Assessing psychosocial distress in diabetes

Development of the Diabetes Distress Scale

William H. Polonsky, Lawrence Fisher, Jay Edward Earles, R. James Dudl, Joel Lees, Joseph Mullan, Richard A. Jackson

Research output: Contribution to journalArticle

497 Citations (Scopus)

Abstract

OBJECTIVE - The purpose of this study was to describe the development of the Diabetes Distress Scale (DDS), a new instrument for the assessment of diabetes-related emotional distress, based on four independent patient samples. RESEARCH DESIGN AND METHODS - In consultation with patients and professionals from multiple disciplines, a preliminary scale of 28 items was developed, based a priori on four distress-related domains: emotional burden subscale, physician-related distress subscale, regimen-related distress subscale, and diabetes-related interpersonal distress. The new instrument was included in a larger battery of questionnaires used in diabetes studies at four diverse sites: waiting room at a primary care clinic (n = 200), waiting room at a diabetes specialty clinic (n = 179), a diabetes management study program (n = 167), and an ongoing diabetes management program (n = 158). RESULTS - Exploratory factor analyses revealed four factors consistent across sites (involving 17 of the 28 items) that matched the critical content domains identified earlier. The correlation between the 28-item and 17-item scales was very high (r = 0.99). The mean correlation between the 17-item total score (DDS) and the four subscales was high (r = 0.82), but the pattern of interscale correlations suggested that the subscales, although not totally independent, tapped into relatively different areas of diabetes-related distress. Internal reliability of the DDS and the four subscales was adequate (α > 0.87), and validity coefficients yielded significant linkages with the Center for Epidemiological Studies Depression Scale, meal planning, exercise, and total cholesterol. Insulin users evidenced the highest mean DDS total scores, whereas diet-controlled subjects displayed the lowest scores (P < 0.001). CONCLUSIONS - The DDS has a consistent, generalizable factor structure and good internal reliability and validity across four different clinical sites. The new instrument may serve as a valuable measure of diabetes-related emotional distress for use in research and clinical practice.

Original languageEnglish (US)
Pages (from-to)626-631
Number of pages6
JournalDiabetes Care
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2005

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Reproducibility of Results
Statistical Factor Analysis
Meals
Epidemiologic Studies
Primary Health Care
Research Design
Referral and Consultation
Cholesterol
Exercise
Insulin
Diet
Physicians
Research
Surveys and Questionnaires

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Polonsky, W. H., Fisher, L., Earles, J. E., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes: Development of the Diabetes Distress Scale. Diabetes Care, 28(3), 626-631. https://doi.org/10.2337/diacare.28.3.626

Assessing psychosocial distress in diabetes : Development of the Diabetes Distress Scale. / Polonsky, William H.; Fisher, Lawrence; Earles, Jay Edward; Dudl, R. James; Lees, Joel; Mullan, Joseph; Jackson, Richard A.

In: Diabetes Care, Vol. 28, No. 3, 01.03.2005, p. 626-631.

Research output: Contribution to journalArticle

Polonsky, WH, Fisher, L, Earles, JE, Dudl, RJ, Lees, J, Mullan, J & Jackson, RA 2005, 'Assessing psychosocial distress in diabetes: Development of the Diabetes Distress Scale', Diabetes Care, vol. 28, no. 3, pp. 626-631. https://doi.org/10.2337/diacare.28.3.626
Polonsky WH, Fisher L, Earles JE, Dudl RJ, Lees J, Mullan J et al. Assessing psychosocial distress in diabetes: Development of the Diabetes Distress Scale. Diabetes Care. 2005 Mar 1;28(3):626-631. https://doi.org/10.2337/diacare.28.3.626
Polonsky, William H. ; Fisher, Lawrence ; Earles, Jay Edward ; Dudl, R. James ; Lees, Joel ; Mullan, Joseph ; Jackson, Richard A. / Assessing psychosocial distress in diabetes : Development of the Diabetes Distress Scale. In: Diabetes Care. 2005 ; Vol. 28, No. 3. pp. 626-631.
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