一种用于测量糖尿病倦怠的量表的开发与验证
Development and validation of a scale to measure diabetes burnout.
作者信息
Abdoli Samereh, Miller-Bains Katherine, Fanti Paulo, Silveira Monica S V M, Hessler Danielle
机构信息
College of Nursing, University of Tennessee, Knoxville, TN, USA.
Assessment and Evaluation, Oak Ridge Associated Universities, Oak Ridge, TN, USA.
出版信息
J Clin Transl Endocrinol. 2021 Feb 11;23:100251. doi: 10.1016/j.jcte.2021.100251. eCollection 2021 Mar.
INTRODUCTION
The aim of this study is to establish reliability and validity of the Diabetes Burnout Scale (DBS) among adults with type 1 diabetes (T1D).
METHODS
We used a multi-stage, mixed methods approach to developing the DBS. First, the research team identified twenty-eight candidate items through a review of the literature and 117 qualitative narratives from adults living with T1D. Next, items were revised based on the expert (n = 20) and individual with T1D (n = 10) feedback. The resulting 18-item DBS measure along with validated measures of diabetes distress, depressive symptoms, and questions related to diabetes outcomes (i.e., last reported hemoglobin A1c [HbA1c] and Time-in-Range [TiR]) were completed by 1099 adults with T1D across the U.S. The sample was randomly divided into two subsets (n1 = 561, n2 = 538) for exploratory and confirmatory factor analyses (EFA/CFA) to determine the underlying structure of the DBS. Regression analyses examined the relationships of the DBS with self-reported glycemic control and socio-demographic characteristics.
RESULTS
Based on the EFA three factors are identified and the DBS demonstrated strong internal consistency with Cronbach alphas (≥0.80). The validation and confirmatory analysis for the structure of the DBS provided consistent results with EFA. Higher burnout (overall DBS) was positively associated with diabetes distress (b = 0.74; p < 0.01) and depressive symptoms (b = 0.61; p < 0.01). Overall DBS, however was the strongest predictor for poorer HbA1c (r2 = 0.19; p < 0.01) and lower TiR (r2 = 0.17; p < 0.01) compared to diabetes distress and depressive symptoms.
CONCLUSION
The 12-item DBS is a reliable and valid scale to measure diabetes burnout in adults with diabetes. The results provide a weak to strong degree of association between the validated DBS scale, T1-DDS and PHQ-8. The DBS can contribute to advancement of diabetes science by measuring diabetes burnout and informing clinical interventions to improve psychosocial care in individuals with diabetes.
引言
本研究旨在确立1型糖尿病（T1D）成人患者中糖尿病倦怠量表（DBS）的信度和效度。
方法
我们采用多阶段混合方法来开发DBS。首先，研究团队通过文献回顾以及来自117名T1D成年患者的定性叙述，确定了28个候选条目。接下来，根据专家（n = 20）和T1D患者（n = 10）的反馈对条目进行修订。最终得到的18个条目的DBS量表，以及经过验证的糖尿病困扰、抑郁症状测量量表，还有与糖尿病结局相关的问题（即最近一次报告的糖化血红蛋白[HbA1c]和血糖达标时间[TiR]），由美国各地的1099名T1D成年患者完成。样本被随机分为两个子集（n1 = 561，n2 = 538），用于探索性和验证性因子分析（EFA/CFA），以确定DBS的潜在结构。回归分析检验了DBS与自我报告的血糖控制及社会人口学特征之间的关系。
结果
基于探索性因子分析确定了三个因子，DBS在克朗巴哈系数（≥0.80）方面显示出很强的内部一致性。DBS结构的验证性分析与探索性因子分析结果一致。更高的倦怠感（总体DBS）与糖尿病困扰（b = 0.74；p < 0.01）和抑郁症状（b = 0.61；p < 0.01）呈正相关。然而，与糖尿病困扰和抑郁症状相比，总体DBS是预测HbA1c较差（r2 = 0.19；p < 0.01）和TiR较低（r2 = 0.17；p < 0.01）的最强指标。
结论
12个条目的DBS是测量糖尿病成人患者糖尿病倦怠的可靠且有效的量表。结果显示，经过验证的DBS量表、T1 - DDS和PHQ - 8之间存在弱到强程度的关联。DBS通过测量糖尿病倦怠并为临床干预提供信息，以改善糖尿病患者的心理社会护理，从而有助于糖尿病科学的发展。
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