Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2012

Open Access 01-12-2012 | Research

Psychometric properties of the Greek Diabetes Treatment Satisfaction Questionnaire

Authors: Nick Kontodimopoulos, Eleni Arvanitaki, Vassilis H Aletras, Dimitris Niakas

Published in: Health and Quality of Life Outcomes | Issue 1/2012

Login to get access

Abstract

Objectives

Measurement of treatment satisfaction in diabetes is important as it has been shown to be associated with positive outcomes, reduced disease cost and better health. The aim of this study was to assess the construct validity and internal consistency reliability of the Greek version of the Diabetes Treatment Satisfaction Questionnaire (DTSQ).

Methods

A sample of type II diabetes patients (N = 172) completed the DTSQ status version, the SF-36 health survey and also provided data regarding treatment method, clinical and socio-demographic status. Instrument structure, reliability (Cronbach's a) and construct validity (convergent, discriminative, concurrent and known-groups) were assessed.

Results

The DTSQ measurement properties were confirmed in the Greek version with confirmatory factor analysis (CFA). Scale reliability was high (Cronbach's a = 0.92). Item-scale internal consistency and discriminant validity were also good, exceeding the designated success criteria. Significant correlations were observed between DTSQ items/overall score and SF-36 scales/component scores, which were hypothesized to measure similar dimensions. Known groups' comparisons yielded consistent support of the construct validity of the instrument.

