title: Psychometric properties of the Chinese version of the Problem Areas in Diabetes scale (SG-PAID-C) among high-risk polypharmacy patients with uncontrolled type 2 diabetes in Singapore.
abstract: OBJECTIVE
  Undetected diabetes distress is a cause of concern. However, the lack of a validated questionnaire is a barrier to screening for diabetes distress. The aim of the present study was to examine the validity and reliability of the Chinese version of the Problem Areas in Diabetes scale (SG-PAID-C), and its association with sociodemographic and clinical parameters in patients with type 2 diabetes.
  
  
  METHODS
  This cross-sectional study was carried out in four outpatient healthcare institutions in Singapore. Chinese-speaking patients with uncontrolled type 2 diabetes, polypharmacy, and multiple comorbidities were administered the SG-PAID-C and European Quality of Life-5 Dimensions questionnaires as quality of life measures. The factorial construct, convergent validity and internal consistency of SG-PAID-C were evaluated.
  
  
  RESULTS
  The exploratory factor analysis resulted in a three-factor structure of SG-PAID-C with subscales on emotional- and management-related problem (11 items), ability to cope with diabetes problem (3 items) and support-related problem (2 items). The findings also showed good model fit in the confirmatory factor analysis, and provided support for the construct and convergent validity of SG-PAID-C. Overall, the internal consistency of SG-PAID-C was good (Cronbach's alpha = 0.900). Sex and duration of diabetes were positively associated with the 16-item SG-PAID-C, whereas age and type of antidiabetic agents were inversely associated with the 16-item SG-PAID-C.
  
  
  CONCLUSIONS
  The 16-item SG-PAID-C is a valid and reliable instrument for use among patients with uncontrolled type 2 diabetes in Singapore. Future studies on its clinical utility should be carried out.
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Melanie Yee Lee
authors.identifier: http://orcid.org/0000-0003-0546-0287
authors.initials: MY
authors.lastname: Siaw
authors.affiliation: School of Health Sciences, Caritas Institute of Higher Education, Caritas Bianchi College of Careers, Hong Kong, China.
authors.forename: Bik-Wai Bilvick
authors.initials: BB
authors.lastname: Tai
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Joyce Yu-Chia
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: Quality of life; Type 2 diabetes mellitus; Validation studies