Abstract
Purpose
This study assessed the psychometric properties of the Audit of Diabetes-Dependent Quality of Life (ADDQoL) modified for low-income, low-education, Spanish-speaking Puerto Ricans with type 2 diabetes residing in the northeastern United States.
Methods
Cross-sectional data from 226 patients were analyzed. Scale modifications included simplification of instructions, question wording and response format, and oral administration. Reliability was assessed with Cronbach’s alpha coefficient and internal structure by exploratory factor analysis. Criterion validity was assessed using correlation analysis and linear and logistic regression models assessing the association of the ADDQoL with standardized physical health status, mental health status, depression, and comorbidity indices.
Results
Two ADDQoL items were dropped. The modified scale had excellent internal consistency and supported the original scale factor structure. Criterion validity results supported the validity of this measure.
Conclusions
The modified ADDQoL showed psychometric properties that support its use in low-income, Spanish-speaking Puerto Ricans with type 2 diabetes who reside in mainland U.S.
References
Mainous, A. G., I. I. I., Baker, R., Koopman, R. J., Saxena, S., Diaz, V. A., Everett, C. J., et al. (2006). Impact of the population at risk of diabetes on projections of diabetes burden in the United States: An epidemic on the way. Diabetologia, 50(5), 934–940.
Brown, S. A., Becker, H. A., Garcia, A. A., Barton, S. A., & Hanis, C. L. (2002). Measuring health beliefs in Spanish-speaking Mexican Americans with type 2 diabetes: Adapting an existing instrument. Research in Nursing and Health, 25(2), 145–158.
Harris, M. I., Eastman, R. C., Cowie, C. C., Flegal, K. M., & Eberhardt, M. S. (1999). Racial and ethnic differences in glycemic control of adults with type 2 diabetes. Diabetes Care, 22(3), 403–408.
Lasater, L. M., Davidson, A. J., Steiner, J. F., Mehler, P. S. (2001). Glycemic control in English- vs Spanish-speaking Hispanic patients with type 2 diabetes mellitus. Archives of Internal Medicine, 161(1), 77–82.
Harris, M. I. (2001). Racial and ethnic differences in health care access and health outcomes for adults with type 2 diabetes. Diabetes Care, 24(3), 454–459.
Brown, S. A., Garcia, A. A., Kouzekanani, K., & Hanis, C. L. (2002). Culturally competent diabetes self-management education for Mexican Americans: The Starr County border health initiative. Diabetes Care, 25(2), 259–268.
Saydah, S., Cowie, C., Eberhardt, M. S., De Rekeneire, N., & Narayan, K. M. (2007). Race and ethnic differences in glycemic control among adults with diagnosed diabetes in the United States. Ethnicity and Disease, 17(3), 529–535.
Diehl, A. K., & Stern, M. P. (1989). Special health problems of Mexican Americans: Obesity, gallbladder disease, diabetes mellitus and cardiovascular disease. Advances in Internal Medicine, 34, 79–96.
Haffner, S. M., Fong, D., Stern, M. P., Pugh, J. A., Hazuda, H. P., Patterson, J. K., et al. (1988). Diabetic retinopathy in Mexican Americans and non-Hispanic whites. Diabetes, 37(7), 878–884.
Graham, J. E., Stoebner-May, D. G., Ostir, G. V., Al Snih, S., Peek, M. K., Markides, K., et al. (2007). Health related quality of life in older Mexican Americans with diabetes: A cross-sectional study. Health and Quality of Life Outcomes, 5, 39.
Corless, I. B., Nicholas, P. K., & Nokes, K. M. (2001). Issues in cross-cultural quality-of-life research. Journal of Nursing Scholarship, 33(1), 15–20.
Schmidt, S., & Bullinger, M. (2003). Current issues in cross-cultural quality of life instrument development. Archives of Physical Medicine and Rehabilitation, 84(4 Suppl 2), S29–S34.
U.S. Census Bureau. (2006). 2006 American community survey (ACS). http://www.census.gov/hhes/www/disability/2006acs.html. Accessed 4 May 2010.
