Validation of a combined health literacy and numeracy instrument for patients with type 2 diabetes

Luo, Huabin; Patil, Shivajirao P.; Wu, Qiang; Bell, Ronny A.; Cummings, Doyle M.; Adams, Alyssa; Hambidge, Bertha; Craven, Kay; Gao, Fei

doi:10.1016/j.pec.2018.05.017

Cited by 12 publications

(19 citation statements)

References 24 publications

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“…cj (Persian version)[145]; T2DHPS (Turkish version)[146]; DHPSC ck (Chinese version)[147]; PDQ-11cl [148];C-PDQ cm[149] •PROMs that assess health-promoting lifestyle behaviours of patients with diabetes.•Examples of domains assessed include physical activity, risk reduction, stress management, health responsibility, enjoyment of life, and healthy diet.Health-promoting lifestyle behaviorsHealth Belief Measures[150]; Given Health Belief Instrument (Spanish version)[151]; Health Belief Model Scale (Turkish version)[152]; Diabetes Health Belief Measure[153] • PROMs that assess diabetes-specific health beliefs of patients.•Examples of domains assessed include perceived benefits of and barriers to treatment and perceived severity of and vulnerability to complications.Health beliefsDiabetes Questionnaire[154]; Diabetes Questionnaire (Spanish version)[154]; Diabetes Knowledge Questionnaire (Spanish version)[31]; DKQ-24 cn[153]; DMKT co[155]; PCSD-P cp[156]; Miller et al[157]; Miller and Edwards[158]; PDDC cq[159]; DRNK cr[160]; FCCHL cs (Norwegian version)[161];KHLS-DM ct[162]; HLS-K cu[163]; HLS/SNS cv[164]; Ashok et al 1[165]; Ashok et al 2[166]; HLS-EU-Q47 cw[167] • PROMs that assess the level of diabetes knowledge, whether in general or for specific areas of knowledge such as nutrition knowledge.•Examples of domains assessed include symptoms (eg, frequent hunger), causes and risk factors (eg, lack of physical activity), complications (eg, kidney failure), and management (eg, reduced consumption of rice). cx[79]; DTSQ (Greek version)[171]; DiabMedSat cy[172]; DTBQ cz[169]; ITEQ da[168]; IITQ db[170]; ITAS dc[173]; C-ITAS-HK...…”

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confidence: 99%

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

Wee¹,

Kwan²,

Loh³

et al. 2021

J Med Internet Res

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Background The management of diabetes is complex. There is growing recognition of the use of patient-reported outcome measures (PROMs) as a standardized method of obtaining an outlook on patients’ functional status and well-being. However, no systematic reviews have summarized the studies that investigate the measurement properties of diabetes PROMs. Objective Our aims were to conduct a systematic review of studies investigating the measurement properties of diabetes PROMs by evaluating the methodological quality and overall level of evidence of these PROMs and to categorize them based on the outcome measures assessed. Methods This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the Embase, PubMed, and PsychINFO databases. The PROMs were evaluated with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines. Results A total of 363 articles evaluating the measurement properties of PROMs for diabetes in the adult population were identified, of which 238 unique PROMs from 248 studies reported in 209 articles were validated in the type 2 diabetes population. PROMs with at least a moderate level of evidence for ≥5 of 9 measurement properties include the Chinese version of the Personal Diabetes Questionnaire (C-PDQ), Diabetes Self-Management Instrument Short Form (DSMI-20), and Insulin Treatment Appraisal Scale in Hong Kong primary care patients (C-ITAS-HK), of which the C-PDQ has a “sufficient (+)” rating for >4 measurement properties. A total of 43 PROMs meet the COSMIN guidelines for recommendation for use. Conclusions This study identified and synthesized evidence for the measurement properties of 238 unique PROMs for patients with type 2 diabetes and categorized the PROMs according to their outcome measures. These findings may assist clinicians and researchers in selecting appropriate high-quality PROMs for clinical practice and research. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020180978; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180978.

