Validation and Cultural Adaptation of the Problem Areas in Diabetes-5 (PAID-5) Scale to European Portuguese
DOI:
https://doi.org/10.20344/amp.18995Keywords:
Diabetes Mellitus/psychology; Emotions; Portugal; Psychometrics; Surveys and QuestionnairesAbstract
Introduction: Diabetes distress syndrome (DDS) can lead to poor outcomes and should be assessed with adapted and validated tools. One of these tools is the Problem Areas in Diabetes (PAID) scale, which assesses diabetes distress in people suffering from diabetes (PsD). A short five-item form, PAID-5, is an easier and quicker alternative to be used in clinical and research practices, than the previous one with 20-items and has been validated by the original authors. This study intended to perform the cultural adaptation and validation of the PAID-5 scale in European Portuguese.
Methods: To create the Portuguese version of PAID-5, translation-back translation, a clinical review, and a cognitive debriefing panel were performed. A convenience sample of 90 PsD was studied in three primary healthcare units for reliability and validity tests. Reliability was studied by the internal consistency (Cronbach’s alpha) and the interval coefficient correlation (ICC) under a test-retest design. Structural validity was studied by principal component analysis. The construct validity was tested by the sensitivity of the PAID-5 total score with age, most recent HbA1c test, and socioeconomic class by the Socio-Economic Deprivation Index (SEDI). Criterion validity was tested by correlating the PAID-5 total score with the psychological distress questions of the Diabetes Health Profile 18 Questions (DHP-PDQ).
Results: A Cronbach’s alpha coefficient value of 0.905 and an ICC of 0.905 were computed. In a sample of n = 90 PsD, 55.6% were males, 63.3% aged 65 years or more, SEDI was 5.2 ± 0.8 [3 to 6], 44.4% studied for less than 4 years, and 18.9% were living alone. The Spearman correlation between PAID-5 and DHP-PDQ total scores was ρ = 0.382, p < 0.001, between PAID-5 total score and age was ρ = -0.207, p = 0.050 and between PAID-5 total score and most recent HbA1c knowledge was ρ = 0.275, p = 0.040. There was no significant relationship between PAID-5 total score and SEDI ρ = 0.080, p = 0.452.
Conclusion: DDS can now be assessed in the Portuguese context, accounting for better intervention by primary care teams. PAID-5 has good psychometric properties and is a reliable scale to identify diabetes-specific distress in the Portuguese diabetic population.
Downloads
References
International Diabetes Federation. IDF Diabetes Atlas. 10th ed. 2021. [cited 2023 Jan 21]. Available from: https://www.diabetesatlas.org.
Chamberlain JJ, Rhinehart AS, Shaefer CF Jr, Neuman A. Diagnosis and management of diabetes: synopsis of the 2016 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2016;164:542-52. DOI: https://doi.org/10.7326/M15-3016
Fisher L, Glasgow RE, Strycker LA. The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes. Diabetes Care. 2010;33:1034-6. DOI: https://doi.org/10.2337/dc09-2175
Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol. 2015;3:450-60. DOI: https://doi.org/10.1016/S2213-8587(15)00135-7
Perrin NE, Davies MJ, Robertson N, Snoek FJ, Khunti K. The prevalence of diabetes-specific emotional distress in people with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2017;34:1508-20. DOI: https://doi.org/10.1111/dme.13448
American Diabetes Association. 5. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes – 2021. Diabetes Care. 2021;44:S53–72. DOI: https://doi.org/10.2337/dc21-S005
Snoek FJ, Pouwer F, Welch GW, Polonsky WH. Diabetes-related emotional distress in Dutch and U.S. diabetic patients: cross-cultural validity of the problem areas in diabetes scale. Diabetes Care. 2000;23:1305-9. DOI: https://doi.org/10.2337/diacare.23.9.1305
Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18:754-60. DOI: https://doi.org/10.2337/diacare.18.6.754
Amsberg S, Wredling R, Lins PE, Adamson U, Johansson UB. The psychometric properties of the Swedish version of the Problem Areas in Diabetes Scale (Swe-PAID-20): scale development. Int J Nurs Stud. 2008;45:1319-28. DOI: https://doi.org/10.1016/j.ijnurstu.2007.09.010
Lygidakis C, Uwizihiwe JP, Bia M, Kallestrup P, Dukundane D, Asiimwe-Kateera B, et al. Cultural adaptation and psychometric evaluation of the Kinyarwanda version of the problem areas in diabetes (PAID) questionnaire. Health Qual Life Outcomes. 2021;19:183. DOI: https://doi.org/10.1186/s12955-021-01821-w
Beléndez M, Hernández-Mijares A, Marco J, Domínguez JR, Pomares FJ. Validation of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale. Diabetes Res Clin Pract. 2014;106:e93-5. DOI: https://doi.org/10.1016/j.diabres.2014.09.012
