Measurement of diabetes-related emotional distress using the Problem Areas in Diabetes scale: psychometric evaluations show that the short form is better than the full form.

Abstract

BACKGROUND: The Problem Areas in Diabetes (PAID) scale is widely used for

measuring diabetes-related emotional distress. There has been debate over the

last 2 decades about the underlying factorial-construct validity of the PAID,

with one- to four-factor structures being reported. A short form of the PAID,

which comprises five items (PAID-5), was recently developed using Western

patients with type 2 diabetes. This study measured the psychometric properties of

the full and short forms of the PAID in Korean patients with type 2 diabetes,

with the aim of determining which form is preferable. METHODS: The PAID and

PAID-5 were translated into Korean (K-PAID and K-PAID-5, respectively) using a

forward-and-backward translation technique. The study participants were recruited

from university hospitals. The factorial-construct, convergent, and known-groups

validity, and internal-consistency and test-retest reliability of both the K-PAID

and K-PAID-5 were evaluated. RESULTS: For the K-PAID, confirmatory factor

analysis revealed a marginal fit to the one-, two-, three-, and four-factor

models. The three- and four-factor models of the K-PAID partially satisfied the

internal-consistency and test-retest reliability, and convergent and known-groups

validity. For the K-PAID-5, confirmatory factor analysis demonstrated an

excellent fit to the one-factor model, with a Cronbach's alpha of 0.87 and an

intraclass correlation coefficient of 0.89. The K-PAID-5 satisfied the convergent

validity, as evaluated using the Center for Epidemiologic Studies Depression

Scale and hemoglobin A1c. Known-groups validity by gender was also satisfied.

CONCLUSIONS: The K-PAID-5 demonstrated excellent psychometric properties as a

one-factor scale. The brevity of the K-PAID-5 represents a major advantage in a

practical context in that it may impose a minimum burden upon patients with

diabetes.