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Development and validation of diabetes empowerment questionnaire in Iranian people with type 2 diabetes

Authors

  • R. Aghili MD,

    PhD student, Clinical Diabetes
    1. Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • M.E. Khamseh MD,

    Associate Professor, Corresponding author
    • Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • M. Malek MD,

    Associate Professor, Endocrinology and Metabolism
    1. Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • A.S. Banikarimi MD,

    Endocrinologist
    1. Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • H.R. Baradaran MD, PhD,

    Associate Professor, Epidemiology
    1. Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • A. Ebrahim Valojerdi BS

    Statistician
    1. Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences, Tehran, Iran
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  • Conflict of Interest: Nothing to declare.

Correspondence address: Dr Mohammad Ebrahim Khamseh, Firouzgar alley, Valadi St., Behafarin St., Karimkhan Ave., Vali-asr Sq., Tehran 15937-48711, Iran; Tel: +98-21-88945172; Fax: +98-21-88945173; E-mail: m-khamseh@tums.ac.ir.

Abstract

Background

Diabetes self-management education programmes which have been reported to improve the self-efficacy of diabetic people can lead to their empowerment. Specialized diabetes nurses also play a fundamental role in empowering patients with diabetes through improving their knowledge and self-care.

Aim

The purpose of this study was to develop a valid and reliable questionnaire to measure empowerment in Iranian people with type 2 diabetes.

Methods

Important subscales of patient empowerment were identified by an expert panel. The subscales included active self-care, coping with personal and social concerns, basic knowledge related to diabetes management and patient-physician communication. Questions related to each subscale were generated and the expert panel renewed the questionnaire to ensure relevance and clarity of the items. Patient focus groups were conducted to establish the face validity of the questionnaire. The final questionnaire consisted of 15 items organized in three subscales.

In a population-based study, a sample of 378 people with type 2 diabetes was recruited. Reliability coefficient (Cronbach's α) was calculated for all of the subscales. Convergent validity was assessed by Pearson's product moment correlation. The scree test was used to select significant subscales.

Findings

Two hundred forty-seven female and 131 male subjects with type 2 diabetes filled out the questionnaire. Three subscales were derived from factor analysis considering item-component loading of 0.4 as significant: ‘active self-care’ (Cronbach's α: 0.78), ‘basic knowledge related to diabetes management’ (Cronbach's α: 0.72) and ‘coping with personal and social concerns’ (Cronbach's α: 0.51).

The scree plot of the eigenvalues of 15 items proposed three subscale solutions. Internal consistency reliabilities for the three subscales were acceptable (α: 0.51–0.78).

Conclusions

The Diabetes Empowerment Questionnaire is a reliable and valid tool to assess patient empowerment in Iranian people with type 2 diabetes.

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