Development and psychometric properties of the 12-item diabetes fatalism scale. J Gen Intern Med 2010 Jan;25(1):61-6
Date
11/13/2009Pubmed ID
19908102Pubmed Central ID
PMC2811603DOI
10.1007/s11606-009-1168-5Scopus ID
2-s2.0-77951110302 (requires institutional sign-in at Scopus site) 54 CitationsAbstract
OBJECTIVE: This study describes the development and validation of the Diabetes Fatalism Scale (DFS) in adults with type 2 diabetes.
METHODS: Thirty-five items were derived from focus groups, literature review, and expert opinion. The items were pilot tested on 20 adults with diabetes and then administered to 216 primary care patients with type 2 diabetes to assess the validity and reliability of the scale. Exploratory factor analysis (Principal Component Analysis with Varimax rotation) yielded a 12-item scale with three subscales. Pearson's correlation was used to test the DFS's association with diabetes self-care, HbA1c and quality of life. Multiple linear regression was used to assess association between the DFS and HbA1c controlling for demographics, comorbidity and insulin use.
RESULTS: Cronbach's alpha for the 12-item DFS scale was 0.804 indicating internal consistency. The DFS is scored in such a way that higher scores represent greater diabetes fatalism. The DFS scores were not significantly correlated with age, years of education, or diabetes duration. Whites, men, those with government or no insurance, and those with 3+ comorbid conditions had significantly higher DFS scores. DFS was significantly correlated with self management understanding (r = -0.35, p < 0.001), control problems (r = 0.22, p = 0.002), self-care ability (r = -0.30, p < 0.001), and self-care adherence (r = -0.23, p < 0.001). The DFS was significantly correlated with HbA1c (r = 0.20, p = 0.004) and mental health component of SF-12 (r = -0.24, p = 0.001). In multivariate models, adjusting for demographics, comorbidity and insulin use, the DFS was independently associated with increased HbA1c (beta 0.21, p = 0.005).
CONCLUSIONS: The DFS is a valid and reliable measure of diabetes fatalism. Diabetes fatalism is associated with self-care problems, poor glycemic control, and decreased quality of life.
Author List
Egede LE, Ellis CAuthor
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Attitude to Health
Diabetes Mellitus, Type 2
Female
Focus Groups
Humans
Male
Middle Aged
Pilot Projects
Psychometrics
Quality of Life
Reproducibility of Results
Severity of Illness Index