 RCMAR