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confidence: 99%

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

Wee¹,

Kwan²,

Loh³

et al. 2021

J Med Internet Res

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“…Information provision was assessed by 9 (56%) scales:[ 41 – 43 , 45 , 47 , 50 – 53 ]. Comprehension of information was also assessed by 7 (44%) scales: [ 44 , 46 , 48 , 53 – 56 ]. Voluntariness was assessed by 5 scales (31%): [ 41 , 45 – 47 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…In terms of the content that is being assessed, no existing scales measure all three consent domains. Several scales measure two of the three domains [41,42,[45][46][47]53]. Moreover, the exact aspect of each domain tapped into by these measures were quite different.…”

Section: Discussionmentioning

confidence: 99%

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Adequacy of measures of informed consent in medical practice: A systematic review

et al. 2021

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As a critical component of medical practice, it is alarming that patient informed consent does not always reflect (1) adequate information provision, (2) comprehension of provided information, and (3) a voluntary decision. Consequences of poor informed consent include low patient satisfaction, compromised treatment adherence, and litigation against medical practitioners. To ensure a well-informed, well-comprehended, and voluntary consent process, the objective and replicable measurement of these domains via psychometrically sound self-report measures is critical. This systematic review aimed to evaluate the adequacy of existing measures in terms of the extent to which they assess the three domains of informed consent, are psychometrically sound and acceptable for use by patients. Extensive searching of multiple databases (PsychINFO, PubMed, Sociological Abstracts, CINAHL, AMED) yielded 10,000 potential studies, with 16 relevant scales identified. No existing scale was found to measure all three consent domains, with most only narrowly assessing aspects of any one domain. Information provision was the most frequently assessed domain, followed by comprehension, and then voluntariness. None of the identified scales were found to have adequate evidence for either high quality psychometric properties or patient user acceptability. No existing scale is fit for purpose in comprehensively assessing all domains of informed consent. In the absence of any existing measure meeting the necessary criteria relating to information, comprehension and voluntariness, there is an urgent need for a new measure of medical consent to be developed that is psychometrically sound, spans all three domains and is acceptable to patients and clinicians alike. These findings provide the impetus and justification for the redesign of the informed consent process, with the aim to provide a robust, reliable and replicable process that will in turn improve the quality of the patient experience and care provided.

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“…In the present study, the DHNT was moderately correlated with a criterion instrument measuring a subjective diabetes numeracy, as expected. The psychometrics study of Luo et al [42] measured the generic types of objective and subjective numeracy instruments using the Short Test of Functional health Literacy in AdultsÀmath test [43] and Self-Numeracy Scale-8 [44] in patients with type 2 diabetes, which revealed a weak correlation. In other words, the correlation was stronger when diabetesspecific health numeracy instruments were used than when using generic instruments.…”

Section: Discussionmentioning

confidence: 99%

A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties

Lee

et al. 2020

Asian Nursing Research

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a b s t r a c tPurpose: Patients with diabetes frequently need to perform certain numeric tasks such as interpreting blood glucose levels. However, there is no psychometrically sound instrument for objectively measuring diabetes-specific health numeracy. This study aimed to develop a new objective diabetes health numeracy test (DHNT) and evaluate its psychometric properties in adult patients with type 2 diabetes. Methods: An instrument development study was conducted. Initial items were evaluated by six experts for content validity. After a pilot test, a convenience sample of 257 participants with type 2 diabetes was recruited at 2 university hospitals from May to September 2018. The structural, convergent, and criteria validity, and internal consistency of the DHNT with binary item responses were evaluated. Data were analyzed using exploratory factor analysis, Rasch analysis, tetrachoric correlation, Spearman's correlation, and the KudereRichardson-20 formula. Results: Exploratory factor analysis yielded a single-factor solution comprising seven items. Rasch analysis confirmed that no item did not fit with the single factor and identified that the item difficulty parameters had moderate values. The convergent and criterion validity of the instrument were demonstrated, with diabetes knowledge and subjective diabetes numeracy, respectively, as was its acceptable internal consistency, by a KudereRichardson-20 coefficient of .81. Conclusion: The DHNT demonstrated satisfactory psychometric properties. The instrument with moderate levels of item difficulty may have a lower cognitive burden. The developed instrument can be applied in practice to tailor the education of diabetes self-management as per the levels of health numeracy of specific patients.

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Validation of a combined health literacy and numeracy instrument for patients with type 2 diabetes

Cited by 12 publications

References 24 publications

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review

Adequacy of measures of informed consent in medical practice: A systematic review

A New Objective Health Numeracy Test for Patients with Type 2 Diabetes: Development and Evaluation of Psychometric Properties

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