Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G)

Health and Quality of Life Outcomes

Dominik Ose³  Joachim Szecsenyi³  Werner Besier¹  Sarah Berger³  Elisabeth Flum³  Markus Qreini³  Marion Kiel³  Tobias Freund³  Johannes Krisam²  Kayvan Bozorgmehr³  Martina Kamradt³ 

[1] Genossenschaft Gesundheitsprojekt Mannheim e.G., Liebfrauenstr. 21, Mannheim, D-68259, Germany;Department of Medical Biometry; Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Im Neuenheimer Feld 305, Heidelberg, D-69120, Germany;Department of General Practice and Health Services Research, University Hospital Heidelberg, Voßstr. 2, Geb. 37, Heidelberg, D-69115, Germany

关键词: Validation;    German;    Outcome measurement;    Self-care;    Self-management;    Diabetes mellitus type 2;   

Others  :  1133911
DOI  :  10.1186/s12955-014-0185-1

 received in 2014-10-06, accepted in 2014-12-06,  发布年份 2014

【 摘 要 】

Background

One of the most widely used self-reporting tools assessing diabetes self-management in English is the Summary of Diabetes Self-Care Activities (SDSCA) measure. To date there is no psychometric validated instrument in German to assess self-management in patients with diabetes mellitus. Therefore, this study aimed to translate the SDSCA into German and examine its psychometric properties.

Methods

The English version of the SDSCA was translated into German following the guidelines for cultural adaptation. The German version of the SDSCA (SDSCA-G) was administered to a random sample of 315 patients with diabetes mellitus type 2. Reliability was analyzed using Cronbach’s alpha coefficient and item characteristics were assessed. Exploratory and confirmatory factor analysis (EFA and CFA) were carried out to explore the construct validity. A multivariable linear regression model was used to identify the influence of predictor variables on the SDSCA-G sum score.

Results

The Cronbach’s alpha for the SDSCA-G (all items) was α = 0.618 and an acceptable correlation between the SDSCA-G and Self-management Diabetes Mellitus-Questionnaire (SDQ) (ρ = 0.664) was identified. The EFA suggested a four factor construct as did the postulated model. The CFA showed the goodness of fit of the SDSCA-G. However, item 4 was found to be problematic regarding the analysis of psychometric properties. The omission of item 4 yielded an increase in Cronbach’s alpha (α = 0.631) and improvements of the factor structure and model fit. No statistically significant influences of predictor variables on the SDSCA-G sum score were observed.

Conclusion

The revised German version of the SDSCA (SDSCA-G) is a reliable and valid tool assessing self-management in adults with type 2 diabetes in Germany.

