title: Maximizing the value of validation findings to better understand treatment satisfaction issues for diabetes.
abstract: BACKGROUND
  Variables associated with treatment satisfaction (TS) can be broadly categorized as precursors, ongoing treatment issues, and treatment outcomes. This study continues the validation process for the Insulin Treatment Satisfaction Questionnaire (ITSQ) while examining relationships between TS and these broader influences.
  
  
  METHODS
  Data (N = 299) were collected in a RCT comparing safety and efficacy of inhaled vs. injectable insulin. Validation examined item and factor characteristics, reliability and validity. Regression analyses examined relationships between overall and domain specific TS and the broader influences.
  
  
  RESULTS
  Patients with less previous or current treatment burden had greater TS (p < 0.001). Gender, injection fear, functioning, age, compliance and glycemic control were differentially related to TS at the beginning and end of study. Baseline satisfaction was predictive of future TS (p < 0.001). When all significant factors were examined together, lower burden with the current treatment and higher satisfaction with previous treatment continued to be key (p < 0.001) while other factors were no longer significant. Validation findings confirmed the ITSQ was psychometrically sound.
  
  
  CONCLUSIONS
  Over the course of treatment, some factors are associated with TS at treatment start while others are key drivers at treatment end. This suggests that TS is not a static concept.
authors.affiliation: The BROD GROUP, 219 Julia Avenue, Mill Valley, CA 94941, USA. mbrod@thebrodgroup.net
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.forename: Torsten
authors.initials: T
authors.lastname: Christensen
authors.forename: Donald
authors.initials: D
authors.lastname: Bushnell
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D001315:Australia; D001786:Blood Glucose / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000295:instrumentation*; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin