Psychometric properties of the Malay version of the Osteoporosis Health Belief Scale (OHBS-M) among Type 2 diabetic patients




The aims of this study were to translate and examine the psychometric properties of the Malaysian version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetes patients (T2DM) and to assess the correlation between osteoporosis knowledge, health belief and self-efficacy scales, as well as assess the osteoporosis risk in the sample population using quantitative ultrasound measurement (QUS).


A standard ‘forward–backward’ procedure was used to translate OHBS into the Malay language, which was then validated with a convenience sample of 250 T2DM. Bone mineral density (BMD) measurements were carried out using QUS at the calcaneus.


The mean score of OHBS-M was 158.31 ± 20.80. The Fleiss' kappa, content validity ratio range and content validity index were 0.99, 0.75–1.00 and 0.88, respectively. Seven factors of the OHBS-M were identified using exploratory factor analysis and were confirmed through confirmatory factor analysis. Internal consistency and test–retest reliability values were 0.89 and 0.555, respectively. In addition, only 22% had a normal BMD (low risk of abnormal BMD), while osteopenia and osteoporosis were 57.6% and 20.4% (considered as high risk of abnormal BMD), respectively.


The results showed that the OHBS-M is a reliable and valid instrument for measuring health belief toward osteoporosis in diabetic patients. In addition, it is an appropriate tool to identify patients needing a bone health-promoting intervention regarding lifestyle behavior changes in a clinical setting. Moreover, the sample population showed high risk of osteoporosis and would subsequently benefit from dual-energy x-ray absorptiometry scanning for definite evaluation and treatment.