Objective : Diabetes self-management is a fundamental aspect of diabetes care and has a significant impact on diabetes-related mortality and morbidity. Assessment of self-care management is thus essential for the clinicians and educators.
Methods : A cross sectional analytic study was done among adult Type 2 diabetic patients at the Ilocos Training and Regional Medical Center Department of Medicine OPD Clinic and three private clinics to determine the reliability and validity of the Filipino-translated Diabetes Self-Management Questionnaire (DSMQ) and its association with glycemic control in terms of HbA1c. The English version of the DSMQ was translated to Filipino using a forward backward translation. The pre-tested Filipino translated questionnaire was distributed to the participants and was analyzed.
Results : There was a total of 78 respondents. The test-retest reliability showed statistically significant correlation (*p value <0.05). All the items showed high difficulty index. Known groups validity was computed. Comparison of patient groups into 'good', 'medium' and 'poor' glycemic control revealed no significant differences regarding the DSMQ Sum Scores and subscale scores.
Discussion : In this study, reliability was measured by test-retest reliability. All the items in the Filipino version are reliable except for item 3 (Keep recommended doctors' appointments) and item 8 (Do physical activity to achieve optimal sugar levels). This indicates unstable responses across time (one month interval). However, the 'Sum Scale' and the mean item subscale correlations showed significant correlation making the questionnaire reliable.
Validity measures whether the test scores are valid. The higher the difficulty index, the easier the time is understood. In the known groups analysis, there were no significant differences between patient groups with 'good', 'moderate', and 'poor' glycemic control. The questionnaire is thus not able to correlate the self-care activities to HbA1c values for this pool of patients.
Nevertheless, this is the first Filipino-translated questionnaire aimed at objectively measuring self-management behaviours of diabetic patients. This has the potential of helping clinicians identify gaps in individual diabetic patients' self management, which can then be targets for emphasis individualized diabetes education.
Conclusion : The Filipino translated DSMQ is a reliable tool in measuring self-care of diabetic Filipino patients. Future research using it with a larger sample size and analysis for other factors affecting diabetes control may be better able to demonstrate its association with glycemic control.
Marie Angeline Ganiban– Medical Officer IV, Philippine Medical Association, San Fernando, Benguet, Philippines
Hannah Corpuz– Assistant Chair for Research, Department of Medicine and Chair, Diabetes Control Committee, Ilocos Training and Regional Medical Center, San Fernando City, La Union, Philippines
Medical Officer IV
Philippine Medical Association
San Fernando, Benguet, Philippines
Dr. Marie Angeline O. Ganiban finished her bachelors degree in Biology at the University of the Philippines. She later on graduated Doctor of Medicine at the Saint Louis University School of Medicine. She is currently the Chief Resident of Internal Medicine at the Ilocos Training and Regional Medical Center.
Assistant Chair for Research, Department of Medicine and Chair, Diabetes Control Committee
Ilocos Training and Regional Medical Center
San Fernando City, La Union, Philippines
I graduated from Internal Medicine Residency and Endocrinology Fellowship from the University fo the Philippines-Philippine General Hospital just a few years ago. Having moved to the province from the city, with my background in research as sub-investigator in clinical trials and having had published work, I was immediately tapped by the local training institution to help out in bolstering its research milieu. I am happy to be able to mentor residents and expose them to international conferences through research and see myself continuing on in this career for a long time.