Psychrometric Properties of the Arabic Version of the Problem Areas in Diabetes Scale in Primary Care

Hazem A Sayed Ahmed; Samar Farag Mohamed; Sally Fawzy Elotla; Mona Mostafa; Jaffer Shah; Ahmed Mahmoud Fouad

doi:10.3389/fpubh.2022.843164

Psychrometric Properties of the Arabic Version of the Problem Areas in Diabetes Scale in Primary Care

Front Public Health. 2022 Feb 25:10:843164. doi: 10.3389/fpubh.2022.843164. eCollection 2022.

Authors

Hazem A Sayed Ahmed¹, Samar Farag Mohamed¹, Sally Fawzy Elotla², Mona Mostafa³, Jaffer Shah⁴, Ahmed Mahmoud Fouad²

Affiliations

¹ Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
² Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
³ Department of Internal Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
⁴ Medical Research Center, Kateb University, Kabul, Afghanistan.

Abstract

Background: The Problem Areas in Diabetes (PAID) scale is a reliable and valid tool that is widely used for diabetes-distress screening, but the Arabic version of the scale lacks validity and reliability analysis in primary healthcare (PHC) patients. Our study aimed to evaluate the psychometric properties of the Arabic version of the PAID (AR-PAID) scale among Egyptian patients with type 2 diabetes mellitus (T2DM) in PHC settings.

Methods: We conducted a cross-sectional study on a convenience sample of 200 patients from six rural PHC settings in the Ismailia governorate. The confirmatory factor analysis (CFA) was performed to test the goodness-of-fit to the predefined models of the PAID. Convergent construct was evaluated through correlations with the Arabic versions of the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and 5-item World Health Organization Well-Being Index (WHO-5), additionally glycated hemoglobin (HbA1c) levels. Discriminant validity was evaluated through associations with patients' sociodemographic and clinical characteristics. Reliability was evaluated through internal consistency (Cronbach's α) and test-retest reliability analysis (intraclass correlation coefficient, ICC).

Results: The CFA demonstrated the best fit for a four-factor model. The AR-PAID was significantly correlated with the following measures: PHQ-9 (rho = 0.71, p < 0.001), GAD-7 (rho = 0.50, p < 0.001), WHO-5 (rho = -0.69, p < 0.001), and HbA1c (rho = 0.36, p < 0.001), supporting sound convergent validity. Discriminant validity was satisfactory demonstrated. Internal consistency was excellent (α = 0.96) and test-retest reliability was stable (ICC = 0.97).

Conclusions: The AR-PAID scale is a valid and reliable instrument for diabetes-distress screening in primary care patients with T2DM that can be used in clinical settings and research. Further research is needed to validate short forms of the AR-PAID scale.

Keywords: Arabic; PAID; diabetes-distress; primary healthcare; type 2 diabetes.

MeSH terms

Cross-Sectional Studies
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / diagnosis
Glycated Hemoglobin
Humans
Primary Health Care
Reproducibility of Results

Substances

Glycated Hemoglobin A