RCMAR Measurement Tools

Diabetes-Related Assessment Tools

Problem Areas in Diabetes (PAID)

• Authors: Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, Schwartz CE (1995)
• Administration: 20 self-administered items each scored 0-4.
• Constructs Measured: The PAID is a measure of diabetes-specific emotional distress.
• Reliability and Validity: The PAID has been shown to have consistently high internal
  reliability (Cronbach alpha = 0.90), sound (r = 0.83) 2-month test–retest reliability using a sample of stable patients, and to correlate strongly with a wide range of theoretically related constructs. In a measure of responsiveness, PAID emotional distress scores declined significantly in several diabetes intervention studies.
• Assessment in Minorities and Elderly: In cross-sectional studies, the PAID has been found to be negatively correlated to age and unrelated to duration of diabetes, education, ethnicity, and gender when adjusted for age.
• Costs: None.
• Detailed Notes

Diabetes Treatment Satisfaction Questionnaire (DTSQ)

• Authors: Bradley C. (1994)
• Administration: 8 questions on each version.
• Constructs Measured: The DTSQ consists of 2 versions with more under development. The status version (DTSQs) is used to make the initial assessment of total diabetes treatment satisfaction, treatment satisfaction in specific areas, and perceived frequencies of hyperglycemia and hypoglycemia. Each of the 8 items are scored on a scale of 0-6. The change version (DTSQc) has the same 8 items as the status version, but reworded slightly to measure the change in satisfaction rather than absolute satisfaction. It was developed to overcome ceiling effects in the status version. Each item is scored on a scale of -3 to +3.
• Reliability and Validity: The DTSQ score correlates well with the General Well Being scale. Both versions of the DTSQ have been tested extensively in English and in many other languages.
• Assessment in Minorities and Elderly: No assessments have been made in minority populations. Assessments in elderly populations show that the DTSQ is a valid measure of treatment satisfaction.
• Costs: None, but a license is requested by the authors.
• Detailed Notes

Audit of Diabetes-Dependent Quality of Life (ADDQoL)

• Authors: C. Bradley, C. Todd, T. Gorton, E. Symonds, A. Martin, and R. Plowright (1999)
• Administration: 13 self-administered questions, takes less than 10 minutes.
• Constructs Measured: Physical functioning, symptoms, psychological well-being, social well-being, role activities, and personal constructs. The ADDQoL is designed to measure the impact of diabetes and its treatment on QOL.
• Reliability and Validity: Excellent reliability. Mean score correlates significantly with other reported complications. Insulin-dependent subjects generally scored lower (=greater impact) than non-insulin-dependent subjects.
• Assessment in Minorities and Elderly: The original population used to test the tool had a mean age of 58.5 years. No specific assessment with minorities has been conducted.
• Costs: None
• Detailed Notes

Appraisal of Diabetes Scale (ADS)

• Authors: Authors: M.O. Carey, R.S. Jorgensen, R.S. Weinstock, R.P. Sprafkin, L.J. Lantinga, C.L.M. Carnrike, M.T. Baker, A.W. Meisler (1991)
• Administration: 7 self-administered items, takes less than 10 minutes.
• Constructs Measured: The ADS is designed to assess an individual’s appraisal of his or her diabetes and how it affects his or her life’s activities and feelings..
• Reliability and Validity: The scale is internally reliable and shows good to excellent validity when compared with several other scales. A modest relationship was found between ADS score and glycosylated hemoglobin. Test-retest analysis showed the ADS score to be stable assessment of diabetes appraisal.
• Assessment in Minorities and Elderly: None
• Costs: None
• Detailed Notes

Diabetes Care Profile (DCP)

