2型糖尿病患者中糖尿病自我管理问卷（DSMQ）波斯语版本的心理测量特性评估。
Assessment of the psychometric properties of the Persian version of the diabetes self-management questionnaire (DSMQ) in patients with type 2 diabetes.
作者信息
Mirzaei Hamed, Siavash Mansour, Shahnazi Hossein, Abasi Mohammad Hadi, Eslami Ahmad Ali
机构信息
Student Research Committee and Department of Health Education and Health Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
出版信息
J Diabetes Metab Disord. 2022 Jan 11;21(1):123-131. doi: 10.1007/s40200-021-00946-5. eCollection 2022 Jun.
BACKGROUND
Performing self-care behaviors by diabetic patients is essential to achieve optimal glycemic control, reduction of complications, and improvement in the quality of life. The Diabetes Self-care Questionnaire (DSMQ) is designed to assess self-care behaviors that can predict glycemic control. The present study aimed to evaluate the psychometric properties of the Persian version of the DSMQ in patients with type 2 diabetes.
METHODS
The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran through the convenience sampling procedure. The translation process of the DSMQ was carried out based on the guidelines suggested by Beaton et al. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Furthermore, a linear regression analysis was used to determine the prediction power of self-care behaviors in explaining the variance of the HbA1c level.
RESULTS
In the EFA with Varimax rotation, we extracted four factors that could explain 67.46% of the total variance of the DSMQ scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from EFA with the following measures. CFI: 0.980, IFI: 0.980, NFI: 0.956, TLI: 0.974, RMSEA: 0.042). Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.84; the subscales: 0.75-0.91). The convergent validity showed significant negative correlations (GM: -0.53; DC: -0.22; PA: -0.16; HU: -0.17; SS: -0.45; < 0.01) between DSMQ subscales and HbA1c. However, only two factors of glucose management and diet control in the statistical model obtained from regression analysis (stepwise) were able to explain 30% of the HbA1c level ( < 0.001).
CONCLUSION
The Persian version of the DSMQ is a valid and reliable instrument to assess self-care behaviors associated with glycemic control in Iranian patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.
背景
糖尿病患者进行自我护理行为对于实现最佳血糖控制、减少并发症以及改善生活质量至关重要。糖尿病自我护理问卷（DSMQ）旨在评估可预测血糖控制的自我护理行为。本研究旨在评估DSMQ波斯语版本在2型糖尿病患者中的心理测量特性。
方法
本方法学横断面研究通过便利抽样程序调查了460例转诊至伊朗伊斯法罕内分泌与代谢研究中心的2型糖尿病患者。DSMQ的翻译过程是根据Beaton等人建议的指南进行的。我们评估了信度（内部一致性）、内容效度、收敛效度和结构效度。使用探索性因子分析（校准样本 = 230）和验证性因子分析（验证样本 = 230）评估结构效度。此外，使用线性回归分析来确定自我护理行为在解释糖化血红蛋白（HbA1c）水平方差方面的预测能力。
结果
在采用方差最大化旋转的探索性因子分析中，我们提取了四个因子，它们能够解释DSMQ量表总方差的67.46%。验证性因子分析显示，从探索性因子分析中提取的四因子结构具有令人满意的拟合水平，具体指标如下：比较拟合指数（CFI）：0.980，增量拟合指数（IFI）：0.980，规范拟合指数（NFI）：0.956，塔克 - 刘易斯指数（TLI）：0.974，均方根误差近似值（RMSEA）：0.042。内部一致性良好（整个量表的克朗巴哈α系数：0.84；各子量表：0.75 - 0.91）。收敛效度显示DSMQ子量表与HbA1c之间存在显著负相关（血糖管理：-0.53；糖尿病知识：-0.22；身体活动：-0.16；血糖监测：-0.17；自我管理：-0.45；P < 0.01）。然而，在逐步回归分析得到的统计模型中，只有血糖管理和饮食控制这两个因子能够解释30%的HbA1c水平（P < 0.001）。
结论
DSMQ波斯语版本是评估伊朗2型糖尿病患者血糖控制相关自我护理行为的有效且可靠工具。因此，该工具可用于未来的研究和临床实践。
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