OBJECTIVETo validate a Chinese version of the Diabetes Distress Scale (CDDS).RESEARCH DESIGN AND METHODSThe CDDS was derived using forward-backward translation and administered in 189 Chinese type 2 diabetic patients with evaluation of its psychometric properties.RESULTSOn the basis of principal-component analysis, three factors of the 15-item version of the CDDS (CDDS-15) accounted for 63% of the variance. The correlation coefficient between the original 17-item and 15-item scales was 0.99. The Cronbach α for internal consistency was 0.90, and the test-retest reliability coefficient was 0.74. The CDDS-15 score was significantly associated with glycemic control, obesity, depressive symptoms, and quality of life.CONCLUSIONSThe CDDS-15 is a valid and reliable instrument to assess diabetes-related distress.

PURPOSEWe examined the effects of participating in a "train-the-trainer" program and being a peer supporter on metabolic and cognitive/psychological/ behavioral parameters in Chinese patients with type 2 diabetes.

Based on results from a comprehensive assessment, the JADE Risk Engine successfully categorizes patients into different risk levels to guide clinical management.

OBJECTIVE -To translate the Diabetes Empowerment Scale (DES) into Chinese and establish its psychometric properties among Hong Kong Chinese people. RESEARCH DESIGN AND METHODS -A two-stage study design, incorporatingqualitative and quantitative components, determined the cultural equivalency and content validity of the translated scale and established the psychometric properties of the Chinese DES (C-DES) in 207 patients.RESULTS -Psychometric analysis supported the reliability and validity of the 20-item Chinese DES (C-DES-20) and five subscales: overcoming barriers (␣ ϭ 0.89), determining suitable methods (␣ ϭ 0.79), achieving goals (␣ ϭ 0.78), obtaining support (␣ ϭ 0.78), and coping (␣ ϭ 0.76). The test-retest reliability of the intraclass correlations was satifactory when a subsample of 20 patients was tested after a 2-week interval. There was criterion validity between the global scale and metabolic control (HbA 1c ) of respondents with type 2 diabetes (P ϭ 0.03).CONCLUSIONS -The C-DES-20 is a reliable and valid outcome measure for patient education and psychosocial interventions among Hong Kong Chinese people with diabetes. Diabetes Care 26:2817-2821, 2003P atients with diabetes have to take responsibility for their own care and in the process make many decisions on a daily basis, often with little support and with the burden of having had to overcome social and cultural barriers (1). If the diabetes treatment regimen is to be effective, patients need to actively engage in self-management, and they need to be empowered to accomplish this (2,3). Empowering patients with a sense of control over diabetes is a central theme supported by the World Health Organization, which advocates the importance of fostering psychological well-being as a major outcome (4,5). This shift toward patient empowerment in diabetes education (6,7) is likely to enhance knowledge and cooperation (5,8,9), foster appropriate selfmanagement abilities, and enable patients to overcome some of the personal, social, and environmental barriers that many of them face (10,11). For example, there is evidence that patient empowerment can improve outcomes such as metabolic control and quality of life (8).Anderson et al. (8), while investigating the application of empowerment with diabetic patients, stated that its purpose was to ensure that patients make informed decisions about their diabetes self-management. Thus, in addition to the knowledge and skills provided by a traditional education program, patients require training in psychosocial skills.The Diabetes Empowerment Scale (DES) was developed and psychometrically tested among Caucasians (8,12,13). Two versions exist: the long one (DES-37) (12) has 37 items (␣ ϭ 0.94) with eight subscales and the short one (DES-28) (13) has 28 items (␣ ϭ 0.96) with three subscales. In the past decade, the prevalence of diabetes and, consequently, hospital admissions and mortality rates have risen steadily in Hong Kong (14), spurring diabetologists to advocate the use of empowerment as a model of diabetes care ...

Diabetes is a complex disease characterized by chronic hyperglycemia and multiple phenotypes. In 1995, we used a doctor-nurse-clerk team and structured protocol to establish the Hong Kong Diabetes Registry in a quality improvement program. By 2009, we had accrued 2616 clinical events in 9588 Chinese type 2 diabetic patients with a follow-up duration of 6 years. The detailed phenotypes at enrollment and follow-up medications have allowed us to develop a series of risk equations to predict multiple endpoints with high sensitivity and specificity. In this prospective database, we were able to validate findings from clinical trials in real practice, confirm close links between cardiovascular and renal disease, and demonstrate the emerging importance of cancer as a leading cause of death. In addition to serving as a tool for risk stratification and quality assurance, ongoing data analysis of the registry also reveals secular changes in disease patterns and identifies unmet needs.

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Background Parent-child exercises involve children and parents to do workout together and have positive effects on physical and mental health. We developed a mobile app on parent-child exercises called Family Move, which combines coaching videos with game features such as points and level system to enhance the health and wellbeing of both children and parents through parent-child exercises. This pilot pre-post study investigated whether the Family Move app-based intervention had a positive effect on children’s health-related quality of life (HRQOL), psychosocial wellbeing, and physical activity (PA) level. Methods We recruited 67 parent-child pairs. During the 8-week intervention, these pairs were invited to perform parent-child exercises using the Family Move app. Points were automatically added to the user account after viewing a coaching video. In-game ranking was available to enhance user engagement. Parent proxy-report questionnaires on children’s HRQOL, psychosocial wellbeing, and PA were administered at baseline and 1- and 6-month follow-up. Paired samples t-tests were conducted to evaluate post-intervention changes in child outcomes (HRQOL, psychosocial wellbeing, and PA). Multiple linear regressions were used to examine these changes as a function of in-game ranking. Results 52 (78%) viewed at least one coaching video in the Family Move app. Children’s PA level significantly increased at 1-month (d = 0.32, p = 0.030) and 6-month (d = 0.30, p = 0.042) follow-up, whereas their psychosocial problems declined at 6-month follow-up (d = 0.35, p = 0.005). Higher in-game ranking was significantly associated with fewer psychosocial problems at 1-month follow-up (β = − 0.15, p = 0.030). Conclusions Our findings suggest that the Family Move app could be a possible intervention to increase children’s PA level and psychosocial wellbeing through parent-child exercise. Trial registration ClinicalTrials.gov number, NCT03279354, registered September 11, 2017 (Prospectively registered).

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