Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison
Ka. Meadows et al., Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison, DIABET MED, 17(8), 2000, pp. 572-580
Aims To adapt the Diabetes Health Profile (DHP-1) for use with English spea
king patients with Type 2 diabetes mellitus and to evaluate the psychometri
c properties of the adapted measure in a UK; and Danish sample of insulin,
tablet and diet-treated patients with Type 2 diabetes.
Methods Following linguistic adaptation using the forward-backward translat
ion procedure, the 32-item DHP-1 was sent to 650 and 800 consecutively sele
cted UK and Danish patients with Type 2 diabetes. Construct validity was as
sessed using principal axis factoring. Factor stability was assessed across
language groups using the coefficient of congruence. Reliability was evalu
ated using Cronbach's alpha and multi-trait analysis, including item conver
gent/discriminant validity. Subscale discriminant validity was assessed thr
ough known groups with one-way ANOVA and post hoc Scheffe tests for multipl
e comparisons.
Results Eighteen items (56.25%) were retained following initial item analys
is. A three-factor solution accounting for 45.6% and 40.3% of the total exp
lained variance was identified in the UK and Danish samples, respectively.
Factors were interpreted as psychological distress (PD), barriers to activi
ty (BA and disinhibited eating (DE). Factor congruence between language gro
ups ranged from 0.98 to 0.99 and Cronbach's alpha ranged between 0.70 and 0
.88. Item scaling success for both language versions was 88.9%. BA scores d
iscriminated between treatment groups in both language groups (F = 24.24, P
< 0.001; F = 7.68, P < 0.001) and PD scores in the UK sample (F = 20.97, P
< 0.001).
Conclusions The DHP-18 developed for use with patients with Type 2 diabetes
has been shown to have satisfactory internal reliability and validity and
measurement equivalence across language groups.