Messer Laurel H, Cook Paul F, Tanenbaum Molly L, Hanes Sarah, Driscoll Kimberly A, Hood Korey K
University of Colorado Anschutz, Barbara Davis Center for Childhood Diabetes, Aurora, CO, USA.
University of Colorado Anschutz, College of Nursing, Aurora, CO, USA.
J Diabetes Sci Technol. 2019 Nov;13(6):1135-1141. doi: 10.1177/1932296819832909. Epub 2019 Mar 10.
Continuous glucose monitors (CGM) are underutilized by individuals with type 1 diabetes (T1D), particularly during the adolescent years. Little is known about perceptions of CGM benefit and burdens, and few tools exist to quantify this information.
Two questionnaires were developed and validated-Benefit of CGM (BenCGM) and Burdens of CGM (BurCGM)-in a sample of adolescents ages 12-19 years involved in the T1D Exchange Registry. We chose to start the validation process with adolescents given their low CGM uptake and high risk for suboptimal glycemic outcomes. Exploratory and confirmatory factor analyses were conducted to confirm factor structure and select items. The resultant scales were tested for internal reliability and convergent/divergent validity with critical diabetes and quality of life outcomes: age, depression, diabetes distress, self-efficacy, technology attitudes, and diabetes technology attitudes.
A total of 431 adolescents with T1D completed the questionnaires (51% female, mean age 16.3 ± 2.26, 83% white non-Hispanic, 70% having used CGM). Two single factor scales emerged, and scales were reduced to 8 items each. Those who perceived higher benefit of CGM exhibited lower diabetes distress, higher self-efficacy, and more positive attitudes toward technology. Those who perceived higher burden of CGM exhibited higher diabetes distress, lower self-efficacy, and less positive technology attitudes.
The BenCGM and BurCGM questionnaires each comprise 8-items that demonstrate robust psychometric properties for use in adolescents with T1D, and can be used to develop targeted interventions to increase CGM wear to improve diabetes management.
连续血糖监测仪（CGM）在1型糖尿病（T1D）患者中未得到充分利用，尤其是在青少年时期。对于CGM的益处和负担的认知知之甚少，并且几乎没有工具可以量化这些信息。
针对参与T1D交换登记处的12 - 19岁青少年样本，开发并验证了两份问卷——CGM益处问卷（BenCGM）和CGM负担问卷（BurCGM）。鉴于青少年CGM使用率低且血糖控制不佳风险高，我们选择从青少年开始验证过程。进行探索性和验证性因素分析以确认因素结构并选择项目。对所得量表进行内部信度以及与关键糖尿病和生活质量结果（年龄、抑郁、糖尿病困扰、自我效能感、技术态度和糖尿病技术态度）的收敛/发散效度测试。
共有431名T1D青少年完成了问卷（51%为女性，平均年龄16.3±2.26岁，83%为非西班牙裔白人，70%使用过CGM）。出现了两个单因素量表，每个量表减少到8个项目。那些认为CGM益处更高的人表现出较低的糖尿病困扰、较高的自我效能感以及对技术更积极的态度。那些认为CGM负担更高的人表现出更高的糖尿病困扰、较低的自我效能感以及对技术不太积极的态度。
BenCGM和BurCGM问卷各包含8个项目，这些项目在T1D青少年中表现出强大的心理测量特性，可用于制定有针对性的干预措施以增加CGM的佩戴率，从而改善糖尿病管理。
