title: Development and validation of the short version of the diabetes obstacles questionnaire (DOQ-30) in six European countries.
abstract: BACKGROUND
  Patients with type 2 diabetes reveal different obstacles in living with the disease. The EGPRN initiated a qualitative research EUROBSTACLE to create a broadly conceptualized diabetes-related quality of life (DR-QoL) instrument. It led to the development of the diabetes obstacle questionnaire (DOQ), a five-point Likert-scaled measure, consisting of 78 items in eight scales.
  
  
  OBJECTIVE
  To develop and validate a short, easy-to-use version of the DOQ.
  
  
  METHODS
  A cross-sectional study with the DOQ was carried out. Participants answered the DOQ and GPs added some clinical data from their medical records. Data of 853 patients from Belgium, France, Estonia, Serbia, Slovenia, and Turkey were included in the analysis. The selection of items for the short version of the DOQ was achieved with exploratory factor analysis (EFA). Construct validity was proved with EFA and Pearson correlations between the DOQ and the new DOQ-30. Internal reliability was established with Cronbach's alpha.
  
  
  RESULTS
  DOQ-30 resulted in 30 items in nine subscales. It explained 49.8% of items' variance. It shows a considerable good internal reliability and construct validity.
  
  
  CONCLUSIONS
  The DOQ-30 is a five-point Likert-scaled broadly conceptualized measure of DR-QoL. It addresses a variety of obstacles, such as social, psychological, cognitive and behavioural. The DOQ-30 is ready for implementation in general practice and research in Europe as a valuable instrument to assess DR-QoL.
authors.affiliation: a Department of Family Medicine , University of Tartu , Tartu , Estonia ;
authors.forename: Liina
authors.initials: L
authors.lastname: Pilv
authors.affiliation: b Department of General Practice of Nursing and Midwifery , University of Antwerp , Antwerp , Belgium ;
authors.forename: Etienne
authors.initials: E
authors.lastname: Vermeire
authors.affiliation: a Department of Family Medicine , University of Tartu , Tartu , Estonia ;
authors.forename: Anneli
authors.initials: A
authors.lastname: Rätsep
authors.affiliation: c Department of General Practice , University Claude Bernard Lyon 1 , Lyon , France ;
authors.forename: Alain
authors.initials: A
authors.lastname: Moreau
authors.affiliation: d Primary Health Care Centre 'Dr Milutin Ivković' , Belgrade , Serbia ;
authors.forename: Dragica
authors.initials: D
authors.lastname: Nikolić
authors.affiliation: e Department of Family Medicine , University of Ljubljana , Ljubljana , Slovenia ;
authors.forename: Davorina
authors.initials: D
authors.lastname: Petek
authors.affiliation: f Department of Family Medicine , Akdeniz University , Antalya , Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yaman
authors.affiliation: a Department of Family Medicine , University of Tartu , Tartu , Estonia ;
authors.forename: Marje
authors.initials: M
authors.lastname: Oona
authors.affiliation: a Department of Family Medicine , University of Tartu , Tartu , Estonia ;
authors.forename: Ruth
authors.initials: R
authors.lastname: Kalda
mesh_terms: D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Clinical domain; DR-QoL; development of measurement instruments; diabetes; easy-to-use; empowerment; general; general practice/family medicine; operational domain; patient involvement; research methodology; self-management