Development and validation of a scale to measure diabetes burnout

Abstract

Introduction The aim of this study is to establish reliability and validity of the Diabetes Burnout Scale (DBS) among adults with type 1 diabetes (T1D). Methods We used a multi-stage, mixed methods approach to developing the DBS. First, the research team identified twenty-eight candidate items through a review of the literature and 117 qualitative narratives from adults living with T1D. Next, items were revised based on the expert (n = 20) and individual with T1D (n = 10) feedback. The resulting 18-item DBS measure along with validated measures of diabetes distress, depressive symptoms, and questions related to diabetes outcomes (i.e., last reported hemoglobin A1c [HbA1c] and Time-in-Range [TiR]) were completed by 1099 adults with T1D across the U.S. The sample was randomly divided into two subsets (n1 = 561, n2 = 538) for exploratory and confirmatory factor analyses (EFA/CFA) to determine the underlying structure of the DBS. Regression analyses examined the relationships of the DBS with self-reported glycemic control and socio-demographic characteristics. Results Based on the EFA three factors are identified and the DBS demonstrated strong internal consistency with Cronbach alphas (≥0.80). The validation and confirmatory analysis for the structure of the DBS provided consistent results with EFA. Higher burnout (overall DBS) was positively associated with diabetes distress (b = 0.74; p < 0.01) and depressive symptoms (b = 0.61; p < 0.01). Overall DBS, however was the strongest predictor for poorer HbA1c (r2 = 0.19; p < 0.01) and lower TiR (r2 = 0.17; p < 0.01) compared to diabetes distress and depressive symptoms. Conclusion The 12-item DBS is a reliable and valid scale to measure diabetes burnout in adults with diabetes. The results provide a weak to strong degree of association between the validated DBS scale, T1-DDS and PHQ-8. The DBS can contribute to advancement of diabetes science by measuring diabetes burnout and informing clinical interventions to improve psychosocial care in individuals with diabetes.

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review

“…Finally, based on qualitative studies and on expert opinion, a recent publication proposed a specific scale for diabetes burnout. This scale shows high correlations with depression and diabetes distress and is a good predictor of HbA1c levels [33].…”

“…Five scales were used to convey the facets of diabetes burnout among 9 articles, which includes Maslach Burnout Inventory-General Survey (MBI-GS) (n = 3, 33%) [32], Diabetes Burnout Scale (DBS) [33] (n = 2, 22%), Illness Identity Questionnaire (IIQ) [34] (n = 1, 11%), Motivation and Attitude Toward Changing Health (MATCH) [35] (n = 1, 11%) and Diabetes Empowerment Scale-Short Form (DES-SF) [36] (n = 1, 11%) (Table 1).…”

Emotional burden and care of adults with type 1 diabetes during the COVID-19 pandemic in Brazilian regions

“…DB: A newly developed measure of diabetes burnout developed by Abdoli et al, 32 was used to assess diabetes burnout. This scale is a 12-item scale including exhaustion ( n = 4), detachment ( n = 5), and loss of control ( n = 3) subscales.…”

“…However, DBS is capable of measuring exhaustion, and detachment from diabetes. 32 The T1DDS has subscales that are not well evaluated by DBS such as specific aspects related to hypoglycemia, the relationship with family, friends, and diabetes professionals, and negative social perception of T1D. 13 On the other hand, PHQ-8 has questions about mood and anhedonia not included in the other instruments and it is proper to evaluate depressive symptoms.…”

Regional Comparison of Diabetes Psychosocial Comorbidities Among Americans With Type 1 Diabetes During the COVID-19 Pandemic

“…Participants were asked to rate how much they agreed or disagreed with each statement using a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). 22 Participants also rated their level of overall burnout on a single item (ie, none, mild, moderate, severe) based on their perceptions of diabetes burnout.…”