Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale
OBJECTIVE:--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS--In consultation with patients and profession...
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| Veröffentlicht in: | Diabetes care 2005-03, Vol.28 (3), p.626-631 |
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| creator | Polonsky, William H Fisher, Lawrence Earles, Jay Dudl, R. James Lees, Joel Mullan, Joseph Jackson, Richard A |
| description | OBJECTIVE:--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS--In consultation with patients and professionals from multiple disciplines, a preliminary scale of 28 items was developed, based a priori on four distress-related domains: emotional burden subscale, physician-related distress subscale, regimen-related distress subscale, and diabetes-related interpersonal distress. The new instrument was included in a larger battery of questionnaires used in diabetes studies at four diverse sites: waiting room at a primary care clinic (n = 200), waiting room at a diabetes specialty clinic (n = 179), a diabetes management study program (n = 167), and an ongoing diabetes management program (n = 158). RESULTS:--Exploratory factor analyses revealed four factors consistent across sites (involving 17 of the 28 items) that matched the critical content domains identified earlier. The correlation between the 28-item and 17-item scales was very high (r = 0.99). The mean correlation between the 17-item total score (DDS) and the four subscales was high (r = 0.82), but the pattern of interscale correlations suggested that the subscales, although not totally independent, tapped into relatively different areas of diabetes-related distress. Internal reliability of the DDS and the four subscales was adequate ([alpha] > 0.87), and validity coefficients yielded significant linkages with the Center for Epidemiological Studies Depression Scale, meal planning, exercise, and total cholesterol. Insulin users evidenced the highest mean DDS total scores, whereas diet-controlled subjects displayed the lowest scores (P < 0.001). CONCLUSIONS:--The DDS has a consistent, generalizable factor structure and good internal reliability and validity across four different clinical sites. The new instrument may serve as a valuable measure of diabetes-related emotional distress for use in research and clinical practice. |
| doi_str_mv | 10.2337/diacare.28.3.626 |
| format | Article |
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James ; Lees, Joel ; Mullan, Joseph ; Jackson, Richard A</creator><creatorcontrib>Polonsky, William H ; Fisher, Lawrence ; Earles, Jay ; Dudl, R. James ; Lees, Joel ; Mullan, Joseph ; Jackson, Richard A</creatorcontrib><description>OBJECTIVE:--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS--In consultation with patients and professionals from multiple disciplines, a preliminary scale of 28 items was developed, based a priori on four distress-related domains: emotional burden subscale, physician-related distress subscale, regimen-related distress subscale, and diabetes-related interpersonal distress. The new instrument was included in a larger battery of questionnaires used in diabetes studies at four diverse sites: waiting room at a primary care clinic (n = 200), waiting room at a diabetes specialty clinic (n = 179), a diabetes management study program (n = 167), and an ongoing diabetes management program (n = 158). RESULTS:--Exploratory factor analyses revealed four factors consistent across sites (involving 17 of the 28 items) that matched the critical content domains identified earlier. The correlation between the 28-item and 17-item scales was very high (r = 0.99). The mean correlation between the 17-item total score (DDS) and the four subscales was high (r = 0.82), but the pattern of interscale correlations suggested that the subscales, although not totally independent, tapped into relatively different areas of diabetes-related distress. Internal reliability of the DDS and the four subscales was adequate ([alpha] > 0.87), and validity coefficients yielded significant linkages with the Center for Epidemiological Studies Depression Scale, meal planning, exercise, and total cholesterol. Insulin users evidenced the highest mean DDS total scores, whereas diet-controlled subjects displayed the lowest scores (P < 0.001). CONCLUSIONS:--The DDS has a consistent, generalizable factor structure and good internal reliability and validity across four different clinical sites. The new instrument may serve as a valuable measure of diabetes-related emotional distress for use in research and clinical practice.