Validation of Diabetes Knowledge Questionnaire (DKQ) in the Taiwanese Population - Concurrent Validity with Diabetes-Specific Quality of Life Questionnaire Module

The Effect of Acculturation on Diabetes Knowledge Among Chinese Americans With Type 2 Diabetes

PurposeThe purpose of the study was to examine the level of diabetes knowledge among Chinese Americans with type 2 diabetes (T2DM) and the influence of acculturation levels on diabetes knowledge. T2DM is a significant health issue for Chinese Americans because of the unique challenges they face that reflect a complex interplay of culture, language, insufficient numbers of culturally congruent health care providers, and socioeconomic factors. Diabetes knowledge is an essential foundation for effective diabetes self-management behaviors. However, few studies have assessed Chinese Americans' level of diabetes knowledge and its relationship to acculturation.MethodsA secondary analysis of cross-sectional survey data from 110 Chinese Americans with T2DM was conducted. Descriptive analyses summarized specific knowledge deficits, and a hierarchical regression model was used to test the contribution of acculturation to the level of knowledge after controlling for demographics, diabetes duration, treatment, number of comorbidities, and diabetes numeracy.ResultThe average percentage of correct responses on the Diabetes Knowledge Questionnaire-Revised was approximately 77%. Items that were answered incorrectly the most frequently pertained to low or high blood glucose symptoms, desired A1C level, and glucose levels' relation to emotions. Diabetes numeracy and acculturation significantly predicted diabetes knowledge after controlling for demographic and health indicators.ConclusionChinese American patients may have significant gaps in knowledge regarding diabetes and its management that correspond to lower numeracy and acculturation levels. Health care providers should reinforce diabetes education for Chinese American patients who have lower acculturation levels.

Diabetes knowledge and glycemic control among type 2 diabetes patients at public hospitals in Debre Berhan, Ethiopia

BACKGROUND

Diabetes mellitus is a growing global health issue, especially in low- and middle-income countries like Ethiopia. To the best of our knowledge, the impact of diabetes knowledge on glycemic control in Ethiopia has not been documented. This study assessed diabetes knowledge and its relationship with glycemic control among Type 2 diabetes (T2DM) patients in Debre Berhan, Ethiopia.

METHODS

A cross-sectional study was conducted involving 380 patients diagnosed with T2DM who were receiving care at two hospitals in Debre Berhan from January 1 to March 30, 2024. Patients' knowledge was assessed using the modified Diabetes Knowledge Questionnaire (DKQ-18), categorizing outcomes as either good or poor. Glycemic control was evaluated using hemoglobin A1c (HbA1c) levels. Logistic regression analyses were conducted to identify predictors of poor diabetes knowledge. Correlation analysis was used to evaluate the relationship between knowledge and glycemic control.

RESULTS

Among the 380 participants, 75.2% were older than 45 years, and 51.3% were male. Overall, 62.4% of participants had poor knowledge of diabetes. Additionally, 72.6% had poor glycemic control, with HbA1C levels ≥7%. The mean average diabetes knowledge score was 7.9 (SD = 3.49) out of 18, and the median HbA1C was 8%. Diabetes knowledge was significantly associated (p < 0.05) with patients' educational level, occupation, family history of diabetes, and glycemic control. The Spearman correlation coefficient between HbA1C and diabetes knowledge scores was -0.166 (p = 0.001), suggesting a weak but statistically significant inverse relationship between knowledge scores and HbA1C levels.

CONCLUSIONS

The study found that the majority of patients had a low level of diabetes knowledge. Enhancing diabetes education and identifying additional factors that influence glycemic control are crucial for achieving optimal diabetes management in Ethiopia. Public health initiatives should prioritize enhancing diabetes knowledge through targeted educational programs and resources to support effective diabetes management and achieve optimal glycemic control.

Translation and Validation of the Diabetes Knowledge Questionnaire in Indonesian Patients With Type 2 Diabetes

PURPOSE

The purpose of the study was to translate and cross-culturally adapt the 24-item Diabetes Knowledge Questionnaire (DKQ) for Indonesian patients with type 2 diabetes (T2D) and evaluate its psychometric properties.

METHODS

Forward-backward translation, adaptation involving 7 experts, and pretesting to develop the Indonesian version of DKQ were conducted. Psychometric analysis was carried out among T2D patients from 40 primary health care centers in Indonesia. Known-group, convergent and discriminant validity, internal consistency and test-retest reliability were assessed. Additionally, a descriptive item analysis was conducted.

RESULTS

In total, 39 patients participated in the pretesting and 304 patients in the validation process and descriptive analysis. Of the 24 items, 2 were adjusted during the adaptation process, and 1 item was deleted because it did not adequately reflect the original item. Known-group validity was demonstrated because patients with younger ages, higher educational levels, and longer diabetes duration had significantly higher DKQ scores. Convergent validity was demonstrated by a significant positive correlation of the DKQ scores with overall treatment satisfaction. The 23-item DKQ Bahasa Indonesia showed satisfactory internal consistency (Cronbach's α = 0.73; omega total = 0.72) and good test-retest reliability (intraclass correlation coefficient = 0.87 in a sample of 27 patients). No floor and ceiling effects were found in the item analysis.

