The psychometric properties of the barriers to insulin treatment questionnaire in Chinese patients with type 2 diabetes mellitus using insulin.

AIM

The objective of this study was to translate the Barriers to Insulin Treatment Questionnaire (BIT) into Chinese and test its psychometric properties in middle-aged and elderly type 2 diabetes mellitus (T2D) patients using insulin in the Han people of urban China.

METHODS

We established the Barriers to Insulin Treatment Questionnaire in Chinese (BIT-C). We selected 296 patients with T2D for testing BIT-C's the reliability and validity, of which 120 patients were retested four weeks later. Another 200 patients with T2D were selected to perform the confirmatory factor analysis (CFA).

RESULTS

The final BIT-C consisted of 11 items (BIT-C-11) and four factors. The explained variances of the BIT-C-11 and its four factors were 90.153%, 51.308%, 18.810%, 10.863%, and 9.173%. CFA validated that the four-factor model fit with the data of the BIT-C-11. Standardized factor loadings ranged between 0.77 and 0.90. The Cronbach's α coefficients of the BIT-C-11 and its four factors were 0.903, 0.952, 0.927, 0.938, and 0.917. Correlation analysis was performed between the BIT-C-11 and General Adherence Scale in Chinese (GAS-C) to calculate the criterion-related validity (r = 0.598, p < 0.001). The correlation coefficient r of the BIT-C-11's test-retest reliability was 0.810 (p < 0.001).

CONCLUSION

The BIT-C-11 has good reliability and validity. It can be used for psychological resistance to insulin therapy studies of middle-aged and elderly patients with T2D using insulin in the Han people of Chinese cities.