Cichoń E, Kiejna A, Gondek TM, Obrębski M, Sutkowska E, Lloyd CE, et al. PAID-PL-The Polish Version of the Problem Areas in Diabetes Scale: perfect reliability and a one-factor structure. Diabetes Metab Syndr Obes. 2021;14:4433-41. DOI: https://doi.org/10.2147/DMSO.S322850
Huang MF, Courtney M, Edwards H, McDowell J. Validation of the Chinese version of the Problem Areas in Diabetes (PAID-C) scale. Diabetes Care. 2010;33:38-40. DOI: https://doi.org/10.2337/dc09-0768
Graue M, Haugstvedt A, Wentzel-Larsen T, Iversen MM, Karlsen B, Rokne B. Diabetes-related emotional distress in adults: reliability and validity of the Norwegian versions of the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS). Int J Nurs Stud. 2012;49:174-82. DOI: https://doi.org/10.1016/j.ijnurstu.2011.08.007
Huis In ‘t Veld EM, Makine C, Nouwen A, Karşıdağ C, Kadıoğlu P, Karşıdağ K, et al. Validation of the Turkish version of the problem areas in diabetes scale. Cardiovasc Psychiatry Neurol. 2011;2011:315068. DOI: https://doi.org/10.1155/2011/315068
Sayed Ahmed HA, Mohamed SF, Elotla SF, Mostafa M, Shah J, Fouad AM. Psychrometric properties of the Arabic version of the Problem Areas in Diabetes Scale in Primary Care. Front Public Health. 2022;10:843164. DOI: https://doi.org/10.3389/fpubh.2022.843164
Sigurdardottir AK, Benediktsson R. Reliability and validity of the Icelandic version of the Problem Area in Diabetes (PAID) Scale. Int J Nurs Stud. 2008;45:526-33. DOI: https://doi.org/10.1016/j.ijnurstu.2006.10.008
McGuire BE, Morrison TG, Hermanns N, Skovlund S, Eldrup E, Gagliardino J, et al. Short-form measures of diabetes-related emotional distress: the Problem Areas in Diabetes Scale (PAID)-5 and PAID-1. Diabetologia. 2010;53:66-9. DOI: https://doi.org/10.1007/s00125-009-1559-5
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34-42. DOI: https://doi.org/10.1016/j.jclinepi.2006.03.012
Meadows KA, Abrams C, Sandbaek A. Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison. Diabet Med. 2000;17:572-80. DOI: https://doi.org/10.1046/j.1464-5491.2000.00322.x
Santos Cruz R, Leitão CE, Lopes Ferreira P. Determinantes do estado de saúde dos diabéticos. RPEDM. 2016;11:188-96. DOI: https://doi.org/10.1016/j.rpedm.2016.05.001
Ribeiro AI, Launay L, Guillaume E, Launoy G, Barros H. The Portuguese version of the European Deprivation Index: development and association with all-cause mortality. PLoS One. 2018;13:e0208320. DOI: https://doi.org/10.1371/journal.pone.0208320
Lamnisos D, Lambrianidou G, Middleton N. Small-area socioeconomic deprivation indices in Cyprus: development and association with premature mortality. BMC Public Health. 2019;19:627. DOI: https://doi.org/10.1186/s12889-019-6973-0
Vislapuu M, Broström A, Igland J, Vorderstrasse A, Iversen MM. Psychometric properties of the Norwegian version of the short form of The Problem Areas in Diabetes scale (PAID-5): a validation study. BMJ Open. 2019;9:e022903. DOI: https://doi.org/10.1136/bmjopen-2018-022903
Simões JA, Prazeres F, Maricoto T, Simões PA, Lourenço J, Romano JP, et al. Physician empathy and patient enablement: survey in the Portuguese primary health care. Family Practice, 2021;38:606-11. DOI: https://doi.org/10.1093/fampra/cmab005
Coelho BM, Santiago LM. Medicina centrada na pessoa: validação populacional de um instrumento de medida pela pessoa. Rev Port Med Geral Fam. 2022;38:247-56. DOI: https://doi.org/10.32385/rpmgf.v38i3.13218
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Acta Médica Portuguesa
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All the articles published in the AMP are open access and comply with the requirements of funding agencies or academic institutions. The AMP is governed by the terms of the Creative Commons ‘Attribution – Non-Commercial Use - (CC-BY-NC)’ license, regarding the use by third parties.
It is the author’s responsibility to obtain approval for the reproduction of figures, tables, etc. from other publications.
Upon acceptance of an article for publication, the authors will be asked to complete the ICMJE “Copyright Liability and Copyright Sharing Statement “(http://www.actamedicaportuguesa.com/info/AMP-NormasPublicacao.pdf) and the “Declaration of Potential Conflicts of Interest” (http:// www.icmje.org/conflicts-of-interest). An e-mail will be sent to the corresponding author to acknowledge receipt of the manuscript.
After publication, the authors are authorised to make their articles available in repositories of their institutions of origin, as long as they always mention where they were published and according to the Creative Commons license.