Sobralske, M. (2006). Machismo sustains health and illness beliefs of Mexican American men. Journal of the American Academy of Nurse Practitioners, 18(8), 348–350.
Tann, S. S. (2005). Implications for quality of life research in Latino populations. Journal of Transcultural Nursing, 16(2), 136–141.
Caban, A., & Walker, E. A. (2006). A systematic review of research on culturally relevant issues for Hispanics with diabetes. The Diabetes Educator, 32(4), 584–595.
Stettler, N. (2006). Disparities in the epidemiology of obesity and related cardiovascular risk factors. Atlanta, GA: Health Disparities in Cardio-Metabolic Disease: Addressing the Epidemic.
Jerant, A., Arellanes, R., & Franks, P. (2008). Health status among US Hispanics: Ethnic variation, nativity, and language moderation. Medical Care, 46(7), 709–717.
National Institute of Diabetes and Digestive and Kidney Diseases, National Diabetes Information Clearinghouse (NDIC). National diabetes statistics. http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.htm. Accessed 22 April 2010.
Bradley, C., Todd, C., Gorton, T., Symonds, E., Martin, A., & Plowright, R. (1999). The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: The ADDQoL. Quality of Life Research, 8(1–2), 79–91.
Bradley, C., & Speight, J. (2002). Patient perceptions of diabetes and diabetes therapy: Assessing quality of life. Diabetes Metabolism Research and Reviews, 18(Suppl 3), S64–S69.
Jenkinson, C., Layte, R., Jenkinson, D., Lawrence, K., Petersen, S., Paice, C., et al. (1997). A shorter form health survey: Can the SF-12 replicate results from the SF-36 in longitudinal studies? Journal of Public Health Medicine, 19(2), 179–186.
Ware, J. E., Kosinski, M., & Keller, S. D. (1995). SF-12: How to score the SF-12 physical and mental health summary scales (2nd ed.). Boston, MA: The Health Institute, New England Medical Center.
Rosal, M. C., White, M. J., Restrepo, A., Olendzki, B., Scavron, J., Sinagra, E., et al. (2009). Design and methods for a randomized clinical trial of a diabetes self-management intervention for low-income Latinos: Latinos en Control. BMC Medical Research Methodology, 9, 81.
Rosal, M. C., Carbone, E. T., & Goins, K. V. (2003). Use of cognitive interviewing to adapt measurement instruments for low-literate Hispanics. The Diabetes Educator, 29(6), 1006–1017.
Rosal, M. C., Olendzki, B., Reed, G. W., Gumieniak, O., Scavron, J., & Ockene, I. S. (2005). Diabetes self-management among low-income Spanish speaking patients: A pilot study. Annals of Behavioral Medicine, 29(3), 225–235.
Sawyer-Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.
Radloff, L. S (1977). Center for Epidemiologic Studies Depression Scale (CES-D). http://www.measurementexperts.org/mei_compendium.asp?detail=12. Accessed 3 May 2010.
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383.
Deyo, R. A., Cherkin, D. C., & Ciol, M. A. (1992). Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology, 45(6), 613–619.
Peek, M. E., Cargill, A., & Huang, E. S. (2007). Diabetes health disparities: A systematic review of health care interventions. Medical Care Research and Review, 64(5 Suppl), 101S–156S.
Sundaram, M., Kavookjian, J., Patrick, J. H., Miller, L. A., Madhavan, S. S., & Scott, V. G. (2007). Quality of life, health status and clinical outcomes in Type 2 diabetes patients. Quality of Life Research, 16(2), 165–177.
Acknowledgments
This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases grant No. 5 R18 DK065985 to Dr. Milagros Rosal. We thank Dr. Clare Bradley, Professor of Health Psychology and Director of Health Psychology Research Ltd at the University of London for her thoughtful review of the manuscript. The ADDQoL can be obtained via the following website: www.healthpsychologyresearch.com.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lemon, S.C., Rosal, M.C. & Welch, G. Measuring quality of life in low-income, Spanish-speaking Puerto Ricans with type 2 diabetes residing in the mainland U.S.. Qual Life Res 20, 1507–1511 (2011). https://doi.org/10.1007/s11136-011-9871-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-011-9871-1