【 授权许可】

   
2014 Kamradt et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Health Organization: 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. World Health Organization, Geneva, Switzerland; 2009.
• [2]International Diabetes Federation: IDF Diabetes Atlas. 6th edition. International Diabetes Federation, Brusells, Belgium; 2013.
• [3]Valent F, Tillati S, Zanier L: Prevalence and comorbidities of known diabetes in northeastern Italy. J Diabetes Investig 2013, 4:355-360.
• [4]Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B: Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012, 380:37-43.
• [5]Smith SM, Dowd T: Chronic diseases: what happens when they come in multiples? Br J Gen Pract 2007, 57:268-270.
• [6]Vogeli C, Shields A, Lee T, Gibson T, Marder W, Weiss K, Blumenthal D: Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med 2007, 22:391-395.
• [7]Heinrich E, Schaper NC, de Vries Nanne K: Self-management interventions for type 2 diabetes: a systematic review. Eur Diab Nursing 2010, 7:71-76.
• [8]Toobert DJ, Hampson SE, Glasgow RE: The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care 2000, 23:943-950.
• [9]Du S, Yuan C: Evaluation of patient self-management outcomes in health care: a systematic review. Int Nurs Rev 2010, 57:159-167.
• [10]Song M, Ratcliffe SJ, Tkacs NC, Riegel B: Self-care and health outcomes of diabetes mellitus. Clin Nurs Res 2012, 21:309-326.
• [11]Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J: Self-management approaches for people with chronic conditions: a review. Patient Educ Couns 2002, 48:177-187.
• [12]Richard AA, Shea K: Delineation of self-care and associated concepts. J Nurs Scholarsh 2011, 43:255-264.
• [13]Wilkinson A, Whitehead L: Evolution of the concept of self-care and implications for nurses: a literature review. Int J Nurs Stud 2009, 46:1143-1147.
• [14]Wilde MH, Garvin S: A concept analysis of self-monitoring. J Adv Nurs 2007, 57:339-350.
• [15]Bodenheimer T, Lorig K, Holman H, Grumbach K: Patient self-management of chronic disease in primary care. JAMA 2002, 288:2469-2475.
• [16]Fransen MP, von Wagner C, Essink-Bot M: Diabetes self-management in patients with low health literacy: ordering findings from literature in a health literacy framework. Patient Educ Couns 2012, 88:44-53.
• [17]Jarvis J, Skinner TC, Carey ME, Davies MJ: How can structured self-management patient education improve outcomes in people with type 2 diabetes? Diabetes Obes Metab 2010, 12:12-19.
• [18]Steinsbekk A, Rygg LO, Lisulo M, Rise MB, Fretheim A: Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Serv Res 2012, 12:213. BioMed Central Full Text
• [19]Schmitt A, Gahr A, Hermanns N, Kulzer B, Huber J, Haak T: The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health Qual Life Outcomes 2013, 11:138. BioMed Central Full Text
• [20]Petrak F, Rodriguez Rubio A, Kaltheuner M, Schepper N, von Hübbenet J, Heinemann L, Faber-Heinemann G: Psychische Belastung und Therapieadhärenz von Patienten mit Diabetes in DSPen. Diabete Stoffw Herz 2011, 20:7-14.
• [21]Freund T, Peters-Klimm F, Rochon J, Mahler C, Gensichen J, Erler A, Beyer M, Baldauf A, Gerlach F, Szecsenyi J: Primary care practice-based care management for chronically ill patients (PraCMan): study protocol for a cluster randomized controlled trial [ISRCTN56104508]. Trials 2011, 12:163. BioMed Central Full Text
• [22]Peeters C, Meyer I, Muls E, Evers G: Die Diabetes Selbstpflege-Skala (LDZ). In Professionelle Selbstpflege. Einschätzen - Messen - Anwenden. 1st edition. Edited by Evers G, Bern CM. Huber, Göttingen, Toronto, Seattle; 2002:235-254.
• [23]Beaton DE, Bombardier C, Guillemin F, Ferraz MB: Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000, 25:3186-3191.
• [24]Guillemin F, Bombardier C, Beaton D: Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993, 46:1417-1432.
• [25]Corp IBM: IBM SPSS Statistics for Windows, Version 21.0. IBM Corp., Armonk, NY; 2012.
• [26]Corp IBM: IBM SPSS AMOS for Windows, Version 22.0. IBM Corp., Armonk, NY; 2013.
• [27]Schenk L, Bau A, Borde T, Butler J, Lampert T, Neuhauser H, Razum O, Weilandt C: A basic set of indicators for mapping migrant status. Recommendations for epidemiological practice. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2006, 49:853-860.
• [28]Hu L, Bentler PM: Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equation Model: Multidisciplinary J 1999, 6:1-55.
• [29]Choi EJ, Nam M, Kim SH, Park CG, Toobert DJ, Yoo JS, Chu SH: Psychometric properties of a Korean version of the summary of diabetes self-care activities measure. Int J Nurs Stud 2011, 48:333-337.
• [30]AlJohani KA, Kendall GE, Snider PD: Psychometric evaluation of the Summary of Diabetes Self-Care Activities-Arabic (SDSCA-Arabic): translation and analysis process.J Transcult Nurs 2014. 1043659614526255, first published on May 19, 2014.
• [31]Jalaludin MY, Fuziaj MZ, Hong J, Mohamad Adam B, Jamaiyah H: Reliability and validity of the revised Summary of Diabetes Self-Care Activities (SDSCA) for Malaysian children and adolescents. Malysian Family Physician 2012, 7:10-20.
• [32]Vincent D, McEwen MM, Pasvogel A: The validity and reliability of a Spanish version of the summary of diabetes self-care activities questionnaire. Nurs Res 2008, 57:101-106.
• [33]Yin X, Savage C, Toobert D, Wei P, Whitmer K: Adaptation and testing of instruments to measure diabetes self-management in people with type 2 diabetes in Mainland China. J Transcult Nurs 2008, 19:234-242.
• [34]Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson J, Garg A, Holzmeister LA, Hoogwerf B, Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2003, 26(Suppl 1):S51-S61.
• [35]Nettleton JA, Steffen LM, Ni H, Liu K, Jacobs DR Jr: Dietary patterns and risk of incident type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2008, 31:1777-1782.
• [36]Aune D, Ursin G, Veierod MB: Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies. Diabetologia 2009, 52:2277-2287.
• [37]Jansa M, Vidal M, Gimenez M, Conget I, Galindo M, Roca D, Colungo C, Esmatjes E, Salamero M: Psychometric analysis of the Spanish and Catalan versions of the diabetes self-care inventory-revised version questionnaire. Patient Prefer Adherence 2013, 7:997-1005.
• [38]Eigenmann CA, Colagiuri R, Skinner TC, Trevena L: Are current psychometric tools suitable for measuring outcomes of diabetes education? Diabet Med 2009, 26:425-436.
• [39]Caro-Bautista J, Martin-Santos FJ, Morales-Asencio JM: Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus. J Adv Nurs 2014, 70:1209-1227.