Department of Social Psychology, Nankai University, Tianjin, China.
Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China.
Front Public Health. 2024 Feb 21;12:1330154. doi: 10.3389/fpubh.2024.1330154. eCollection 2024.
The Diabetes Health Profile (DHP18), initially created in the United Kingdom, currently lacks a Chinese version. This study endeavors to authenticate the Chinese adaptation of the DHP18 and assess the influence of mobile health (mHealth) education intervention on the quality of life of individuals living with diabetes.
The study included 470 Type 2 diabetes Mellitus (T2DM) patients (204 men, 266 women), spanning an age range of 19-79 years, with an average age of 54 ± 12.40 years. Data analysis employed Jamovie and Mplus software. Moreover, test-retest reliability was evaluated in 52 hospitalized T2DM patients through two repeated measurements taken 4 weeks apart.
The Chinese version DHP18 scale exhibited high reliability, evidenced by a Cronbach's alpha of 0.88, and coefficient of test-retest reliability of 0.84. Individual subscales also demonstrated strong reliability, ranging from 0.76 to 0.84, with test-retest reliability spanning from 0.71 to 0.74. Confirmatory Factor Analysis (CFA) employing a three-factor structure (χ = 294.69, GFI = 0.92, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06) validated the scale's construct validity. Notably, there was a statistically significant difference ( < 0.05) in the quality of life between Type 2 diabetes patients using mHealth education intervention and those without mHealth education intervention. Mediation analysis revealed that Appraisal of Diabetes (ADS) and Self-Management Efficacy (SED) mediated the effects of Psychological Distress (PD) and Behavior Adherence (BA) on quality of life, both significant direct and indirect effects ( < 0.001). In addition, Dietary Abstinence (DE) displayed significant overall impact ( = -0.13, < 0.001) and indirect influence ( = -0.10, < 0.01) on diabetic patients' quality of life, though lacking a significant direct effect ( = -0.03, = 0.38).
The Chinese version of the Diabetes Health Profile Scale meets stringent psychometric standards and stands as an appropriate measurement tool for Chinese T2DM patients, maintaining comparable results to the original scale's structure. The mHealth education intervention yielded a notably positive impact on the quality of life among T2DM patients. Mediation analysis revealed that the three dimensions of the DHP were mediated by Appraisal of Diabetes and Diabetes Self-Management Efficacy, partially mediated by Psychological Distress and Behavior Adherence, and fully mediated by Dietary Abstinence, providing insight into the positive effects of the mHealth model on the quality of life of diabetic patients.
最初在英国创建的糖尿病健康状况量表（DHP18）目前缺乏中文版本。本研究旨在验证 DHP18 的中文适应版本，并评估移动健康（mHealth）教育干预对糖尿病患者生活质量的影响。
本研究纳入了 470 名 2 型糖尿病（T2DM）患者（男性 204 名，女性 266 名），年龄范围为 19-79 岁，平均年龄为 54±12.40 岁。数据分析采用 Jamovie 和 Mplus 软件进行。此外，通过在 4 周内进行两次重复测量，对 52 名住院 T2DM 患者进行了测试-重测信度评估。
中文版本的 DHP18 量表表现出高度的可靠性，Cronbach's alpha 为 0.88，测试-重测信度系数为 0.84。个体分量表也表现出很强的可靠性，范围在 0.76 到 0.84 之间，测试-重测信度范围在 0.71 到 0.74 之间。采用三因素结构（χ=294.69，GFI=0.92，TLI=0.91，RMSEA=0.05，SRMR=0.06）的验证性因子分析验证了量表的结构效度。值得注意的是，使用 mHealth 教育干预的 2 型糖尿病患者与未使用 mHealth 教育干预的患者之间，生活质量存在统计学显著差异（<0.05）。中介分析表明，对糖尿病的评价（ADS）和自我管理效能（SED）中介了心理困扰（PD）和行为依从性（BA）对生活质量的影响，均具有显著的直接和间接效应（<0.001）。此外，饮食节制（DE）对糖尿病患者的生活质量具有显著的总体影响（=−0.13，<0.001）和间接影响（=−0.10，<0.01），尽管缺乏显著的直接效应（=−0.03，=0.38）。
中文版糖尿病健康状况量表符合严格的心理测量学标准，是中国 T2DM 患者的合适测量工具，与原始量表结构保持可比结果。mHealth 教育干预对 T2DM 患者的生活质量产生了显著的积极影响。中介分析表明，DHP 的三个维度由对糖尿病的评价和糖尿病自我管理效能中介，部分由心理困扰和行为依从性中介，完全由饮食节制中介，为 mHealth 模型对糖尿病患者生活质量的积极影响提供了深入了解。