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/diacare.28.3.626</identifier><identifier>PMID: 15735199</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>Alexandria, VA: American Diabetes Association</publisher><subject>Adult ; Biological and medical sciences ; Boston - epidemiology ; California - epidemiology ; Diabetes ; Diabetes Mellitus - psychology ; Diabetes Mellitus - rehabilitation ; Diabetes. Impaired glucose tolerance ; Diet, Diabetic ; Disease management ; Educational Status ; Emotional conditioning ; Emotions ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Ethnic Groups ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Hawaii - epidemiology ; Health risk assessment ; Hospitals, Veterans ; Humans ; Hypoglycemic Agents - therapeutic use ; Interpersonal Relations ; Male ; Medical equipment ; Medical examination ; Medical sciences ; Middle Aged ; Psychological aspects ; Self Care ; Stress, Psychological - epidemiology ; United States</subject><ispartof>Diabetes care, 2005-03, Vol.28 (3), p.626-631</ispartof><rights>2005 INIST-CNRS</rights><rights>COPYRIGHT 2005 American Diabetes Association</rights><rights>Copyright American Diabetes Association Mar 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-fb05395638ce44b95f8814e0e0e1d497886a14305bcf479284cff38214850f303</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16612400$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15735199$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Polonsky, William H</creatorcontrib><creatorcontrib>Fisher, Lawrence</creatorcontrib><creatorcontrib>Earles, Jay</creatorcontrib><creatorcontrib>Dudl, R. James</creatorcontrib><creatorcontrib>Lees, Joel</creatorcontrib><creatorcontrib>Mullan, Joseph</creatorcontrib><creatorcontrib>Jackson, Richard A</creatorcontrib><title>Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE:--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS--In consultation with patients and professionals from multiple disciplines, a preliminary scale of 28 items was developed, based a priori on four distress-related domains: emotional burden subscale, physician-related distress subscale, regimen-related distress subscale, and diabetes-related interpersonal distress. The new instrument was included in a larger battery of questionnaires used in diabetes studies at four diverse sites: waiting room at a primary care clinic (n = 200), waiting room at a diabetes specialty clinic (n = 179), a diabetes management study program (n = 167), and an ongoing diabetes management program (n = 158). RESULTS:--Exploratory factor analyses revealed four factors consistent across sites (involving 17 of the 28 items) that matched the critical content domains identified earlier. The correlation between the 28-item and 17-item scales was very high (r = 0.99). The mean correlation between the 17-item total score (DDS) and the four subscales was high (r = 0.82), but the pattern of interscale correlations suggested that the subscales, although not totally independent, tapped into relatively different areas of diabetes-related distress. Internal reliability of the DDS and the four subscales was adequate ([alpha] > 0.87), and validity coefficients yielded significant linkages with the Center for Epidemiological Studies Depression Scale, meal planning, exercise, and total cholesterol. Insulin users evidenced the highest mean DDS total scores, whereas diet-controlled subjects displayed the lowest scores (P < 0.001). CONCLUSIONS:--The DDS has a consistent, generalizable factor structure and good internal reliability and validity across four different clinical sites. The new instrument may serve as a valuable measure of diabetes-related emotional distress for use in research and clinical practice.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Boston - epidemiology</subject><subject>California - epidemiology</subject><subject>Diabetes</subject><subject>Diabetes Mellitus - psychology</subject><subject>Diabetes Mellitus - rehabilitation</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diet, Diabetic</subject><subject>Disease management</subject><subject>Educational Status</subject><subject>Emotional conditioning</subject><subject>Emotions</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Ethnic Groups</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Hawaii - epidemiology</subject><subject>Health risk assessment</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Interpersonal Relations</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Medical examination</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Psychological aspects</subject><subject>Self Care</subject><subject>Stress, Psychological - epidemiology</subject><subject>United States</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkd1rFDEQwIMo9lp990kXQd92zcdkN_HtaGstFCrU4uOSzU2uKbvJmewJ_e_NcaeFUuZhhpnffBPyjtGGC9F9WXljTcKGq0Y0LW9fkAXTQtZSgnpJFpSBrqXW_Igc53xPKQVQ6jU5YrITkmm9IL-WOWPOPqyrH_nB3sUcrTdjdebznEqg8qHYZsAZ89fqDP_gGDcThrmKrprv8H_wMePGmhHfkFfOjBnfHvQJuf12_vP0e311fXF5uryqLTCYazdQKbRshbIIMGjplGKAtAhbge6Uag0DQeVgHXSaK7DOCcUZKEmdoOKEfN7X3aT4e4t57iefLY6jCRi3uW87aLVUvIAfn4D3cZtCma3nXOwOI6BA9R5alxV6H1yck7FrDJjMGAM6X9xLJihXXKtd9-YZvsgKJ2-fTXh_mGI7TLjqN8lPJj30_x5SgE8HwORyR5dMsD4_cm3LONBdoQ97zpnYm3UqzO0Np6UT1UoDB_EXlLShgg</recordid><startdate>20050301</startdate><enddate>20050301</enddate><creator>Polonsky, William H</creator><creator>Fisher, Lawrence</creator><creator>Earles, Jay</creator><creator>Dudl, R. James</creator><creator>Lees, Joel</creator><creator>Mullan, Joseph</creator><creator>Jackson, Richard A</creator><general>American Diabetes Association</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0K</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20050301</creationdate><title>Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale</title><author>Polonsky, William