VALIDATION OF A DIABETES-SPECIFIC QUALITY-OF-LIFE SCALE FOR PATIENTS WITH TYPE-1 DIABETES

OBJECTIVE - To validate a diabetes-specific quality-of-life scale and to assess its psychometric properties in a large sample of patients wi th type 1 diabetes. RESEARCH DESIGN AND METHODS - To assess the qualit y of diabetes care in a population-based study, a representative sampl e of 684 patients with type 1 diabetes was examined. A total of 657 pa tients (42% female; mean age 36 years; mean diabetes duration 18 years ) completed the diabetes-specific quality-of-life scale (DSQOLS), whic h comprised 64 items on individual treatment goals (10 items), satisfa ction with treatment success (10 items), and diabetes-related distress (44 items). Statistical examinations covered factor analysis, interna l consistency of subscales, and construct and discriminant validity. R ESULTS - Factor analysis of the 44 items on diabetes-specific burdens revealed six reliable components (Cronbach's alpha): social relations (0.88), physical complaints (0.84), worries about future (0.84), leisu re time flexibility (0.85), diet restrictions (0.71), and daily hassle s (0.70). All six subscales were significantly correlated with a valid ated well-being scale (r = -0.35 to -0.53, P < 0.001) and treatment sa tisfaction (r = 0.28 to 0.43, P < 0.001). Physical complaints (r = 0.2 4) and worries about future (r = 0.17) showed the highest correlations with HbA(1c) (P < 0.001). A flexible insulin therapy a liberalized di et, the absence of late complications, and a higher social status were significantly associated with more favorable scores in different doma ins. CONCLUSIONS - The DSQOLS is a reliable and valid measure of diabe tes-specific quality of life. The scale is able to distinguish between patients with different treatment and dietary regimens and to detect social inequities. Use of the DSQOLS for assessment of individual trea tment goals as defined by the patients may be helpful to identify moti vational deficits and to tailor individual treatment strategies.