Psychometric properties of a questionnaire to measure adherence to treatment in patients with type 1 diabetes mellitus.
Carmen Grau-Del Valle, José Francisco Marco-Expósito, Eva Solá and 4 others
PMID 35445584WHAT IT FOUND
Adults with type 1 diabetes answered a questionnaire about insulin, diet, exercise, stress, and appointments.
The final 25-item version grouped into five patterns, and people with higher self-reported adherence had lower HbA1c.
Key findings
01The final 25-item questionnaire had a Cronbach's alpha of .92 after items 26 and 27 were omitted.
02Factor analysis identified five dimensions: insulin administration and medical visits, involvement in treatment, psychological variables, physical exercise, and nutritional guidelines.
03Higher self-reported adherence was associated with lower HbA1c (r = -.440; p < .001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The questionnaire was self-reported, so patients may overestimate their adherence. Participants were recruited from endocrinology appointments, diabetes education sessions, or psychology consultations, which may have selected people already engaged with their care. The study did not test external validity or convergent validity against another T1DM-specific adherence questionnaire. The association between adherence scores and HbA1c was cross-sectional, so it cannot show that using the questionnaire improves control or that adherence caused lower HbA1c. Fourteen of 167 patients were excluded from reliability analysis because they did not complete the questionnaire adequately. The tool was validated only in Spanish-speaking adults with T1DM attending one hospital. Some items showed ceiling effects because many respondents chose the highest answer. Patients with comprehension difficulties were excluded, so the results may not apply to people who need simpler assessment methods.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that using this questionnaire will improve diabetes control. It was validated in one cross-sectional sample of adults with T1DM and showed an association between self-reported adherence and HbA1c, not a treatment effect.