H ; Fisher, Lawrence ; Earles, Jay ; Dudl, R. James ; Lees, Joel ; Mullan, Joseph ; Jackson, Richard A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-fb05395638ce44b95f8814e0e0e1d497886a14305bcf479284cff38214850f303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Boston - epidemiology</topic><topic>California - epidemiology</topic><topic>Diabetes</topic><topic>Diabetes Mellitus - psychology</topic><topic>Diabetes Mellitus - rehabilitation</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diet, Diabetic</topic><topic>Disease management</topic><topic>Educational Status</topic><topic>Emotional conditioning</topic><topic>Emotions</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Ethnic Groups</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Hawaii - epidemiology</topic><topic>Health risk assessment</topic><topic>Hospitals, Veterans</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Interpersonal Relations</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Medical examination</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Psychological aspects</topic><topic>Self Care</topic><topic>Stress, Psychological - epidemiology</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Polonsky, William H</creatorcontrib><creatorcontrib>Fisher, Lawrence</creatorcontrib><creatorcontrib>Earles, Jay</creatorcontrib><creatorcontrib>Dudl, R. James</creatorcontrib><creatorcontrib>Lees, Joel</creatorcontrib><creatorcontrib>Mullan, Joseph</creatorcontrib><creatorcontrib>Jackson, Richard A</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Agricultural Science Database</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Polonsky, William H</au><au>Fisher, Lawrence</au><au>Earles, Jay</au><au>Dudl, R. James</au><au>Lees, Joel</au><au>Mullan, Joseph</au><au>Jackson, Richard A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2005-03-01</date><risdate>2005</risdate><volume>28</volume><issue>3</issue><spage>626</spage><epage>631</epage><pages>626-631</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE:--The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS--In consultation with patients and professionals from multiple disciplines, a preliminary scale of 28 items was developed, based a priori on four distress-related domains: emotional burden subscale, physician-related distress subscale, regimen-related distress subscale, and diabetes-related interpersonal distress. The new instrument was included in a larger battery of questionnaires used in diabetes studies at four diverse sites: waiting room at a primary care clinic (n = 200), waiting room at a diabetes specialty clinic (n = 179), a diabetes management study program (n = 167), and an ongoing diabetes management program (n = 158). RESULTS:--Exploratory factor analyses revealed four factors consistent across sites (involving 17 of the 28 items) that matched the critical content domains identified earlier. The correlation between the 28-item and 17-item scales was very high (r = 0.99). The mean correlation between the 17-item total score (DDS) and the four subscales was high (r = 0.82), but the pattern of interscale correlations suggested that the subscales, although not totally independent, tapped into relatively different areas of diabetes-related distress. Internal reliability of the DDS and the four subscales was adequate ([alpha] > 0.87), and validity coefficients yielded significant linkages with the Center for Epidemiological Studies Depression Scale, meal planning, exercise, and total cholesterol. Insulin users evidenced the highest mean DDS total scores, whereas diet-controlled subjects displayed the lowest scores (P < 0.001). CONCLUSIONS:--The DDS has a consistent, generalizable factor structure and good internal reliability and validity across four different clinical sites. The new instrument may serve as a valuable measure of diabetes-related emotional distress for use in research and clinical practice.</abstract><cop>Alexandria, VA</cop><pub>American Diabetes Association</pub><pmid>15735199</pmid><doi>10.2337/diacare.28.3.626</doi><tpages>6</tpages></addata></record> |
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| ispartof | Diabetes care, 2005-03, Vol.28 (3), p.626-631 |
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| subjects | Adult Biological and medical sciences Boston - epidemiology California - epidemiology Diabetes Diabetes Mellitus - psychology Diabetes Mellitus - rehabilitation Diabetes. Impaired glucose tolerance Diet, Diabetic Disease management Educational Status Emotional conditioning Emotions Endocrine pancreas. Apud cells (diseases) Endocrinopathies Ethnic Groups Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Hawaii - epidemiology Health risk assessment Hospitals, Veterans Humans Hypoglycemic Agents - therapeutic use Interpersonal Relations Male Medical equipment Medical examination Medical sciences Middle Aged Psychological aspects Self Care Stress, Psychological - epidemiology United States |
| title | Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale |
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