1型糖尿病患儿现代依从性测量方法的验证：糖尿病管理问卷
Validation of a contemporary adherence measure for children with Type 1 diabetes: the Diabetes Management Questionnaire.
作者信息
Mehta S N, Nansel T R, Volkening L K, Butler D A, Haynie D L, Laffel L M B
机构信息
Pediatric, Adolescent and Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Boston, MA, USA.
Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
出版信息
Diabet Med. 2015 Sep;32(9):1232-8. doi: 10.1111/dme.12682. Epub 2015 Jan 30.
AIMS
To evaluate the psychometric properties of the Diabetes Management Questionnaire, a brief, self-report measure of adherence to contemporary diabetes management for young people with Type 1 diabetes and their caregivers.
METHODS
A total of 273 parent-child dyads completed parallel versions of the Diabetes Management Questionnaire. Eligible children (aged 8-18 years) had Type 1 diabetes for ≥1 year. A multidisciplinary team designed the Diabetes Management Questionnaire as a brief, self-administered measure of adherence to Type 1 diabetes management over the preceding month; higher scores reflect greater adherence. Psychometrics were evaluated for the entire sample and according to age of the child.
RESULTS
The children (49% female) had a mean ± sd (range) age 13.3 ± 2.9 (8-18) years and their mean ± sd HbA1c was 71 ± 15 mmol/mol (8.6 ± 1.4%). Internal consistency was good for parents (α = 0.83) and children (α = 0.79). Test-retest reliability was excellent for parents (intraclass correlation coefficient =0.83) and good for children (intraclass correlation coefficient = 0.65). Parent and child scores had moderate agreement (intraclass correlation coefficient = 0.54). Diabetes Management Questionnaire scores were inversely associated with HbA1c (parents: r = -0.41, P < 0.0001; children: r = -0.27, P < 0.0001). Psychometrics were stronger in the children aged ≥13 years compared with those aged < 13 years, but were acceptable in both age groups. Mean ± sd Diabetes Management Questionnaire scores were higher among children who were receiving insulin pump therapy (n = 181) than in children receiving multiple daily injections (n = 92) according to parent (75.9 ± 11.8 vs. 70.5 ± 15.5; P = 0.004) and child report (72.2 ± 12.1 vs. 67.6 ± 13.9; P = 0.006).
CONCLUSIONS
The Diabetes Management Questionnaire is a brief, valid self-report measure of adherence to contemporary diabetes self-management for people aged 8-18 years who are receiving either multiple daily injections or insulin pump therapy.
目的
评估糖尿病管理问卷的心理测量特性，这是一种针对1型糖尿病青少年及其照顾者对当代糖尿病管理依从性的简短自我报告测量工具。
方法
共有273对亲子完成了糖尿病管理问卷的平行版本。符合条件的儿童（8 - 18岁）患1型糖尿病至少1年。一个多学科团队将糖尿病管理问卷设计为一种针对前一个月1型糖尿病管理依从性的简短自我管理测量工具；得分越高表明依从性越高。对整个样本以及根据儿童年龄评估了心理测量特性。
结果
儿童（49%为女性）的平均年龄±标准差（范围）为13.3 ± 2.9（8 - 18）岁，其平均±标准差糖化血红蛋白为71 ± 15 mmol/mol（8.6 ± 1.4%）。父母（α = 0.83）和儿童（α = 0.79）的内部一致性良好。父母的重测信度极佳（组内相关系数 = 0.83），儿童的重测信度良好（组内相关系数 = 0.65）。父母和儿童的得分有中度一致性（组内相关系数 = 0.54）。糖尿病管理问卷得分与糖化血红蛋白呈负相关（父母：r = -0.41，P < 0.0001；儿童：r = -0.27，P < 0.0001）。与13岁以下儿童相比，13岁及以上儿童的心理测量特性更强，但两个年龄组的结果均可接受。根据父母报告（75.9 ± 11.8对70.5 ± 15.5；P = 0.004）和儿童报告（72.2 ± 12.1对67.6 ± 13.9；P = 0.006），接受胰岛素泵治疗的儿童（n = 181）的糖尿病管理问卷平均±标准差得分高于接受每日多次注射的儿童（n = 92）。
结论
糖尿病管理问卷是一种针对8 - 18岁接受每日多次注射或胰岛素泵治疗的人群对当代糖尿病自我管理依从性的简短、有效的自我报告测量工具。
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