Conclusions

The instrument was well-accepted by the patients and its psychometric properties were similar to those reported in validation studies of other language versions. Further research, incorporating a longitudinal study design, is required for examining test-retest reliability and responsiveness of the instrument, which were not addressed in this study. Overall, the present results confirm that the DTSQ status version is a reasonable choice for measuring diabetes treatment satisfaction in Greece.
Literature
1.
Wild S, Roglic G, Green A, Sicree R, King H: Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004, 27: 1047–53. 10.2337/diacare.27.5.1047CrossRefPubMed
2.
Stumvoll M, Goldstein BJ, van Haeften TW: Type 2 diabetes: Principles of pathogenesis and therapy. Lancet 2005, 365: 1333–46. 10.1016/S0140-6736(05)61032-XCrossRefPubMed
3.
Massi-Benedetti M: The cost of Diabetes Type II in Europe. The CODE-2 Study. Diabetologia 2002, 4: S1-S4.CrossRef
4.
Rose M, Burkert U, Scholler G, Schirop T, Danzer G, Klapp BF: Determinants of quality of life of patients with diabetes under intensified insulin therapy. Diabetes Care 1998, 21: 1876–85. 10.2337/diacare.21.11.1876CrossRefPubMed
5.
Holmes J, McGill S, Kind P, Bottomley J, Gillam S, Murphy M: Health-related quality of life in type 2 diabetes (TARDIS-2). Value Health 2000, 3(Suppl 1):47–51.CrossRefPubMed
6.
Watkins K, Connell CM: Measurement of health-related QOL in diabetes mellitus. Pharmacoeconomics 2004, 22: 1109–26. 10.2165/00019053-200422170-00002CrossRefPubMed
7.
Weaver M, Patrick DL, Markson LE, Martin D, Frederic I, Berger M: Issues in the measurement of satisfaction with treatment. Am J Manag Care 1997, 3: 579–94.PubMed
8.
Albrecht G, Hoogstraten J: Satisfaction as determination of compliance. Community Dent Oral Epidemiol 1998, 26: 139–46. 10.1111/j.1600-0528.1998.tb01940.xCrossRefPubMed
9.
McCormick D, Himmelstein DU, Woolhandler S, Wolfe SM, Bor DH: Relationship between low quality-of-care scores and HMO's subsequent public disclosure of quality-of-care scores. J Am Med Assoc 2002, 288: 1484–90. 10.1001/jama.288.12.1484CrossRef
10.
Finkel MI: The importance of measuring patient satisfaction. Empl Benefits J 1997, 22: 12–15.PubMed
11.
Redekop WK, Koopmanschap MA, Stolk RP, Rutten GE, Wolffenbuttel BH, Niessen LW: Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes. Diabetes Care 2002, 25: 458–63. 10.2337/diacare.25.3.458CrossRefPubMed
12.
Menzin J, Langley-Hawthorne C, Friedman M, Boulanger L, Cavanaugh R: Potential short-term economic benefits of improved glycemic control: a managed care perspective. Diabetes Care 2001, 24: 51–55. 10.2337/diacare.24.1.51CrossRefPubMed
13.
Hogan P, Dall T, Nikolov P, American Diabetes Association: Economic costs of diabetes in the U.S. in 2002. Diabetes Care 2003, 26: 917–32.CrossRefPubMed
14.
Selby JV, Ray GT, Zhang D, Colby CJ: Excess costs of medical care for patients with diabetes in a managed care population. Diabetes Care 1997, 20: 1396–402. 10.2337/diacare.20.9.1396CrossRefPubMed
15.
Nicolucci A, Cucinotta D, Squatrito S, Lapolla A, Musacchio N, Leotta S, Vitali L, Bulotta A, Nicoziani P, Coronel G, QuoLITy Study Group: Clinical and socio-economic correlates of quality of life and treatment satisfaction in patients with type 2 diabetes. Nutr Metab Cardiovasc Dis 2009, 19: 45–53. 10.1016/j.numecd.2007.12.005CrossRefPubMed
16.
Pala T, Eser E, Ozmen B, Aydemir O, Boyvoda S: The determinants of quality of life including treatment satisfaction in patients with type two diabetes mellitus: are different generic Qol instruments sensitive to the same determinants? Turkish J Endocrinol Metabol 2004, 3: 91–99.
17.
Bradley C, Lewis KS: Measures of psychological well-being and treatment satisfaction developed from the responses of people with tablet-treated diabetes. Diabet Med 1990, 7: 445–51. 10.1111/j.1464-5491.1990.tb01421.xCrossRefPubMed
18.
Bradley C: The Diabetes Treatment Satisfaction Questionnaire: DTSQ. In Handbook of Psychology and Diabetes: a guide to psychological measurement in diabetes research and practice. Edited by: Bradley C. Chur, Switzerland: Harwood Academic; 1994.
19.
Bradley C, Gamsu DS: Guidelines for encouraging psychological well-being: Report of a working group of the World Health Organisation Regional Office for Europe and International Diabetes Federation European Region St. Vincent Declaration Action Programme for Diabetes. Diabet Med 1994, 11: 510–6.PubMed
20.
