Measurement of psychological adjustment to diabetes with the diabetes acceptance scale

Faculty/Professorship: Clinical Psychology and Psychotherapy  
Author(s): Schmitt, Andreas; Reimer, Andre; Kulzer, Bernhard ; Icks, Andrea; Paust, Rainer; Roelver, Klaus-Martin; Kaltheuner, Matthias; Ehrmann, Dominic  ; Krichbaum, Michael; Haak, Thomas; Hermanns, Norbert  
Title of the Journal: Journal of Diabetes and its Complications
ISSN: 1056-8727
Publisher Information: Amsterdam [u.a.] : Elsevier
Year of publication: 2018
Volume: 32
Issue: 4
Pages: 384-392
Language(s): English
DOI: 10.1016/j.jdiacomp.2018.01.005
Aims: To develop a psychometric measure of diabetes acceptance.
Methods: An item pool was developed and pilot-tested using a sample of 220 people with diabetes; item selection resulted in the 20-item ‘Diabetes Acceptance Scale (DAS)’. 606 people with diabetes were then cross-sectionally assessed with the DAS to evaluate its reliability, validity and clinical utility; concurrent measurements included diabetes-related coping (FQCI), diabetes distress (PAID-5), depressive symptoms (PHQ-9), quality of life (EQ-5D), self-management (DSMQ), glycaemic control (HbA1c) and complications.
Results: Internal reliability was high (Cronbach's α = 0.96). Factorial and criterion-related results supported validity. Higher diabetes acceptance scores correlated with more functional coping styles, lower distress and depression levels, higher treatment adherence, better glycaemic control and better quality of life (all P < .001). Persons with low diabetes acceptance (22% of the sample) were four times more likely to have HbA1c values over 9.0% (75 mmol/mol), two times more likely to be diagnosed with long-term complications and each over two times more likely to have had episodes of severe hypoglycaemia and ketoacidosis in the past year; the prevalence of major depression in this group was fivefold increased (all P < .05).
Conclusions: The DAS is a reliable and valid tool to measure diabetes acceptance. It may help identify patients with significant problems of accepting diabetes, a putative high-risk group in need of tailored care and Support.
Keywords: Diabetes integration, Illness acceptance, Psychological adjustment, Self and identity, Diabetes-related distress
Peer Reviewed: Ja
International Distribution: Ja
Type: Article
Year of publication: 21. August 2019