title: Adaptation and validation of the Distress Scale for Mexican patients with type 2 diabetes and hypertension: a cross-sectional survey.
abstract: OBJECTIVE
  The aim of this study was to adapt and validate the Distress Scale for Mexican patients with type 2 diabetes and hypertension (DSDH17M).
  
  
  METHODS
  Two family medicine clinics affiliated with the Mexican Institute of Social Security.
  
  
  METHODS
  722 patients with type 2 diabetes and/or hypertension (235 patients with diabetes, 233 patients with hypertension and 254 patients with both diseases).
  
  
  METHODS
  A cross-sectional survey.
  
  
  METHODS
  The validation procedures included: (1) content validity using a group of experts, (2) construct validity from exploratory factor analysis, (3) internal consistency using Cronbach's α, (4) convergent validity between DSDH17M and anxiety and depression using the Spearman correlation coefficient, (5) discriminative validity through the Wilcoxon rank-sum test and (6) test-retest reliability using intraclass correlation coefficient.
  
  
  RESULTS
  The DSDH17M has 17 items and three factors explaining 67% of the total variance. Cronbach α ranged from 0.83 to 0.91 among factors. The first factor of 'Regime-related Distress and Emotional Burden' moderately correlated with anxiety and depression scores. Discriminative validity revealed that patients with obesity, those with stressful events and those who did not adhere to pharmacological treatment had significantly higher distress scores in all DSDH17M domains. Test-retest intraclass correlation coefficient for DSDH17M ranged from 0.92 to 0.97 among factors.
  
  
  CONCLUSIONS
  DSDH17M is a valid and reliable tool to identify distress of patients with type 2 diabetes and hypertension.
authors.affiliation: Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: Ingrid Patricia
authors.initials: IP
authors.lastname: Martinez-Vega
authors.affiliation: Epidemiology and Health Services Research Unit, CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico.
authors.forename: Svetlana V
authors.initials: SV
authors.lastname: Doubova
authors.affiliation: Departamento de Farmacología de la Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Aguirre-Hernandez
authors.affiliation: Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, México City, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Infante-Castañeda
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
keywords: Diabetes; Distress; Instrumental study; Psychometric properties