EXPLORING DIABETES SYMPTOMS: REVISION OF THE DIABETES SYMPTOM SELF-CARE INVENTORY Items focus on diabetes-related symptoms and their management. …
EXPLORING DIABETES SYMPTOMS:
REVISION OF THE DIABETES SYMPTOM SELF-CARE INVENTORY
Alexandra A Garcia, PhD, RN
School of Nursing, The University of Texas at Austin
Purpose: Mexican Americans are two to five times more likely than non-
Hispanic Whites to have diabetes and suffer its consequences Intensive
self-management, starting with symptom management, effectively prevents and
minimizes diabetes complications A culturally relevant, reliable and valid
measurement of diabetes symptoms is needed to improve diabetes self-
management education and Mexican American patients diabetes control and
quality of life
The purpose of this study was to revise and pilot test the
Diabetes Symptom Self-Care Inventory DSSCI, the only known questionnaire
developed for use with Mexican Americans Specifically the study 1
explores Mexican Americans perceptions of symptoms related to diabetes,
symptom seriousness, and significance; 2 describes Mexican Americans
perceptions of appropriate actions and treatments for diabetes symptoms; 3
examines the test-retest reliability of the revised DSSCI; and 4 examines
the
construct validity of the revised DSSCI The revised DSSCI will be used
as a pre- and post-test measure of diabetes symptoms in a future community-
based intervention aimed at helping Mexican Americans address their
diabetes symptoms effectively
Methods: The study was conducted in three Phases In Phase I n 45
seven focus groups were conducted to explore symptom experience and these
data were used to inform revisions to the DSSCI that include a more
culturally targeted symptom list and response format In Phase II n16
cognitive interviews were used to explore the thought processes
participants use to understand and answer the questionnaire items leading
to improvements in phrasing and response format In Phase III anticipated
n80 the revised DSSCI was administered on two occasions and with
established questionnaires CES-D, ADDQoL, IPQ-R to examine preliminary
evidence for test-retest reliability and convergent validity
Findings: In Phase I, participants described a variety of conventional
symptoms and unique body cues they used to evaluate their diabetes status
and guide treatments Their responses were used to revise the DSSCI items
In Phase II, cognitive interviews revealed
difficulties with item wording,
response choices, and format Revisions were made in three rounds The
final version includes changes in format and items The instrument is now
in the form of an interview guide DSSC-IG to be administered in one-on-
one interviews Items focus on diabetes-related symptoms and their
management In Phase III still underway as of 12/16/05 the DSSC-IG has
been administered to 55 participants and retested in 25 with interviews
lasting approximately 15 minutes When data collection is complete the
researcher will evaluate test-retest and inter-rater reliability and
construct validity with measures of quality of life, illness perception,
and depression These results will be included in the poster
Conclusions: Focus groups and cognitive interviewing are effective means
of eliciting the emic perspective to guide instrument development
Preliminary evidence suggests the DSSC-IG is an easy to administer measure
of diabetes symptoms and treatments Participants have commented that the
DSSCI-IG is easily understandable
Acknowledgement: This study was funded by the Center for Health Promotion
Research, NINR/NIH 5 P30 NR005051