Saatci E, Tahmiscioglu G, Bozdemir N, Akpinar E, Ozcan S, Kurdak H: The well-being and treatment satisfaction of diabetic patients in primary care. Health Qual Life Outcomes 2010, 8: 67. 10.1186/1477-7525-8-67PubMedCentralCrossRefPubMed
21.
DAFNE Study Group: Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: the dose adjustment for normal eating (DAFNE) randomized controlled trial. BMJ 2002, 325: 746–9. 10.1136/bmj.325.7367.746PubMedCentralCrossRef
22.
Witthaus E, Stewart J, Bradley C: Improved psychological outcomes after initiation of insulin treatment in patients with Type II diabetes. Diabetologia 2000, 43(suppl 1):A205.
23.
Witthaus E, Stewart J, Bradley C: Treatment satisfaction and psychological well-being with insulin glargine compared with NPH in patients with Type 1 diabetes. Diabet Med 2001, 18: 619–25. 10.1046/j.1464-5491.2001.00529.xCrossRefPubMed
24.
Howorka K, Pumprla J, Schlusche C, Wagner-Nosiska D, Schabmann A, Bradley C: Dealing with ceiling baseline treatment satisfaction level in patients with diabetes under flexible, functional insulin treatment: assessment of improvements in treatment satisfaction with a new insulin analogue. Qual Life Res 2000, 9: 915–30. 10.1023/A:1008921419108CrossRefPubMed
25.
Acquadro C, Conway K, Girourdet C, Mear I: Linguistic validation manual for patient-reported outcomes (PRO) instruments. Lyon, France: MAPI Research Trust; 2004.
26.
Ware JE, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36). Conceptual framework and item selection. Med Care 1992, 30: 473–483. 10.1097/00005650-199206000-00002CrossRefPubMed
27.
Ware JE, Snow KK, Kosinski M, Gandek B: SF-36 Health survey manual and interpretation guide. Boston, MA: The Health Institute; 1993.
28.
Ware JE, Kosinski M, Keller SD: SF-36 physical and mental health summary scales: A user's manual. Boston MA: The Health Institute; 1994.
29.
Pappa E, Kontodimopoulos N, Niakas D: Validating and norming of the Greek SF-36 Health Survey. Qual Life Res 2005, 14: 1433–38. 10.1007/s11136-004-6014-yCrossRefPubMed
30.
Anagnostopoulos F, Niakas D, Pappa E: Construct validation of the Greek SF-36 Health Survey. Qual Life Res 2005, 14: 1959–65. 10.1007/s11136-005-3866-8CrossRefPubMed
31.
Alonso J, Ferrer M, Gandek B, Ware JE Jr, Aaronson NK, Mosconi P, Rasmussen NK, Bullinger M, Fukuhara S, Kaasa S, Leplège A, IQOLA Project Group: Health-related quality of life associated with chronic conditions in eight countries: Results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 2004, 13: 283–98.CrossRefPubMed
32.
Papadopoulos AA, Kontodimopoulos N, Frydas A, Ikonomakis E, Niakas D: Predictors of health-related quality of life in type II diabetic patients in Greece. BMC Public Health 2007, 7: 186. 10.1186/1471-2458-7-186PubMedCentralCrossRefPubMed
33.
Papadopoulos AA, Kontodimopoulos Ν, Niakas D: Health related quality of life in type II diabetes patients: Assessing socio-demographic and clinical variables. In Health-Related Quality of Life. Edited by: Hoffmann EC. New York: Nova Science; 2009.
34.
Nunnaly JC, Bernstein IR: Psychometric Theory. 3rd edition. New York: McGraw-Hill; 1994.
35.
Brown TA: Confirmatory factor analysis for applied research. New York: Guilford Press; 2006.
36.
Ware JE, Gandek B: Methods for testing data quality, scaling assumptions and reliability: The IQOLA Project Approach. J Clin Epidemiol 1998, 51: 945–52. 10.1016/S0895-4356(98)00085-7CrossRefPubMed
37.
Westaway MS, Rheeder P, Van Zyl DG, Seager JR: Interpersonal and organizational dimensions of patient satisfaction: the moderating effects of health status. Int J Qual Health Care 2003, 15: 337–44. 10.1093/intqhc/mzg042CrossRefPubMed
38.
Biderman A, Noff E, Harris SB, Friedman N, Levy A: Treatment satisfaction of diabetic patients: what are the contributing factors? Fam Pract 2009, 26: 102–8. 10.1093/fampra/cmp007CrossRefPubMed
39.
Jonsson PM, Sterky G, Gafvals C, Ostman J: Gender equity in health care: the case of Swedish diabetes care. Health Care Women Int 2000, 21: 413–31. 10.1080/07399330050082245CrossRefPubMed
40.
Greenfield S, Kaplan SH, Kahn R, Ninomiya J, Griffith JL: Profiling care provided by different groups of physicians: effects of patient case-mix (bias) and physician-level clustering on quality assessment results. Ann Intern Med 2002, 136: 111–21.CrossRefPubMed
41.
Özmen B, Eser E, Özkaya Kafesçiler S, Pala T, Güçlü F, Hekimsoy Z: Psychometric properties and responsiveness of the Turkish version of the Diabetes Treatment Satisfaction Questionnaire(s) on a sample of diabetics of three consecutive monitoring periods. Acta Diabetol 2010, 47(Suppl 1):123–31.CrossRefPubMed
