Psychometric properties of the Thai version of the Diabetes Distress Scale in diabetic seniors

BACKGROUND The Diabetes Distress Scale (DDS) is an important measure of diabetes-related emotional distress that has been widely used in the Western world. In Thailand, there is a lack of reliable and valid scales for assessing distress levels in diabetes patients, specifically in older adults. OBJECTIVES The main objectives of this study were to adapt the DDS for use in Thai diabetic elderly and to evaluate its psychometric properties. METHODS The 17-item DDS was linguistically adapted using forward-backward translation and administered to 170 diabetic patients ≥ 60 years selected from diabetes outpatient clinics of four hospitals in Buriram, Thailand. Statistical analyses included exploratory factor analysis, internal consistency, convergent validity, and test-retest reliability. RESULTS During factor analysis, a three-factor solution was found to be reasonable for the sub-dimensions of emotional and regimen-related burden (ten items), physician- and nurse-related distress (four items), and diabetes-related interpersonal distress (three items). The Cronbach's alpha coefficient for the total score was 0.95 and varied between 0.85 and 0.96 in the three subscales. The results provided evidence that supports the convergent validity of the Thai version of the DDS as well as its stability. CONCLUSION The Thai version of the DDS has acceptable psychometric properties. It enables assessment of diabetes-specific distress in elderly patients and has the advantage of being easy to use in both clinical and research settings.