Israel Center for Technology Assessment in Health Care, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.
Diabetes Metab Res Rev. 2012 Mar;28(3):246-51. doi: 10.1002/dmrr.1300.
The objective of this study is to describe the design and validation of a newly developed brief, treatment-focused scale for use with type 1 and type 2-diabetes, exploring patient-perceived difficulties that are associated with treatment.
The content of the construct was derived from consultation with experts, from existing instruments and the literature, as well as from diabetic patients. The original draft was comprised of 11 attributes. Based on an interim analysis, an additional 12th attribute was added. The final scale was tested on 988 diabetic patients from 25 practices in Israel. Respondents also completed a diabetes-specific quality of life (QoL) questionnaire and indicated their current perceived overall health status.
The patient-perceived difficulty of diabetes treatment (PDDT) scale contains 12 items reflecting diabetes-treatment characteristics: adherence to self-monitoring of glucose schedule, frequency of self-monitoring of glucose, adherence to medication administration schedule, frequency of medication administration, multiple number of medications, synchronization between meals and medications, dependence on the medications, pain associated with treatment, diet restrictions, self-care, multiple healthcare providers, and costs of treatment. Response rate to all attributes was very high. Construct validity was shown by significant correlations between PDDT attributes and diabetes-specific quality of life (r = 0.31-0.46) and self-report adherence to recommended treatment (r = 0.14-0.28), as well as between overall perceived difficulty and diabetes-specific quality of life (r = 0.60). Furthermore, the PDDT items showed discriminant capabilities with respect to known groups of patients.
The PDDT scale is a simple and valid instrument that may assist in identifying potential barriers in adherence to recommended treatments and to new treatment options.
本研究旨在描述一种新开发的简短、以治疗为重点的量表的设计和验证，用于 1 型和 2 型糖尿病，探索与治疗相关的患者感知困难。
该量表的构建内容源自专家咨询、现有工具和文献以及糖尿病患者。原始草案由 11 个属性组成。基于中期分析，又增加了第 12 个属性。最终的量表在以色列 25 家诊所的 988 名糖尿病患者中进行了测试。受访者还完成了糖尿病特定的生活质量（QoL）问卷，并表示他们目前对整体健康状况的感知。
患者感知的糖尿病治疗困难（PDDT）量表包含 12 个反映糖尿病治疗特征的项目：对血糖监测时间表的依从性、血糖监测的频率、对药物管理时间表的依从性、药物给药的频率、多种药物、饮食与药物的同步性、对药物的依赖性、治疗相关的疼痛、饮食限制、自我护理、多个医疗服务提供者以及治疗费用。对所有属性的回应率都非常高。结构有效性表现为 PDDT 属性与糖尿病特定生活质量（r = 0.31-0.46）和自我报告对推荐治疗的依从性（r = 0.14-0.28）之间存在显著相关性，以及整体感知困难与糖尿病特定生活质量（r = 0.60）之间存在显著相关性。此外，PDDT 项目在具有已知患者群体方面表现出了区分能力。
PDDT 量表是一种简单有效的工具，可用于识别依从性治疗建议和新治疗方案的潜在障碍。