• Authors: J.T. Fitzgerald, W.K. Davis, C.M. Connell, G.E. Hess, M.M. Funnell, R.G. Hiss (1996)
• Administration: The DCP is a self-administered questionnaire containing 234 items which include demographic information, self-care practices, and 116 questions divided into 16 profile scales with 4 to 19 questions per scale. It takes approximately 30 to 40 minutes to complete.
• Constructs Measured: The DCP was developed as an instrument to assess social and psychological factors related to diabetes and its treatment. The 16 profile scales assess control problems, social and personal factors, positive attitude, negative attitude, self-care ability, importance of care, self-care adherence, diet adherence, medical barriers, exercise barriers, monitoring barriers, understanding management practice, long-term care benefits, support needs, support, and support attitudes.
• Reliability and Validity: Internal reliability was good to excellent. External validity is also good. Significant differences were found between type I and type II diabetics for 6 of the 14 scales. Three scales (control problems, self-care ability, and self-care adherence) were significantly correlated with GHb level.
• Assessment in Minorities and Elderly: Assessments in elderly Type II diabetic populations show good to excellent reliability. The DCP has been tested specifically with an elderly Black population (average age 61) to confirm its reliability.
• Costs: There is no cost, but a letter of permission to use the DCP from the developers at the University of Michigan is requested.
• Detailed Notes

Diabetes-39 Questionnaire (D-39)

• Authors: Greg Boyer and Jo Anne L. Earp (1997)
• Administration: 39 items. This tool uses a visual analogue scale for each question on which the respondent places an ‘X’ to indicate level of agreement to the question.
• Constructs Measured: The D-39 was developed to assess the quality of life of diabetic patients, and covers five dimensions of health: Energy and Mobility, Diabetes Control, Anxiety and Worry, Social Burden, and Sexual Functioning.
• Reliability and Validity: Reliability ranges from good to excellent for the five dimensions. Construct validity was assessed by comparison with the SF-36 Health Status Questionnaire. Significant correlations for the three comparable scales were found.
• Assessment in Minorities and Elderly: It was developed and tested in various populations including low education, elderly (>75), rural (Iowa), and minority (North Carolina).
• Costs: None
• Detailed Notes

Diabetes Health Profile (DHP-1, DHP-18)

• Authors: K. Meadows, N. Steen., E. McColl, M. Eccles, C. Shiels, J. Hewison, A. Hutchinson (1996)
• Administration: The DHP-1 contains 32 items in a self-administered questionnaire. The DHP-18 contains only 18 items .
• Constructs Measured: The DHP-1 was designed for insulin-dependent diabetic patients. Factor analysis revealed three subscales: Psychological Distress, Barriers to Activity, and Disinhibited Eating. The DHP-18 was adapted for use with type 2 diabetics, but the same three subscales were identified.
• Reliability and Validity: The three subscales showed good internal reliability. Construct-convergent validity was assessed by comparison with the Hospital Anxiety and Depression Scale and the SF-36. Strong correlations existed between the Psychological Distress and Barriers to Activity factors and these other measures.
• Assessment in Minorities and Elderly: None
• Costs: None
• Detailed Notes

Diabetes Impact Measurement Scales (DIMS)

• Authors: G.S. Hammond, T.T. Aoki (1992)
• Administration: The self-administered questionnaire contains 44 items, and takes 15-20 minutes to complete.
• Constructs Measured: DIMS was designed with both Type I and Type II diabetics The items are grouped into five subscales: Diabetes-specific symptoms, Nonspecific symptoms, Well-being, Diabetes-related morale, and Social role fulfillment. It was designed for adults, but could be used with children or adolescents with the elimination of a few questions.
• Reliability and Validity: Internal reliability of the five subscales were fair to good. Validity is poor as DIMS scores were not significantly correlated with a diabetes complications index.
• Assessment in Minorities and Elderly: DIMS has not been specifically tested in elderly or minority populations.
• Costs: None
• Detailed Notes

Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ and DQLCTQ-R)

• Authors: J.G. Kotsanos, L. Vignati, W. Huster, C. Andrejasich, M.B. Boggs, A.M. Jacobson, D. Marrero, S.D. Mathias, D. Patrick, S. Zalani, J. Anderson (1997)
• Administration: The self-administered questionnaire is composed of 142 items (including 4 demographic questions). The revised version (DQLCTQ-R) contains only 57 questions and takes about 10 minutes to complete.
• Constructs Measured: This instrument was designed for use in a clinical trial to measure the QOL changes in patients receiving insulin lispro. The DQLCTQ is divided into 34 generic and diabetes-specific domains. The revised version is divided into 8 generic and disease-specific domains: physical function, energy/fatigue, health distress, mental health, satisfaction, treatment satisfaction, treatment flexibility, and frequency of symptoms.
• Reliability and Validity: The questionnaire was tested with a large number of Type I and Type II diabetics in four countries and showed favorable internal reliability and validity. The revised version has also shown good reliability and validity.
• Assessment in Minorities and Elderly: Validity and reliability of the DQLCTQ has not been investigated specifically for elderly populations although the mean age of type 2 diabetics in the initial surveys was 58.2. It has been tested with large numbers of patients in several countries. It has not, however, been tested in minority populations.
• Costs: None. Contact the authors for copyright information.
• Detailed Notes

