PAID-11：一种在 1 型糖尿病成人中验证的简短糖尿病困扰测量工具。

PAID-11: A brief measure of diabetes distress validated in adults with type 1 diabetes.

机构信息

Division of Psychology, De Montfort University, UK.

Department of Diabetes and Endocrinology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

出版信息

Diabetes Res Clin Pract. 2019 Mar;149:27-38. doi: 10.1016/j.diabres.2019.01.026. Epub 2019 Jan 30.

DOI:10.1016/j.diabres.2019.01.026

PMID:30710656

Abstract

OBJECTIVE

The Problem Areas In Diabetes (PAID) questionnaire is widely used to assess emotional distress related to living with diabetes, although it is lengthy for routine clinical use. Our aim was to determine whether the original 20-item PAID questionnaire can be abbreviated, whilst maintaining its reliability, validity and utility.

METHODS

We analysed data from the UK DAFNE (Dose Adjustment For Normal Eating) education programme for adults with Type 1 diabetes. Data were analysed at baseline (n = 1547) and 1-year post intervention (n = 846). Exploratory factor analysis (EFA) with principal axis factoring method was used to examine PAID responses within a random half of the baseline data (n = 746). Then, two confirmatory factor analyses (CFA) were conducted using the remaining baseline (n = 801) and 1-year data. Reliability, predictive validity, convergent validity and responsiveness were also examined.

RESULTS

Based on the EFA results, which were corroborated by CFA, an 11-item PAID questionnaire was identified with a cut-off score of 18 indicating severe diabetes distress. In the current sample, this brief version had high internal consistency (Cronbach's α = 0.93). Predictive validity was demonstrated with the PAID-11 identifying severe diabetes distress from the original 20-item measure, with 95% sensitivity and 96% specificity. Convergent validity was demonstrated by strong positive correlations with HADS anxiety and depressive symptoms (average r = 0.65 and r = 0.55, respectively), while divergent validity was shown with weaker correlations with EQ5D health status (average r = 0.37).

CONCLUSIONS

Based on present results, PAID-11 appears to be a valid and reliable measure, which seems suitable for use as a brief tool for the detection of diabetes distress in adults with type 1 diabetes. Importantly, this tool may reduce participant burden in multi-measure studies. However, further studies are urgently needed to determine the validity and utility of PAID-11 beyond the UK DAFNE population.

摘要

目的

Problem Areas In Diabetes（PAID）问卷广泛用于评估与糖尿病共存相关的情绪困扰，尽管它对于常规临床使用来说过长。我们的目的是确定原始的 20 项 PAID 问卷是否可以缩写，同时保持其可靠性、有效性和实用性。

方法

我们分析了英国 DAFNE（正常饮食剂量调整）成人 1 型糖尿病教育计划的数据。数据分析包括基线（n=1547）和干预后 1 年（n=846）。使用主成分因子分析法对基线数据的一半（n=746）进行探索性因子分析（EFA）。然后，使用剩余的基线数据（n=801）和 1 年数据进行了两次验证性因子分析（CFA）。还检查了可靠性、预测有效性、收敛有效性和响应能力。

结果

基于 EFA 结果，通过 CFA 进行了验证，确定了一个 11 项的 PAID 问卷，截断值为 18 表示严重的糖尿病困扰。在当前样本中，该简短版本具有较高的内部一致性（Cronbach's α=0.93）。预测有效性表明，PAID-11 可从原始的 20 项测量中识别出严重的糖尿病困扰，具有 95%的敏感性和 96%的特异性。与 HADS 焦虑和抑郁症状的强正相关（平均 r=0.65 和 r=0.55）证明了收敛有效性，而与 EQ5D 健康状况的弱相关（平均 r=0.37）则证明了发散有效性。