Diabetes Strengths and Challenges Scale: A Scale Development Study

Abstract

Aim: Diabetes is one of the fastest-growing non-communicable global epidemics of the 21st century. Diabetes continues to increase rapidly and affects more and more people every day, in our country as well as all over the world. To live and manage diabetes; The individual needs to acquire many very healthy living behaviors. It is known that individuals with diabetes may experience difficulties in individual, personal and psychosocial aspects while performing diabetes management. From this point of view, this research is a methodological study conducted with the aim of developing the scale of strengths and difficulties in diabetes. The aim of the study is to reveal the difficulties experienced by individuals with type 2 diabetes and to shed light on the work that can be done for these difficulties. Method: The study was conducted with 315 individuals with Type 2 diabetes who applied to the internal medicine outpatient clinics of a state hospital. The study data were collected with the sociodemographic data form and the “Diabetes Strengths and Difficulties Scale”. The validity of the scale was examined as language, content (content) validity and construct validity. Reliability analyzes of the scale was calculated with the Cronbach Alpha value. Results: As a result of the factor analysis, a 3-dimensional structure (psychosocial difficulties, individual difficulties, difficulties related to lack of knowledge) consisting of 30 items with an item load value between 0.859-0.522 was obtained. It explains 59.328% of the total variance. Conclusion: It has been concluded that the scale of strengths and difficulties in diabetes applied to individuals with type 2 diabetes is a valid and reliable scale.

Keywords

• Diabetes mellitus
• nursing
• scale development
• challenges

Diyabette Güçler ve Güçlükler Ölçeği: Bir Ölçek Geliştirme Çalışması

Abstract

Amaç: Diyabet 21.yüzyılın en hızlı büyüyen bulaşıcı olmayan küresel salgınlarından birisidir. Diyabet tüm dünyada olduğu gibi ülkemizde de hızla artmaya ve her geçen gün daha fazla insanı etkilemeye devam etmektedir. Diyabetle yaşamak ve yönetmek için; bireyin birçok çok sağlıklı yaşam davranışı kazanması gerekmektedir. Diyabet yönetimini gerçekleştirirken diyabetli bireylerin bireysel, kişisel ve psikososyal açıdan zorluk yaşayabildiği bilinmektedir. Bu noktadan hareketle bu araştırma diyabette güçler ve güçlükler ölçeğinin geliştirilmesi amacı ile yapılmış metodolojik bir çalışmadır. Çalışmanın amacı tip 2 diyabetli bireylerin yaşadıkları güçlüklerin ortaya çıkmasını sağlamak ve bu güçlüklere yönelik yapılabilecek çalışmalara ışık tutmaktır. Yöntem: Araştırma, bir devlet hastanesinin dahiliye polikliniklerine başvuran 315 Tip 2 diyabetli bireylerle yapılmıştır. Araştırmanın verileri sosyodemografik veri formu ve “Diyabette Güçler ve Güçlükler Ölçeği” ile toplanmıştır. Ölçeğin geçerliliği, dil, kapsam (içerik) geçerliği ve yapı geçerliği olarak incelenmiştir. Ölçeğin güvenirlik analizleri Cronbach Alfa değeri ile hesaplanmıştır. Bulgular: Faktör analizi sonucu 0,859-0,522 arasında madde yük değerine sahip 30 maddeden oluşan 3 alt boyutlu (psikososyal güçlükler, bireysel güçlükler, bilgi eksikliği ile ilgili güçlükler) bir yapı elde edilmiştir. Toplam varyansı %59,328 oranında açıklamaktadır. Sonuç: Tip 2 diyabetli bireylere uygulanan diyabette güçler ve güçlükler ölçeğinin geçerli ve güvenilir bir ölçek olduğu sonucuna ulaşılmıştır.

Keywords

• Diabetes mellitus
• hemşirelik
• ölçek geliştirme
• güçlükler

References

1. World Health Organization 2021: Health Topics: Diabetes https://www.who.int/health-topics/diabetes#tab=tab_1 Yayınlanma tarihi 2021. Erişim tarihi 22 Aralık 2022.
2. Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu-2022. Ankara: Endokrinoloji ve Metabolizma Derneği; 2022:159-186.
3. Uluslararası Diyabet Federasyonu. IDF Diyabet Atlas 9. baskı https://diabetesatlas.org/en/sections/worldwide-toll-of-diabetes.html Yayınlanma tarihi 2019. Erişim tarihi 22 Aralık 2022.
4. Türkiye Diyabet Vakfı. Diyabet hakkında her şey: Komplikasyonlar. https://www.turkdiab.org/diyabet-hakkinda-hersey.asp?lang=TR&id=58 Yayınlanma tarihi 2016. Erişim tarihi 22 Aralık 2022.
5. Lallukka T, Ervasti J, Mittendorfer-Rutz E, et al. The joint contribution of diabetes and work disability to premature death during working age: a population-based study in Sweden. Scand J Public Health. 2016;44(6):580-586.
6. World Health Organization. Global Report on Diabetes: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua =1 Yayınlanma tarihi 2016. Erişim tarihi 22 Aralık 2022.
7. American Diabetes Association. Standards of medical care in diabetes 2017. Diabetes Care. 2017;40(1):33-43.
8. Lin BJ, Lee PF. From monologue to dialogue: the evolution of diabetes self-management education. J of Nurs. 2018;65(5):20- 26

9. Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American association of clinical endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm–2017. Executive summary. Endocrine Practice. 2017;23(2):207-238.
10. Gregg EW, Sattar N, Ali MK. The changing face of diabetes complications. The Lancet Diabetes & Endocrinology. 2016;4(6):537–547.
11. Thompson M. Occupations, habits, and routines: perspectives from persons with diabetes. Scand J Occup Ther. 2014;21(2):153-160.
12. Hill-Briggs F. Problem solving in diabetes self-management: a model of chronic illness self-management behavior. Ann Behav Med. 2003;25(3):182-193.
13. Pyatak E. Participation in occupation and diabetes self-management in emerging adulthood. Am J Occup Ther. 2011;65(4):462-469.
14. Downer B, Crowe M, Markides KS. Influence of type II diabetes and high depressive symptoms on the likelihood for developing Activities of Daily Living (ADL) disability and mortality in older Puerto Ricans. J Aging and Health. 2017;29(6):1079-1095.
15. Bolge SC, Flores NM, Phan JH. The burden of poor mental well-being among patients with type 2 diabetes mellitus: examining health care resource use and work productivity loss. Int J Occup Environ Med. 2016;58(11):1121.
16. Sudhir PM. Advances in psychological interventions for lifestyle disorders: overview of interventions in cardiovascular disorder and type 2 diabetes mellitus. Curr Opin Psychiatry. 2017;30(5):346-351.
17. Haltiwanger EP. Effect of a group adherence intervention for MexicanAmerican older adults with type 2 diabetes. Am J Occup Ther. 2012;66(4):447-454.
18. Kalyani RR, Saudek CD, Brancati FL, Selvin E. Association of diabetes, comorbidities, and A1c with functional disability in older adults. Diabetes care. 2010;33(5):1055-1060.
19. Poole JL, Gashytewa C, Sullivan AT. Activity limitations, participation, and quality of life in American Indians with and without diabetes. Occupational therapy in health care. 2016;30(1):58-68.
20. Edwall LL, Hellström AL, Öhrn I, Danielson E. The lived experience of the diabetes nurse specialist regular check‐ups, as narrated by patients with Type 2 diabetes. J Nurs Clin Pract. 2008;17(6):772-781.
21. Nicolucci A, Kovacs Burns K, Holt RI, et al. Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross‐national benchmarking of diabetes‐related psychosocial outcomes for people with diabetes. Diabetic Medicine. 2013;30(7):767-777.
22. Dost A, Bahçecik AN. Developing a scale for the image of nursing profession. EAH JAREN. 2015;1(2):51-59.
23. Taşkın Ç, Akat Ö. Araştırma Yöntemlerinde Yapısal Eşitlik Modelleme. Bursa: Ekin Yayınevi; 2010.
24. Forero CG, Maydeu-Olivares A, Gallardo-Pujol D. Factor analysis with ordinal indicators: A Monte Carlo study comparing DWLS and ULS estimation. Structural Equation Modeling. 2009;16(4):625-641.
25. R Core Team, R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/. 2023.
26. Lavaan RY: An R package for structural equation modeling and more. Version 0.5–12 (BETA). Journal of statistical software. 2012;48(2):1-36.
27. Epskamp S. SemPlot: Unified visualizations of structural equation models. Structural Equation Modeling: a multidisciplinary journal. 2015;22(3):474-483.
28. Revelle W. Psych: Procedures for Personality and Psychological Research, Northwestern University, Evanston, Illinois, USA, project.org/package=psych Version=1.8.12. 2018.
29. Hair JF, Black B, Babin B, Anderson RE, Tatham RL. Multivariate data analysis., 6th edn. NJ; Prentice Hall: Englewood Cliffs; 2005.
30. Howard MC. A review of exploratory factor analysis decisions and overview of current practices: What we are doing and how can we improve? International Journal of Human-Computer Interaction. 2016;32(1):51-62.
31. Hsu HY, Skidmore ST, Li Y, Thompson B. Forced zero cross-loading misspecifications in measurement component of structural equation models. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences. 2004;10(4):138–152.
32. Shinn E, Basen-Engquist K, Le T, et al. Distress after an abnormal Pap smear result: scale development and psychometric validation. Preventive Medicine. 2004;39(2):404-412.
33. Xie J, Lu H, Kang L, Cheng Y. Citing criteria and its effects on researcher's intention to cite: A mixed‐method study. Journal of the Association for Information Science and Technology. 2022;73(8):1079-1091.
34. Hooper D, Coughlan J, Mullen MR. Structural equation modelling: Guidelines for determining model fit. Electronic journal of business research methods. 2008;6(1):53-60.
35. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal. 1999;6(1):1-55.
36. Mulaik SA, James LR, Van Alstine J, Bennett N, Lind S, Stilwell CD. Evaluation of goodness-of-fit indices for structural equation models. Psychological bulletin. 1989;105(3):430.
37. Özdamar K. Paket Programlar ile İstatistiksel Veri Analizi. 5. Baskı, Eskişehir: Kaan Kitabevi; 2004.
38. Warne RT, Larsen R. Evaluating a proposed modification of the Guttman rule for determining the number of factors in an exploratory factor analysis. Psychological Test and Assessment Modeling. 2014;56(1):104.