Health Belief Scales Developed Specifically for People with Tablet‐treated Type 2 Diabetes

Abstract

The design and development of scales to measure diabetes-specific health beliefs of patients treated with oral hypoglycaemic agents and diet are described. The scales, which were developed from the responses of 187 tablet-treated patients, measure perceived Benefits of, and Barriers to Treatment, and perceived Severity of, and Vulnerability to Complications of diabetes and other disorders unrelated to diabetes. Cronbach's alpha indicated that each scale was internally reliable (alpha = 0.67 to 0.89) and construct validity was indicated by expected correlations between the scales and other variables including measures of blood glucose control, body weight, and psychological well-being. Thus, patients who were overweight and/or had higher glycosylated haemoglobin (HbA1) levels perceived their treatment to be less 'Cost-effective' (Benefits less Barriers), rated Complications as being more severe, and reported greater Vulnerability for themselves and the 'average person' with diabetes to these Complications (p less than 0.05 to p less than 0.01). Furthermore, respondents with higher Depression and Anxiety scores and lower Positive Well-being and Treatment Satisfaction scores reported greater Vulnerability to Complications for themselves and the 'average person', and also felt that their treatment was less 'Cost-effective' (p less than 0.01 to p less than 0.001). The measures are likely to be particularly useful in studies which assess the efficacy of interventions in modifying health beliefs with a view to achieving desired behaviours. They may also be useful as an instrument of audit if indicators about the suitability of possible interventions are sought.

Blood glucose self-monitoring in type 2 diabetes: a randomised controlled trial

“…Questionnaires were included at baseline and 12 months to measure dietary intake and physical activity (the diabetes self-care activities questionnaire with five subscales), 51 medication adherence (the medication adherence rating scale), 52 and the scores in the diabetes treatment satisfaction questionnaire 53 and the well-being questionnaire (12 items). 54 Beliefs about diabetes and its management were assessed using the revised illness perceptions questionnaire (IPQ-R) 55 which has eight subscales.…”

In a randomized trial, outcomes were not affected by intensive follow-up over 1 year

“…The WBQ-12 was used to identify changes in well-being. The WBQ-12 is a reliable and valid measure of well-being, but the threshold score for clinical significance remains to be determined [15,16]. The overall General Well-Being score is the sum of all 12 items and is scored from 0 to 36, where a higher score indicates a greater level of well-being.…”

A Comparison of Views of Individuals with Type 2 Diabetes Mellitus and Diabetes Educators About Barriers to Diet and Exercise

“…Thus, the educators reported the proportion of their patient population that they believed had experienced the barrier, whereas the patients reported how often they felt each item was a barrier for them. Although barriers statements may utilize an agree±disagree scale (Glasgow, 1994;Lewis et al, 1990;Swift et al, 1995), frequency scales also have been used Glasgow, McCaul, & Schafer, 1986). Our approach was selected to avoid the bias of respondent s trying to``average' ' a magnitude of barrier impact (patients) or to describe the``average' ' patient or patient group (educators).…”