Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Victoria, Australia
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia.
Diabetes Care. 2017 Nov;40(11):1462-1468. doi: 10.2337/dc17-0441. Epub 2017 Sep 7.
To establish cut point(s) for the Problem Areas in Diabetes-teen version (PAID-T) scale to identify adolescents with clinically meaningful, elevated diabetes distress.
Data were available from the Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Youth-Australia Study, a national survey assessing various psychosocial indicators among self-selected National Diabetes Services Scheme registrants. Participants in the current study ( = 537) were (mean ± SD) 16 ± 2 years old, had type 1 diabetes for 6 ± 4 years, and 62% ( = 334) were girls. They completed measures of diabetes distress (PAID-T) and depressive symptoms (Patient Health Questionnaire for Adolescents) and self-reported their most recent HbA and frequency of self-monitoring of blood glucose (SMBG). Relationships between the PAID-T and the psychological and clinical variables were examined to identify a clinically meaningful threshold for elevated diabetes distress. ANOVA was used to test whether these variables differed by levels of distress.
Two cut points distinguished none-to-mild (<70), moderate (70-90), and high (>90) diabetes distress. Moderate distress was experienced by 18% of adolescents and high distress by 36%. Mean depressive symptoms, self-reported HbA, and SMBG differed significantly across the three levels of diabetes distress (all < 0.001), with moderate-to-large effect sizes.
Using the PAID-T, this study defined two clinically meaningful cut points to distinguish none-to-mild, moderate, and high diabetes distress in adolescents (aged 13-19). Based on these cut points, most respondents experienced at least moderate diabetes distress, which was clinically significant. Establishing thresholds for elevated diabetes distress will aid clinicians and researchers to interpret PAID-T scores, prompt discussion and intervention for those with unmet needs, and enable the effectiveness of interventions to be evaluated.
确定青少年糖尿病困扰量表（PAID-T）的切点，以识别出具有临床意义的、显著升高的糖尿病困扰的青少年。
数据来自澳大利亚糖尿病管理和长期赋权与成功研究（MILES Youth-Australia），这是一项全国性调查，评估了自我选择的国家糖尿病服务计划注册者的各种社会心理指标。本研究的参与者（n=537）年龄（均数±标准差）为 16±2 岁，1 型糖尿病病程为 6±4 年，62%（n=334）为女性。他们完成了糖尿病困扰量表（PAID-T）和青少年患者健康问卷（PHQ-A）的抑郁症状评估，并自我报告了最近的糖化血红蛋白（HbA）和自我监测血糖（SMBG）的频率。通过分析 PAID-T 与心理和临床变量之间的关系，确定了一个具有临床意义的、升高的糖尿病困扰阈值。方差分析用于检验这些变量是否因困扰程度的不同而有所差异。
两个切点将无到轻度（<70）、中度（70-90）和重度（>90）糖尿病困扰区分开来。18%的青少年经历了中度困扰，36%的青少年经历了重度困扰。中度到重度的糖尿病困扰在三个水平上，抑郁症状、自我报告的 HbA 和 SMBG 均有显著差异（均<0.001），且具有中到大的效应量。
本研究使用 PAID-T 确定了两个具有临床意义的切点，以区分青少年（13-19 岁）的无到轻度、中度和重度糖尿病困扰。根据这些切点，大多数受访者至少经历了中度糖尿病困扰，这具有临床意义。确定升高的糖尿病困扰的阈值将有助于临床医生和研究人员解释 PAID-T 评分，为那些有未满足需求的人提供讨论和干预，并评估干预措施的有效性。