42.
Browne MW, Cudeck R: Alternative ways of assessing model fit. In Testing Structural Equation Models. Edited by: Bollen KA, Long JS. Beverly Hills, CA: Sage; 1993.
43.
Kontodimopoulos N, Pappa E, Chadjiapostolou Z, Arvanitaki E, Papadopoulos AA, Niakas D: Comparing the sensitivity of EQ-5D, SF-6D and 15D utilities to the specific effect of diabetic complications. Eur J Health Econ 2012, 13: 111–20. 10.1007/s10198-010-0290-yCrossRefPubMed
44.
Chin MH, Zhang JX, Merrell K: Specialty differences in the care of older patients with diabetes. Med Care 2000, 38: 131–40. 10.1097/00005650-200002000-00003CrossRefPubMed
45.
Niakas D, Gnardellis C, Theodorou M: Is there a problem with quality in the Greek hospital sector? Preliminary results from a a patient satisfaction survey. Health Serv Manag Res 2004, 17: 62–9. 10.1258/095148404322772741CrossRef
46.
Bradley C, Speight J: Patient perceptions of diabetes and diabetes therapy: assessing quality of life. Diabetes Metab Res Rev 2002, 18(Suppl 3):S64–9.CrossRefPubMed
47.
Pouwer F, Snoek FJ, Heine RJ: Ceiling effect reduces the validity of the Diabetes Treatment Satisfaction Questionnaire (Letter). Diabetes Care 1998, 21: 2039.CrossRefPubMed
48.
Bradley C: Diabetes treatment satisfaction questionnaire. Change version for use alongside status version provides appropriate solution where ceiling effects occur. Diabetes Care 1999, 22: 530–2. 10.2337/diacare.22.3.530CrossRefPubMed
49.
Wredling R, Stålhammar J, Adamson U, Berne C, Larsson Y, Ostman J: Well-being and treatment satisfaction in adults with diabetes: a Swedish population-based study. Qual Life Res 1995, 4: 515–22. 10.1007/BF00634746CrossRefPubMed
50.
Westaway MS, Seager JR: The Diabetes Treatment Satisfaction Questionnaire: a cross-cultural South African perspective. Diabetes Care 2004, 27: 618. 10.2337/diacare.27.2.618CrossRefPubMed
51.
Nicolucci A, Giorgino R, Cucinotta D, Zoppini G, Muggeo M, Squatrito S, Corsi A, Lostia S, Pappalardo L, Benaduce E, Girelli A, Galeone F, Maldonato A, Perriello G, Pata P, Marra G, Coronel GA: Validation of the Italian version of the WHO-Well-Being Questionnaire (WHO-WBQ) and the WHO-Diabetes Treatment Satisfaction Questionnaire (WHO-DTSQ). Diabetes Nutr Metab 2004, 17: 235–43.PubMed
52.
Brod M, Cobden D, Lammert M, Bushnell D, Raskin P: Examining correlates of treatment satisfaction for injectable insulin in type 2 diabetes: lessons learned from a clinical trial comparing biphasic and basal analogues. Health Qual Life Outcomes 2007, 5: 8. 10.1186/1477-7525-5-8PubMedCentralCrossRefPubMed
53.
Petterson T, Lee P, Hollis S, Young B, Newton P, Dornan T: Well-being and treatment satisfaction in older people with diabetes. Diabetes Care 1998, 21: 930–5. 10.2337/diacare.21.6.930CrossRefPubMed
54.
Kapantais E, Tzotzas T, Ioannidis I, Mortoglou A, Bakatselos S, Kaklamanou M, Lanaras L, Kaklamanos I: First National Epidemiology study on the prevalence of obesity and abdominal fat distribution in Greek adults. Ann Nutr Metab 2006, 50: 330–38. 10.1159/000094296CrossRefPubMed
55.
Fallowfield L: The ideal consultation. Br J Hosp Med 1992, 47: 364–67.PubMed
56.
Zachariae R, Pedersen CG, Jensen AB, Ehrnrooth E, Rossen PB, von der Maase H: Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. Br J Cancer 2003, 88: 658–65. 10.1038/sj.bjc.6600798PubMedCentralCrossRefPubMed
Metadata
Title
Psychometric properties of the Greek Diabetes Treatment Satisfaction Questionnaire
Authors
Nick Kontodimopoulos
Eleni Arvanitaki
Vassilis H Aletras
Dimitris Niakas
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2012
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-10-17

Other articles of this Issue 1/2012

Health and Quality of Life Outcomes 1/2012 Go to the issue

Research

Parental stress when caring for a child with cancer in Jordan: a cross-sectional survey

Research

Peer support and improved quality of life among persons living with HIV on antiretroviral treatment: A randomised controlled trial from north-eastern Vietnam

Research

Validation of the Japanese version of the EORTC hepatocellular carcinoma-specific quality of life questionnaire module (QLQ-HCC18)

Research

Health-related quality of life in different clinical subgroups with typical AFL who have undergone cavo-tricuspid isthmus ablation

Research

Development of six PROMIS pediatrics proxy-report item banks

Research

Developing a new self-reported scale of oral health outcomes for 5-year-old children (SOHO-5)