Polonsky William H, Fisher Lawrence, Hessler Danielle, Edelman Steven V
1 University of California , San Diego, San Diego, California.
2 Behavioral Diabetes Institute , San Diego, California.
Diabetes Technol Ther. 2015 Nov;17(11):773-9. doi: 10.1089/dia.2015.0140. Epub 2015 Jul 13.
Although many different types of insulin delivery devices are currently available, there is no well-accepted, validated method to assess patient satisfaction with these devices and their impact on quality of life and other patient-reported outcomes. To address this problem, we developed the Insulin Device Satisfaction Survey (IDSS) and herein describe its construction and validation. We then examine how key patient factors are associated with device satisfaction.
Items were developed from interviews with adults with type 1 diabetes (T1D) (n=10) and type 2 diabetes (T2D) using insulin (n=10), as well as eight healthcare professionals, leading to an initial pool of 32 items. Separate exploratory factor analyses (EFAs) were conducted with T1D subjects (n=279) and insulin-using T2D subjects (n=209). Construct validity was established with overall well-being (World Health Organization-5), diabetes distress (Diabetes Distress Scale), diabetes self-efficacy (Self-Efficacy for Diabetes Management Scale), and subscales from the Insulin Delivery System Rating Questionnaire. Regression analyses examined associations between total scale satisfaction and demographics, insulin adherence, clinical indicators, and device type (pump vs. nonpump users).
The two EFAs resulted in a 14-item scale for T1D subjects and a 12-item scale for T2D subjects, with eight items common across both samples. The EFAs yielded three coherent, meaningful factors in each sample, accounting for 55.6% (T1D sample) and 64.1% (T2D sample) of the variance. Validity was established by significant correlations with all criterion variables. For both samples, higher IDSS scores were significantly associated with better glycemic control and greater insulin adherence and pump use. For T2D subjects only, IDDS scores were significantly linked to fewer long-term complications, fewer low blood glucose readings, and older age.
The IDSS is a reliable, valid measure of insulin device satisfaction in both its T1D form and T2 form. It provides a comprehensive profile of sources of device satisfaction for use in clinical care and research.
尽管目前有许多不同类型的胰岛素给药装置，但尚无一种被广泛接受且经过验证的方法来评估患者对这些装置的满意度及其对生活质量和其他患者报告结局的影响。为解决这一问题，我们开发了胰岛素装置满意度调查问卷（IDSS），并在此描述其构建和验证过程。然后，我们研究关键患者因素与装置满意度之间的关联。
通过对10名1型糖尿病（T1D）成人患者和10名使用胰岛素的2型糖尿病（T2D）成人患者以及8名医疗保健专业人员进行访谈，形成了一个包含32个条目的初始题库。对T1D受试者（n = 279）和使用胰岛素的T2D受试者（n = 209）分别进行探索性因子分析（EFA）。通过总体幸福感（世界卫生组织-5）、糖尿病困扰（糖尿病困扰量表）、糖尿病自我效能感（糖尿病管理自我效能量表）以及胰岛素给药系统评分问卷的子量表来建立结构效度。回归分析检验了总量表满意度与人口统计学、胰岛素依从性、临床指标和装置类型（泵使用者与非泵使用者）之间的关联。
两次EFA分别得出T1D受试者的14个条目量表和T2D受试者的12个条目量表，两个样本共有8个条目。EFA在每个样本中产生了三个连贯且有意义的因子，分别解释了55.6%（T1D样本）和64.1%（T2D样本）的方差。通过与所有标准变量的显著相关性建立了效度。对于两个样本，较高的IDSS分数均与更好的血糖控制、更高的胰岛素依从性和更多地使用泵显著相关。仅对于T2D受试者，IDDS分数与更少的长期并发症、更少的低血糖读数以及更高的年龄显著相关。
IDSS在其T1D形式和T2形式中都是一种可靠、有效的胰岛素装置满意度测量工具。它为临床护理和研究中使用的装置满意度来源提供了全面的概况。
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