Diabetes Quality of Life Measure (DQOL)

• Authors: A.M. Jacobson, I. Barofsky, P. Cleary, L. Rand (1988)
• Administration: 46 questions.
• Constructs Measured: The DQOL measure was developed toward patients with insulin-dependent diabetes mellitus. It was designed using primarily young adults and adolescents. Four subscales measure life satisfaction, diabetes impact, worries about diabetes, and social/vocational concerns.
• Reliability and Validity: Overall reliability was excellent with the reliability of the 4 individual subscales rated as good to excellent. Validity was measured by comparison with three established instruments. The DQOL compares favorably to the SF-36.
• Assessment in Minorities and Elderly: It has been tested in elderly populations with both Type I and Type II diabetes. However, having been designed for a younger population, including a high percentage of adolescents, many of the items are not appropriate for elderly populations. A Chinese translation of the DQOL has been assessed.
• Costs: None
• Detailed Notes

Diabetes-Specific Quality-of-Life Scale (DSQOLS)

• Authors: U. Bott, I. Muhlhauser, H. Overmann, M. Berger (1998)
• Administration: 64-item self-administered questionnaire.
• Constructs Measured: The DSQOLS was developed from a population with Type I diabetes in Northrhine, Germany. Th DSQOLS rates the importance of 10 treatment goals, measures satisfaction with these goals, and defines six components measuring the burden of diabetes care and management: Social Relations, Physical complaints, Worries about the future, Leisure Time, Diet Restrictions, and Treatment Satisfaction..
• Reliability and Validity: The authors state that this instrument contains the sensitivity to distinguish the relative effectiveness of different treatment and dietary regimens.
• Assessment in Minorities and Elderly: None
• Costs: None
• Detailed Notes

Questionnaire on Stress in Patients with Diabetes – Revised (QSD-R)

• Authors: G. Duran, P. Herschbach, S. Waadt, F. Strain, A. Zettler (1995)
• Administration: This 64-item self-administered instrument takes about 20 minutes to complete.
• Constructs Measured: It contains sections on individual treatment goals (10 items), satisfaction with treatment success (10 items), and defines six components measuring the burden of diabetes care and management (44 items): Social Relations, Physical Complaints, Worries about the Future, Leisure Time, Diet Restrictions, and Treatment Satisfaction.
• Reliability and Validity: This questionnaire has been tested on both Type I and Type II diabetics. Internal reliability, construct validity, and test-retest reliability are all in the acceptable statistical range.
• Assessment in Minorities and Elderly: Validity and reliability of the DSQOLS has not been investigated for elderly nor minority populations.
• Costs: None
• Detailed Notes

Well-being Enquiry for Diabetics (WED)

• Authors: E. Mannucci, V. Ricca, G. Bardini, C.M. Rotella (1996)
• Administration: 50 self-reported questions.
• Constructs Measured: The WED provides an evaluation of four areas of quality of life: diabetes-related somatic symptoms and physical functioning (Symptoms), diabetes worries and emotional status (Discomfort), mental health (Serenity), and relationships, role functioning, and social network (Impact)..
• Reliability and Validity: It has been tested and validated with both Type I and Type II diabetics. Internal consistency was very good for the four subscales and excellent for the WED total score. External validity by comparison to the DQOL total score and other psychometric measures is fair to good.
• Assessment in Minorities and Elderly: No studies involving elderly or minority populations have been conducted.
• Costs: None
• Detailed Notes

Translations

Many of these Diabetes tools have been translated into other languages by the MAPI Research Institute.

Web Sites with Additional Information about Diabetes

American Diabetes Association

Diabetes UK

Canadian Diabetes Association

Centers for Disease Control Diabetes Public Health Resources

If you know of a measurement tool that should be included in this list please contact the Measurement Tools Site administrator: Mark Geesey