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Assessing Diabetes Distress in Emerging Adults With Type 1 Diabetes: Development and Validation of the Problem Areas in Diabetes—Emerging Adult Version

Published:February 12, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.02.004

      Abstract

      Objectives

      Emerging adults (18 to 30 years of age) with type 1 diabetes experience suboptimal glycemic and psychological outcomes compared with other groups. The emotional burden of the unending self-care needs of diabetes management appears to be related to these poor health outcomes. However, there is no validated measure of this emotional burden in the developmental context of emerging adulthood. The primary aim of this study was to examine the psychometric properties of a new measure of diabetes distress in emerging adults with type 1 diabetes in the United States.

      Methods

      In this cross-sectional study, emerging adults with type 1 diabetes completed an online survey, including measures of diabetes distress, depressive symptomology and the newly developed measure, the Problem Areas in Diabetes—Emerging Adult version (PAID-EA). Participants also answered demographic and clinical outcomes questions. Internal consistency, reliability, construct validity and the underlying factor structure of the PAID-EA were assessed.

      Results

      Participants (N=287, 78% women) had a median age of 24 years, 43% were full-time students, 78% wore an insulin pump and 90% used a continuous glucose monitor. Mean self-reported glycated hemoglobin was 7.1%±1.2%. The PAID-EA demonstrated good internal consistency and reliability (Cronbach alpha=0.89), was composed of 1 component accounting for 29% of the observed variance and demonstrated construct validity as it was significantly correlated with known measures of similar constructs and with glycated hemoglobin levels (ρ=0.20, p=0.001).

      Conclusions

      The PAID-EA holds promise as a reliable and valid measure of diabetes distress in emerging adults.

      Résumé

      Objectifs

      Les adultes émergents (de 18 à 30 ans) atteints du diabète de type 1 connaissent des résultats glycémiques et psychosociaux sous-optimaux par rapport aux autres groupes. Le fardeau émotionnel des besoins incessants d’autosoins liés à la prise en charge du diabète semble être relié à ces résultats médiocres. Toutefois, il n’existe aucun outil validé pour mesurer ce fardeau émotionnel dans le contexte développemental de l’âge adulte émergent. Le principal objectif de la présente étude était d’examiner les propriétés psychométriques d’un nouvel outil pour mesurer la détresse liée au diabète des adultes émergents atteints du diabète de type 1 des États-Unis.

      Méthodes

      Dans cette étude transversale, les adultes émergents atteints du diabète de type 1 ont rempli une enquête en ligne, soit les mesures de la détresse liée au diabète, la symptomatologie de la dépression et le nouvel outil d’évaluation récemment élaboré, le Problem Areas in Diabetes—Emerging Adult (PAID-EA), c.-à-d. la version pour les adultes émergents. Les participants ont aussi répondu aux questions sur les résultats cliniques et aux questions démographiques. Nous avons évalué la cohérence interne, la fiabilité, la validité de construit et la structure des facteurs sous-jacents du PAID-EA.

      Résultats

      L’âge médian des participants (N = 287, 78 % de femmes) était de 24 ans, 43 % étaient des étudiants à temps complet, 78 % portaient une pompe à insuline et 90 % utilisaient un lecteur de glycémie en continu. L’hémoglobine glyquée moyenne auto-déclarée était de 7,1 % ± 1,2 %. Le PAID-EA démontrait une bonne cohérence interne et une bonne fiabilité (coefficient α de Cronbach = 0,89), comportait une composante qui représentait 29 % de la variance observée et démontrait une validité de construit puisqu’elle était en corrélation significative avec les mesures connues de construits similaires et les concentrations d’hémoglobine glyquée (ρ = 0,20, p = 0,001).

      Conclusions

      L’outil d’évaluation PAID-EA s’avère une échelle fiable et valide pour mesurer la détresse liée au diabète des adultes émergents.

      Keywords

      Mots clés

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