CONCLUSION

The study demonstrates adequate validity and reliability of the 23-item DKQ Bahasa Indonesia for assessing diabetes knowledge in Indonesian primary care patients with T2D. This instrument can be used to identify room for improvement and develop diabetes education programs.

The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis

OBJECTIVE

The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults.

DATA SOURCES

Eleven electronic databases were searched for randomised and quasi-randomised controlled trials.

REVIEW METHODS

Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed.

RESULTS

Twelve studies (n = 3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e., cancer and diabetes demonstrated significant improvements in quality of life (n = 2 studies) and disease-specific psychological outcomes respectively (n = 3 studies). There was some evidence for improvement in physical activity (n = 2 studies) but most changes were within group only (n = 4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being.

CONCLUSION

Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.

Diabetes-related instrument to assess preventive behaviors among adolescents (DIAPBA): a tool development and psychometric research

BACKGROUND

Type 2 diabetes is a chronic but preventable disease that is on the rise among adolescents. Evaluating adolescents' behavior and planning to prevent it require a valid and reliable instrument. This study aims at designing a psychometric instrument to measure adolescents' behavior with respect to type-2 diabetes.

RESEARCH DESIGN AND METHODS

In this methodological research, 770 students (adolescent boys and girls aged 13-15 years) participated through multistage sampling. The Inclusion criteria were: junior high school students, students' willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by examining the relevant literature and the existing questionnaires as well as considering the research team's comments. The validity of the study was determined through face validity and content validity both quantitatively and qualitatively. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via intraclass consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and Eq. 6.1 were used for data analysis.

RESULTS

At first, a list of 47 initial items was designed and compiled, and after by removing similar (10 questions) or inappropriate sentences (12 questions), a draft questionnaire with 25 questions was designed. No items were removed in the face validity phase. Based on exploratory factor analysis, the number of items in the questionnaire was reduced to 20 items and was categorized in five dimensions of stress management, healthy food/healthy diet, unhealthy food/unhealthy diet, high-risk behavior, and self-care. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.70 with ICC = 0.80.

CONCLUSION

The questionnaire designed has standard psychometric properties to assess adolescents' behavior with respect to type-2 diabetes prevention. The reliability and the validity of the questionnaire as well as its general structure were confirmed.

Associated Factors Influencing Quality of Life and Knowledge Among Type 2 Diabetic Patients: A Cross-Sectional Study

BACKGROUND

The assessment of the quality of life (QoL) among type 2 diabetic patients is associated with different factors. Evidence shows that these patients usually suffer from a lack of knowledge about the disease, inadequate self-care, and low QoL.

OBJECTIVE

The study aimed to assess knowledge of the QoL of type 2 diabetes patients and its possible associated factors.

METHODS

This cross-sectional descriptive correlational study recruited type 2 diabetic patients conveniently from out-clinics to achieve the objective of the study. The Diabetes Quality of Life Brief Clinical Inventory (DQoL) and the Diabetes Knowledge Questionnaire 18 (DKQ-18) along with a demographic questionnaire were used for patient assessment.

RESULTS

A total of 184 patients participated in the study. Patients' knowledge of diabetes was found to be low (8.57 out of 18), with no statistical differences between male and female participants (p=0.259). The average DQoL score was 2.87 out of 5, indicating moderate satisfaction and self-care behavior. DKQ-18 and DoQL were found to be correlated (r= 0.216, p=0.003). However, the patient's age was found to be a significant factor that influences patients' QoL (F=4.27, p=0.040), whereas patients' knowledge contributed weakly to the variation of QoL (F=1.70, p=0.084).

CONCLUSION

Irrespective of knowledge and educational background, the patient's age is influential in enhancing better QoL among type 2 diabetic patients.

A phubbing scale tested in Bangladesh, Iran, and Pakistan: confirmatory factor, network, and Rasch analyses

BACKGROUND

Phubbing, a phenomenon of ignoring others in face-to-face conversations due to mobile phone use, can be assessed using a Phubbing Scale (PS). Recently, the PS has been shortened into an eight-item version, the PS-8. However, psychometric properties of the PS-8 among Iranian, Bangladeshi and Pakistani individuals remain understudied, especially using advanced psychometric testing, such as Rasch and network analyses.

METHODS

Participants residing in Iran, Bangladesh, and Pakistan (n = 1902; 50.4% females; mean age = 26.3 years) completed the PS-8 and the Internet Disorder Scale-Short Form (IDS9-SF) via an online survey. Network analysis was used to examine if PS-8 items were differentiated from IDS9-SF items; confirmatory factor analysis (CFA) was used to examine the factor structure and measurement invariance of the PS-8; Rasch modeling was used to examine the dimensionality of the PS-8 and differential item functioning (DIF).

RESULTS

Network analysis showed that PS-8 items were clustered together with a distance to the IDS9-SF items. The CFA results supported a two-factor structure of the PS-8, and the two-factor structure was found to be invariant across countries and women and men. Rasch model results indicated that the two PS-8 subscales were both unidimensional and did not display DIF across countries and gender/sex.

CONCLUSION

The PS-8 is a feasible and robust instrument for healthcare providers, especially mental health professionals, to quickly assess and evaluate individuals' phubbing behaviors.