Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Front Public Health. 2022 Feb 25;10:843164. doi: 10.3389/fpubh.2022.843164. eCollection 2022.
The Problem Areas in Diabetes (PAID) scale is a reliable and valid tool that is widely used for diabetes-distress screening, but the Arabic version of the scale lacks validity and reliability analysis in primary healthcare (PHC) patients. Our study aimed to evaluate the psychometric properties of the Arabic version of the PAID (AR-PAID) scale among Egyptian patients with type 2 diabetes mellitus (T2DM) in PHC settings.
We conducted a cross-sectional study on a convenience sample of 200 patients from six rural PHC settings in the Ismailia governorate. The confirmatory factor analysis (CFA) was performed to test the goodness-of-fit to the predefined models of the PAID. Convergent construct was evaluated through correlations with the Arabic versions of the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and 5-item World Health Organization Well-Being Index (WHO-5), additionally glycated hemoglobin (HbA1c) levels. Discriminant validity was evaluated through associations with patients' sociodemographic and clinical characteristics. Reliability was evaluated through internal consistency (Cronbach's α) and test-retest reliability analysis (intraclass correlation coefficient, ICC).
The CFA demonstrated the best fit for a four-factor model. The AR-PAID was significantly correlated with the following measures: PHQ-9 (rho = 0.71, < 0.001), GAD-7 (rho = 0.50, < 0.001), WHO-5 (rho = -0.69, < 0.001), and HbA1c (rho = 0.36, < 0.001), supporting sound convergent validity. Discriminant validity was satisfactory demonstrated. Internal consistency was excellent (α = 0.96) and test-retest reliability was stable (ICC = 0.97).
The AR-PAID scale is a valid and reliable instrument for diabetes-distress screening in primary care patients with T2DM that can be used in clinical settings and research. Further research is needed to validate short forms of the AR-PAID scale.
Problem Areas in Diabetes（PAID）量表是一种可靠且有效的工具，广泛用于糖尿病困扰的筛查，但该量表的阿拉伯语版本在基层医疗保健（PHC）患者中缺乏有效性和可靠性分析。我们的研究旨在评估 PAID 量表阿拉伯语版本（AR-PAID）在埃及 2 型糖尿病（T2DM）PHC 患者中的心理测量特性。
我们对来自伊斯梅利亚省六个农村 PHC 环境的 200 名患者进行了横断面研究。通过验证性因子分析（CFA）对 PAID 的预定义模型进行拟合优度测试。通过与阿拉伯语版本的患者健康问卷 9 项（PHQ-9）、广泛性焦虑症量表（GAD-7）和 5 项世界卫生组织幸福感指数（WHO-5）以及糖化血红蛋白（HbA1c）水平的相关性来评估聚合结构。通过与患者的社会人口统计学和临床特征的相关性来评估判别有效性。通过内部一致性（Cronbach's α）和测试-重测可靠性分析（组内相关系数，ICC）来评估可靠性。
CFA 表明四因素模型拟合最好。AR-PAID 与以下措施显著相关：PHQ-9（rho = 0.71，<0.001）、GAD-7（rho = 0.50，<0.001）、WHO-5（rho = -0.69，<0.001）和 HbA1c（rho = 0.36，<0.001），支持良好的聚合有效性。判别有效性令人满意。内部一致性很好（α=0.96），重测可靠性稳定（ICC=0.97）。
AR-PAID 量表是一种有效的、可靠的 T2DM PHC 患者糖尿病困扰筛查工具，可用于临床和研究。需要进一步研究来验证 AR-PAID 量表的简短形式。
