Cross-cultural adaptation of the Diabetes Management Self-Efficacy Scale for patients with type 2 diabetes mellitus: scale development

Abstract

Background: As a profession, nurses are particularly concerned with cross-cultural influences that affect the health practices of populations. Although the international literature describes questionnaires and specific scales in health and disease behaviours, adequate Turkish-language instruments are scarce. Therefore, suitable Turkish-language instruments need to be developed or adapted for the Turkish population.

Objectives: Study aim was to adapt a Dutch/English version of the diabetes management self-efficacy (SE) scale for use with a Turkish population and evaluate its psychometric properties.

Design: Methodological research design.

Settings: Attendants of an outpatient clinic of a university hospital in Turkey.

Participants: A convenience sample of 110 patients with type 2 diabetes mellitus (DM).

Methods: Translation and back-translation of the original English instrument and content validation through a expert panel were the first two steps of the study. Third step was the psychometric testing of the adapted instrument by establishing internal consistency (Cronbach's alpha), stability (test-retest reliability), and construct validity (factor analysis).

Results: Content validity procedure resulted in a final scale that consisted of 20 items. Internal consistency of the total scale was coefficient alpha=0.88, and test-retest reliability with a 4-week time interval was r=0.91 (p<0.001). Factor analysis yielded three factors related to diet, exercise and medical treatment. Two relevant items of the scale, weight control and blood sugar control, however, had low reliability and validity scores.

Conclusions: Although acceptable levels of reliability and validity of the Turkish version of the diabetes management SE scale for people with type 2 DM were reached, cultural factors appeared to play a role in the applicability of some items of the scale.