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The Problem Areas in Diabetes Scale: An evaluation of its clinical utility
Abstract
OBJECTIVE: To evaluate the reliability and concurrent and discriminant validity of the Problem Areas in Diabetes (PAID) scale, a new measure of emotional functioning in diabetes. RESEARCH DESIGN AND METHODS: A battery of questionnaires, including the PAID, was completed by 256 volunteer diabetic outpatients. In our analyses, we examined the PAID's internal structure and compared mean IDDM and NIDDM treatment group scores in regression analyses to explore its discriminant validity. We also evaluated concurrent validity from the correlations between the PAID and diabetes-specific measures of coping and health attitudes and HbA1c. RESULTS: Principal component analyses identified a large emotional adjustment factor, supporting the use of the total score. Significant sizable correlations were found between the PAID and a range of selected health attitudinal measures. There were significant differences (with small-to-moderate effect sizes) in PAID scores between IDDM and NIDDM patients and between IDDM and NIDDM insulin- and tablet-treated subgroups; no differences were found between NIDDM insulin- and tablet-treated subgroups. CONCLUSIONS: The study findings provided support for the construct validity of the PAID, including evidence for discriminant validity from its ability to detect differences between IDDM and NIDDM treatment groups expected to differ in the emotional impact of life with diabetes. Future studies should explore the PAID's performance in nonspecialist treatment settings as well as its responsiveness to clinical change.
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In the citing paper
“However, participants were experiencing severe diabetes distress (>40) (Welch et al., 1997).”
From An online acceptance, commitment, and self-compassion based treatment to decrease psychological distress in people with type 2 diabetes: A feasibility randomised-controlled trial (2023) · cites this paper as Welch et al., 1997
In the citing paper
“The original PAID Scale and the Swedish version of the scale (Swe-PAID-20), which will be used in this study, have been proven in terms of validity and reliability.25 32 33”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [33]
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Assessing Psychosocial Distress in Diabetes
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.626 · Cited by 1,575
“PAID scores have been linked to diabetes self-care behaviors (5,6) and glycemic control (2,5–9) and are associated with general emotional distress (5), perceived burden of diabetes (8), diabetes-related health beliefs (10), diabetes coping (10), and marital adjustment (11,12).”
BackgroundSelf-citationPeyrot, M., Rubin, R. R., Lauritzen, T., Snoek, F. J., Matthews, D. R., & Skovlund, S. E. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01644.x · Cited by 931
Feig, D. S., Donovan, L. E., Corcoy, R., Murphy, K. E., Amiel, S. A., Hunt, K. F., Asztalos, E., Barrett, J. F. R., Sanchez, J. J., de Leiva, A., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32400-5 · Cited by 803
Davies, M. J., Heller, S. R., Skinner, T. C., Campbell, M. J., Carey, M., Cradock, S., Dallosso, H. M., Daly, H., Doherty, Y., Eaton, S., et al. (2008) · BMJ · doi:10.1136/bmj.39474.922025.be · Cited by 761
Fisher, L., Mullan, J. T., Arean, P., Glasgow, R. E., Hessler, D., & Masharani, U. (2010) · Diabetes Care · doi:10.2337/dc09-1238 · Cited by 681
“, Problem Areas in Diabetes Scale [14] or Diabetes Distress Scale [15]).”
Background
Metadata
- Authors
- Welch, G. W., Jacobson, A. M., & Polonsky, W. H.
- Affiliations
- Mental Health Unit, Balboa Medical Center San Diego, California
- Joslin Diabetes Center (US)
- ORCID
- Polonsky, William H
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1997-05-01
- Volume
- 20
- Issue
- 5
- Pages
- 760-766
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2134365893
- Cited by
- 664
- References
- 0
- Citations by year
- 2026: 20 · 2025: 20 · 2024: 35 · 2023: 37 · 2022: 49 · 2021: 46 · 2020: 35 · 2019: 37 · 2018: 28 · 2017: 33 · 2016: 23 · 2015: 31 · 2014: 32 · 2013: 25 · 2012: 37
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01dk027845-14)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK27845, DK42315, R01DK042315)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Keywords
- Problem Areas in Diabetes scale, emotional adjustment, type 1 diabetes, type 2 diabetes, discriminant validity, concurrent validity, psychometric properties, coping, health attitudes, insulin-treated diabetes, HbA1c
- MeSH terms
- Adaptation, Psychological, Adult, Attitude to Health, Demography, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diet, Diabetic, Education, Emotions, Female, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Surveys and Questionnaires, Socioeconomic Factors, Reproducibility of Results, Discriminant Analysis
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