Further investigation of the psychometric properties of the insulin treatment appraisal scale among insulin-using and non-insulin-using adults with type 2 diabetes: results from diabetes MILES – Australia

Health and Quality of Life Outcomes

Jane Speight¹  Frans Pouwer³  Elizabeth Holmes-Truscott² 

[1] Applied Health Psychology Research Ltd, 16 Walden Way, Hornchurch RM11 2LB, United Kingdom;School of Psychology, Deakin University, 221 Burwood Highway, Burwood 3125, VIC, Australia;Department of Medical and Clinical Psychology, Centre of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands

关键词: Psychometric validation;    Questionnaire;    Type 2 diabetes;    Psychological insulin resistance;   

Others  :  814678
DOI  :  10.1186/1477-7525-12-87

 received in 2013-09-20, accepted in 2014-05-30,  发布年份 2014

【 摘 要 】

Background

Negative attitudes towards insulin are commonly reported by people with type 2 diabetes mellitus (T2DM) and can act as a barrier to timely insulin initiation. The Insulin Treatment Appraisal Scale (ITAS) is a widely used 20-item measure of attitudes towards insulin. While designed for completion by both insulin using and non-insulin using adults with T2DM, its psychometric properties have not been investigated separately for these groups. Furthermore, the total score is routinely reported in preference to the published two-factor structure (negative/positive appraisals). Further psychometric validation of the ITAS is required to examine its properties.

Methods

The ITAS was completed by a subgroup of 748 Diabetes MILES – Australia study participants with T2DM, who were either insulin using (n = 249; 45% women; mean age = 58 ± 9 years; mean diabetes duration = 13, SD = 8 years) or non-insulin using (n = 499; 47% women; mean age 57 ± 9 years; mean diabetes duration 7 ± 6 years). We replicated the psychometric analyses reported in the ITAS development paper. In addition, we explored factor structure and investigated internal consistency separately for the insulin using and non-insulin using samples.

Results

Factor analyses supported a two-factor structure with good internal consistency (negative subscale α = .90; positive subscale α = .69). Scale performance differed slightly in the insulin using and non-insulin using samples, with some items loading inconsistently between groups. A one-factor solution was not supported in either sample, with the positive items and some negative items failing to load adequately. Consistent with prior research, negative appraisals were significantly more common among non-insulin using participants compared to those using insulin (d = 1.04), while the positive subscale score did not discriminate between groups.

Conclusions

The data supported a two factor structure and the positive subscale did not discriminate between insulin using and non-insulin using participants. As such, we recommend use of the negative subscale score in preference to the ITAS total score, and suggest close attention is paid to the relevance of the positive items in the given population.

【 授权许可】

   
2014 Holmes-Truscott et al.; licensee BioMed Central Ltd.

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