title: Diabetes Health Profile-18 is Reliable, Valid and Sensitive in Singapore.
abstract: BACKGROUND
  The Diabetes Health Profile-18 (DHP-18) measures diabetes-related psychological well-being in patients with type 2 diabetes mellitus (T2DM). It includes 3 subscales: psychological distress (PD), barriers to activity and disinhibited eating. The psychometric properties of the DHP have not been evaluated in Asia. The aim of this study was to determine the psychometric properties of the DHP in multiethnic Singapore.
  
  
  METHODS
  Patients between the ages of 18 to 65 diagnosed with diabetes (either type 1 or type 2) for at least 1 year were recruited from a diabetes outpatient clinic in a tertiary hospital. They completed a set of self-administered questionnaires including sociodemographic information and the DHP. Validity of the DHP was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Reliability was assessed with internal consistency and sensitivity was determined by effect size, associated with detecting a statistically significant and clinically important difference between various patient subgroups.
  
  
  RESULTS
  A total of 204 patients with mean age 45.4 (11.9) years, comprising 64% males and 50% Chinese, 27% Indian and 12% Malay were studied. In CFA, model fit was poor. Forced 3-factor EFA supported the original 3-factor structure of the DHP. Convergent and discriminant validity was demonstrated (100% scaling success). DHP was sensitive across majority of social demographic, clinical and social-functioning determinants (i.e., effect size >0.3). Cronbach's alpha exceeded 0.70 for all subscales. Ceiling effects were negligible but large floor effects were seen for the PD subscale (23%).
  
  
  CONCLUSIONS
  The DHP is valid, reliable and sensitive for measuring well-being in Asian patients with T2DM.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Maudrene Ls
authors.initials: ML
authors.lastname: Tan
authors.forename: Eric Yh
authors.initials: EY
authors.lastname: Khoo
authors.forename: Konstadina
authors.initials: K
authors.lastname: Griva
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.forename: Mohamed
authors.initials: M
authors.lastname: Amir
authors.forename: Yasmin Lm
authors.initials: YL
authors.lastname: Zuniga
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Hwee Lin
authors.initials: HL
authors.lastname: Wee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D000066498:Emotional Adjustment; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012846:Singapore; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult