The PAID-5:A valid and reliable short-form measure of diabetes-distress developed from the DAWN MIND study

SNOEK FJ; MCGUIRE BE; MORRSION T; HERMANNS N; ELDRUP E; GAGLIARDINO JJ; KOKOSZKA A; PIBERNIK-OKANOVIC M; MATTHEWS DR; RODRIGUEZ-SALDANA J; DE WIT M; SKOVLUND SE

Montreal, Canadá

Congreso; IDF 20th World Diabetes Congress; 2009

International Diabetes Federation

Background: Emotional distress is common in diabetes patients but poorly recognized by health care professionals and undertreated. The DAWN MIND (Monitoring of Individual Needs in Diabetes) study is a cross-national implementation project, promoting systematic evaluation of the psychological status of patients in diabetes c1inics and improvement of psychosocial care. Aim: There is a need for short valid instruments that can be used in busy diabetes clinics by nonmental health specialists to screen patients for psychological distress. We sought to develop and validate a 5-item short form of the 20-item Problem Areas In Diabetes (PAID) scale) a widely used nd well-validated measure of diabetes-related emotional distress. Methods: Data from 1153 participants of the DAWN MIND study were available on the PAID questionnaire and WHO-5 (World Health Organisation 5 item Well-being Index) along with socio-demographic and biomedical characteristics. Mean age 53.8 years (SD 14.7, 52.1% female, 63.2% Type 2 diabetes 54.9% reported no complications) 20.4% 2 or more complications. Two random sub-samples were created (sample 1: n=589 and sample 2: n=564) for psychometric testing, including descriptive statistics, Principal Components Factor Analysis (PCA), Explorative Factor Analysis (EFA), tests of internal consistency and validity, Receiver Operator Characteristics (ROC) analysis was performed to test for diagnostic accuracy. Results: Based on PCA in sample 1, 10 items from the full PAID were identified constituting a negative emotions scale, from which 5 were retained after reliability analysis (alpha .86) 95% CI= .84- .88). Average score 6.07 (SD 5.09) 0-20). Convergent and construct validity of PAID-5 were confirmed with WHO5 (r=-.4 7 )p< .001) and females reporting higher PAID-5 scores then males (p< .001). Patients with complications tend to report more distress than those without complications. These data were confirmed in sample 2. Diagnostic accuracy was tested by ROC analysis, showing 94% sensitivíty and 89% specificity for usíng as cut-off PAID-5 score of >7 against established criterion score for high distress of full PAID. Conclusion: We have identified a brief, user fríendly and reliable measure of diabetes-specific emotional distress, that should prove useful in busy practices, taking 1 minute maximum to complete and offering a clear cut-off score for clinically relevant levels of diabetes distress. The PAID-5 is an excellent candidate for systematic screening in ongoing diabetes care as recommended by the ADA and IDF, either alone or combined with a measure of general wellbeing such as the WHO-5. No conflict of interest