Item reduction and validation of the Chinese version of diabetes quality-of-life measure (DQOL)

Abstract

BackgroundThe Diabetes Quality-of-Life (DQOL) Measure is a 46-item diabetes-specific quality of life instrument. The original English version of the DQOL has been translated into Chinese after cultural adaption, and the Chinese DQOL has been validated in the Chinese diabetic patient population and used in diabetes-related studies. There are two recognized problems with the Chinese DQOL: 1) the instrument is too long, and 2) the non-response rate of certain items is relatively high. This study aimed to develop and validate a short version for the Chinese DQOL.MethodsItem reduction was conducted based on the classical test theory (CTT) and item response theory (IRT), each combined with exploratory factor analysis (EFA). The confirmatory factor analysis (CFA) and Spearman correlation coefficient were employed in validating the short versions.ResultsBoth the study sample (n = 2,886) and the validation sample (n = 2,286) were from a longitudinal observation study of Chinese type 2 diabetic patients. The CTT kept 32 items, and the IRT kept 24 items from the original 46-item version. The two short versions were comparable in psychometric properties.ConclusionThe 24-item IRT-based short version of the Chinese DQOL was selected as the preferred short version because it imposes a lower burden on patients without compromising the psychometric properties of the instrument.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-0905-z) contains supplementary material, which is available to authorized users.

Assessment of the psychometric properties and refinement of the Health and Self-Management in Diabetes Questionnaire (HASMID)

“…Both assessments were used, in conjunction with clinical opinion to inform the final selection of items. This approach has been used by others in PRO development [18,19]. There are benefits to considering alternative sources of evidence.…”

Cultural Adaptation and Psychometric Properties of the Diabetes Quality of Life Scale in Afaan Oromoo Among People Living With Type 2 Diabetes in Ethiopia

“…Diabetes-speci c tools are designed to measure the speci c content, disease condition, and target population [11][12][13]. Even though various forms of diabetes-speci c QOL measures are available, the diabetes quality of life (DQOL) scale provides a comprehensive assessment of the components of QOL among people living with diabetes in general; it has been widely used in different studies to measure QOL among people living with diabetes [14][15][16][17] and is sensitive to disease severity and lifestyle changes [18].…”

“…The DQOL has 46 items measuring four domains: satisfaction, impact, social/vocational worry and diabetes-related worry [19]. Subsequently, numerous shortened versions of the DQOL were produced in different languages [14,17,[20][21][22]. A 24-item Chinese version [17], a 44-item Brazilian DQOL version [21], an 8-item Brazilian brief version [20], a 45-item Turkish version [22], a 46-item Iranian version [23] and a 13-item Malay revised version were developed [14]; all showed acceptable validity and reliability.…”

“…Subsequently, numerous shortened versions of the DQOL were produced in different languages [14,17,[20][21][22]. A 24-item Chinese version [17], a 44-item Brazilian DQOL version [21], an 8-item Brazilian brief version [20], a 45-item Turkish version [22], a 46-item Iranian version [23] and a 13-item Malay revised version were developed [14]; all showed acceptable validity and reliability. Consistent with the original version of the DQOL, all the shortened versions of the DQOL have four domains, with one exception: the 13-item Malay revised version [14] measures three domains, namely satisfaction, impact, and worry.…”

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“…7 Nevertheless, this theory has its own shortcomings. 8 For example, it requires large sample sizes for model fitting. Considering that these two theories are applied based on different assumptions and statistical approaches, and both are characterized by shortcomings, it is necessary to combine the two theories to achieve complementary advantages.…”