Assessing the reliability and validity of the Slovenian version of the Appraisal of Diabetes Scale (ADS-S) in type 2 diabetes patients

Matic Mihevc; Špela Miroševič; Majda Mori Lukančič; Tina Virtič Potočnik; Črt Zavrnik; Marija Petek Šter; Zalika Klemenc-Ketiš; Antonija Poplas Susič

doi:10.1371/journal.pone.0300797

Assessing the reliability and validity of the Slovenian version of the Appraisal of Diabetes Scale (ADS-S) in type 2 diabetes patients

PLoS One. 2024 Mar 25;19(3):e0300797. doi: 10.1371/journal.pone.0300797. eCollection 2024.

Authors

Matic Mihevc^{1

2}, Špela Miroševič², Majda Mori Lukančič¹, Tina Virtič Potočnik^{1

3}, Črt Zavrnik^{1

2}, Marija Petek Šter², Zalika Klemenc-Ketiš^{1

3}, Antonija Poplas Susič^{1

2}

Affiliations

¹ Primary Healthcare Research and Development Institute, Community Health Centre Ljubljana, Ljubljana, Slovenia.
² Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
³ Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia.

Abstract

Managing type 2 diabetes (T2D) effectively is a considerable challenge. The Appraisal of Diabetes Scale (ADS) has proven valuable in understanding how individuals perceive and cope with their condition. This study aimed to evaluate the psychometric properties of the Slovenian version of ADS (ADS-S). We recruited a sample of 400 adult individuals with T2D from three primary healthcare centers in Slovenia, ensuring an average of 57 cases per individual item. The psychometric evaluation included internal consistency, test-retest reliability, construct validity, and discriminant validity. Confirmatory factor analysis (CFA) was additionally performed to evaluate the fit of one- and two-factor models. After excluding incomplete questionnaires, 389 individuals participated, averaging 72.0±7.5 years, with 196 men and 193 women. ADS-S exhibited acceptable internal consistency (Cronbach's α = 0.70) and strong test-retest reliability (interclass correlation = 0.88, p <0.001). Criterion validity was established through significant correlations between ADS-S score and EQ-5D utility score (r = -0.34, p <0.001), EQ-VAS score (r = -0.38, p <0.001), and HbA1c >7.5% (r = 0.22, p = 0.019). Discriminant validity assessment found no significant correlation between ADS-S score and age, but a significant correlation with female gender (r = 0.17, p = 0.001). CFA results supported a two-factor structure (psychological impact of diabetes and sense of self-control) over a one-factor structure, as indicated by model fit indicators. ADS-S stands as a valid and reliable tool for assessing psychological impact and self-control in Slovenian T2D patients. Future research should explore adding items for capturing secondary appraisal of diabetes and studying the influence of female gender on ADS scores.

Copyright: © 2024 Mihevc et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Adult
Diabetes Mellitus, Type 2* / diagnosis
Female
Humans
Male
Patients
Psychometrics / methods
Reproducibility of Results
Surveys and Questionnaires

Grants and funding

The research is financially supported by the SCUBY project, an international research initiative co-financed by the European Union through the H2020 - Health Program (H2020-SC1) and identified by contract number 825432 - SCUBY. SM acknowledges support from the Slovenian Research Agency ARIS (program P3-0339). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.