Development and evaluation of the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes

Objectives:This study aims to develop the Directive and Nondirective Support Scale for Patients with Type 2 Diabetes(DNSS-T2DM)to measure diabetes-specific support and patients’preference as well as evaluate the construct validity and reliability of the DNSS-T2DM.Methods:A cross-sectional study was conducted in Tongzhou District,Beijing,China from July to September 2015.A total of 474 participants who had been diagnosed as type 2 diabetes by physicians and completed the DNSS-T2DM were included.The original 11-item DNSS-T2DM contains five items on nondirective support(Items 1-5)and six items on directive support(Items 6-11).There were two parallel questions for each item with one to measure the preference for support(Preference part)and the other to measure the perception of support in reality(Reality part).The final DNSS-T2DM was determined based on the results of the exploratory factor analysis(EFA).The construct validity of the final DNSS-T2DM was evaluated by the confirmatory factor analysis(CFA).The reliability was evaluated by internal consistency with Cronbach’sαcoefficients.Results:A final 7-item DNSS-T2DM loaded on 2 factors with four items representing nondirective support and three items representing directive support was determined based on the EFA.The CFA indicated a satisfactory construct validity.The internal consistency of the 7-item DNSS-T2DM as well as the nondirective support items was satisfactory with Cronbach’sα≥7.00.70.Conclusions:Our study supported the validity and reliability of the 7-item DNSS-T2DM.Further studies on the application of the DNSS-T2DM in different settings and population are needed.