Young Children's Subjective Reports About Their Diabetes Mellitus: A Validation of the Diabetes Pictorial Scale

The authors report on a validation study using the Diabetes Pictorial Scale (DPS), a measure of disease-related attitudes, behaviors, and knowledge specifi cally designed for use with younger children with insulin dependent diabetes mellitus (IDDM). Results of this study, based on the responses of 39 children ages 4 to 10, suggest that the DPS demonstrates sufficient variation between and within patients to merit further field- testing of the technique. Pre selected DPS items hypothesized to affect metabolic control in IDDM were examined in this study and compared with glycosy lated hemoglobin (HbA1) values collected concurrently. Children's reports concerning adherence to their dietary plan, the regularity of insulin injections, and the regularity ofmealslsnacks were related to glycemic control. Broader issues pertinent to the utility, reliability, and validity of children's subjective reports are briefly discussed within the context of demand characteristics in the IDDM provider-patient interaction.