Proposed revisions to Diabetes Distress Scale to benefit Spanish speakers
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Study results published in The Science of Diabetes Self-Management and Care highlight the need to revise the Diabetes Distress Scale for Spanish-speaking people with diabetes to improve understanding and focused responses.
“Ensuring that what we believe we are measuring is what is actually being measured, as researchers and/or clinicians, is an intentional process,” Deshira D. Wallace, PhD, MSPH, assistant professor in the department of health behavior at the University of North Carolina at Chapel Hill, told Healio. “When making this evaluation of measurement we often limit this to only quantitative assessments and perhaps speaking to subject matter experts, we lose an opportunity to be intentional with communities actually affected by a condition or experience.”
Wallace and colleagues conducted cognitive interviews with 20 adults with type 2 diabetes (mean age, 55 years; 55% women) for at least 1 year from 10 rural communities in the Dominican Republic to evaluate how they answered the Spanish version of the 17-item Diabetes Distress Scale. Interviews were conducted iteratively and revised with participants.
These interviews highlighted required changes across comprehension, judgment, recall, response process and logical-structural issue domains. Generally, participants understood the Diabetes Distress Scale. However, four items in the scale required revision to improve participant response. The researchers revised these items using wording from the participants and changed certain terms and split a few items to improve participant comprehension and judgment.
Specifically, they simplified the introduction to the Diabetes Distress Scale from two to one paragraph to improve structural issues, and response options were reduced from six to five to improve participant response processes.
According to the researchers, these revisions may support future research to effectively measure diabetes distress among adults in the Dominican Republic and similar settings.
According to Wallace, it is important to take time to understand how patients interpret close-ended questions to ensure they are in line with the concept being measured and to avoid misinterpretations.
“Additional research that is needed, and some that I am doing, is quantitative scale validation to examine how the revised scale functions in the Dominican Republic,” Wallace said. “However, this study also showcases the need to consistently evaluate the scales/measures we use for research and in clinical practice. This includes verifying where and in which communities the scales have been used, if there is documentation of any qualitative and quantitative validation efforts for the scale and ensuring clarity regarding what circumstances scales can and cannot be used.”
For more information:
Deshira D. Wallace, PhD, MSPH, can be reached at ddwallac@email.unc.edu.
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