Validation and Cultural Adaptation of the Problem Areas in Diabetes-5 (PAID-5) Scale to European Portuguese

Cláudia Sofia Pereira; Luiz Miguel Santiago; Inês Rosendo Silva; Pedro Ferreira

doi:10.20344/amp.18995

Authors

Cláudia Pereira Faculdade de Medicina. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0001-9717-9454
Luiz Miguel Santiago Faculdade de Medicina. Universidade de Coimbra. Coimbra. & Centro de Estudos e Investigação em Saúde – CEISUC. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0002-9343-2827
Inês Rosendo Silva Faculdade de Medicina. Universidade de Coimbra. Coimbra. & Unidade de Saúde Familiar Coimbra Centro. Agrupamento de Centros de Saúde Baixo Mondego. Coimbra. https://orcid.org/0000-0001-8838-6021
Pedro Lopes Ferreira Centro de Estudos e Investigação em Saúde – CEISUC. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0002-9448-9542

DOI:

https://doi.org/10.20344/amp.18995

Keywords:

Diabetes Mellitus/psychology; Emotions; Portugal; Psychometrics; Surveys and Questionnaires

Abstract

Introduction: Diabetes distress syndrome (DDS) can lead to poor outcomes and should be assessed with adapted and validated tools. One of these tools is the Problem Areas in Diabetes (PAID) scale, which assesses diabetes distress in people suffering from diabetes (PsD). A short five-item form, PAID-5, is an easier and quicker alternative to be used in clinical and research practices, than the previous one with 20-items and has been validated by the original authors. This study intended to perform the cultural adaptation and validation of the PAID-5 scale in European Portuguese.
Methods: To create the Portuguese version of PAID-5, translation-back translation, a clinical review, and a cognitive debriefing panel were performed. A convenience sample of 90 PsD was studied in three primary healthcare units for reliability and validity tests. Reliability was studied by the internal consistency (Cronbach’s alpha) and the interval coefficient correlation (ICC) under a test-retest design. Structural validity was studied by principal component analysis. The construct validity was tested by the sensitivity of the PAID-5 total score with age, most recent HbA1c test, and socioeconomic class by the Socio-Economic Deprivation Index (SEDI). Criterion validity was tested by correlating the PAID-5 total score with the psychological distress questions of the Diabetes Health Profile 18 Questions (DHP-PDQ).
Results: A Cronbach’s alpha coefficient value of 0.905 and an ICC of 0.905 were computed. In a sample of n = 90 PsD, 55.6% were males, 63.3% aged 65 years or more, SEDI was 5.2 ± 0.8 [3 to 6], 44.4% studied for less than 4 years, and 18.9% were living alone. The Spearman correlation between PAID-5 and DHP-PDQ total scores was ρ = 0.382, p < 0.001, between PAID-5 total score and age was ρ = -0.207, p = 0.050 and between PAID-5 total score and most recent HbA1c knowledge was ρ = 0.275, p = 0.040. There was no significant relationship between PAID-5 total score and SEDI ρ = 0.080, p = 0.452.
Conclusion: DDS can now be assessed in the Portuguese context, accounting for better intervention by primary care teams. PAID-5 has good psychometric properties and is a reliable scale to identify diabetes-specific distress in the Portuguese diabetic population.

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Author Biography

Luiz Miguel Santiago, Faculdade de Medicina. Universidade de Coimbra. Coimbra. & Centro de Estudos e Investigação em Saúde – CEISUC. Universidade de Coimbra. Coimbra.

Licenciado em Medicina pela Universidade de Coimbra desde 1979, Mestre em Saúde Pública pela Universidade de Coimbra desde 2006 e Doutorado por unanimidade com distinção e louvor, pela Universidade de Coimbra, na Especialidade de Sociologia Médica, ramo de Medicina Preventiva e Comunitária desde 11/11/2009. É desde1/7/2017 Professor Associado da Faculdade de Medicina da Universidade de Coimbra, regendo as Unidades Curriculares de MISP IV, 3º Ano e de Medicina Geral e Familiar, 5º Ano. Médico, especialista em Medicina Geral e Familiar, é Consultor com o Grau de Assistente Graduado Sénior da Carreira de Medicina Geral e Familiar desde 2002, sendo orientador no Internato Complementar de Medicina Geral e Familiar desde 2006, tendo exercido na Unidade de Saúde Familiar Topázio em Coimbra, onde ainda continua actividade clínica, agora reduzida. Professor Associado Convidado da Universidade da Beira Interior, onde é regente das cadeiras de CSP I, II e III entre 2011 e 2017. Desde 2014 até 2017 foi Professor Adjunto Convidado da Coimbra Health Scholl lecionando Patologia Geral. Membro da Academia Europeia de Professores em Medicina Geral e Familiar (EURACT) é orientador de Teses de Mestrado Integrado e de Mestrado Pré-Bolonha bem como de Doutoramento, na Universidade de Coimbra (2) e na Universidade da Beira Interior (6). É membro da Comissão de Ética da ARS do Centro. Tem vasta bibliografia publicada individualmente e em co-autoria em revistas nacionais e internacionais com “revisores-par” e indexadas (27 artigos). Desde março de 2017 é membro investigador do CEISUC, FEUC. Em Novembro de 2017 é eleito sócio correspondente da Academia Nacional de Medicina. Aguarda a marcação de Provas de Agregação a serem prestadas na Universidade da Beira Interior.

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