Diabetes Problem-Solving Scale Development in an Adult, African American Sample

Division of General Internal Medicine, Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21205, USA.
The Diabetes Educator (Impact Factor: 1.79). 03/2007; 33(2):291-9. DOI: 10.1177/0145721707299267
Source: PubMed


The purpose of this pilot study was to examine psychometric properties of the Diabetes Problem-Solving Scale (DPSS), which was designed to assess how adults with type 2 diabetes approach and manage problems encountered in diabetes self-management.
Participants were 64 African American adults with type 2 diabetes. The 30-item DPSS and measures of social problem solving, diabetes self-management, and depressive symptoms were administered. Blood samples were collected to measure hemoglobin A1C level.
Cronbach alpha for the DPSS total scale was .77 and ranged from .72 to .78 for subscales. Correlations of the DPSS total score and subscale scores with a standardized social problem-solving scale ranged from 0.30 to 0.46 (all P < .01). Higher DPSS total scores, indicating better self-reported diabetes problem solving, were associated with higher medication adherence, more frequent self-monitoring of blood glucose, and lower hemoglobin A1C level. Of the DPSS subscales, Impulsive Style, Negative Transfer of Past Experience/Learning, and Negative Motivation were differentially associated with reduced self-management and disease control.
The DPSS demonstrated acceptable total scale and subscale internal consistency, construct validity, and predictive validity in this pilot sample. The scale may have utility both in identifying associations between diabetes-related problem solving and self-management and in guiding problem solving interventions to improve self-management and control.

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    ABSTRACT: The purpose of this systematic review is to assess the published literature on problem solving and its associations with diabetes self-management and control, as the state of evidence exists. PubMed, PsychINFO, and ERIC electronic databases were searched for the years 1990 to the present and for English-language articles, and reference lists from included studies were reviewed to capture additional studies. Quantitative and qualitative studies that addressed problem solving as a process or strategy for diabetes self-management were included. Fifty-two studies met the criteria for inclusion. Study design, sample characteristics, measures, and results were reviewed. Thirty-six studies were quantitative; 16 were conceptual or qualitative. Studies were classified as addressing the problem-solving definition/framework, assessment, intervention, or health care professional issues. Problem solving is a multidimensional construct encompassing verbal reasoning/rational problem solving, quantitative problem solving, and coping. Aspects of problem solving can be assessed using newly developed diabetes-specific problem-solving measures for children/adolescents and adults. Cross-sectional studies in adults, but not children/adolescents, provide consistent evidence of associations between problem solving and A1C level. Only 25% of problem-solving intervention studies with children/adolescents and 50% of interventions with adults reported improvement in A1C. Most intervention studies reported an improvement in behaviors, most commonly global adherence in children/adolescents and dietary behavior in adults. Methodological limitations (noninclusion of problem-solving measures, inadequate descriptions of problem-solving interventions, homogenous samples) need to be addressed in future research to clarify the effect of problem solving on diabetes outcomes, identify characteristics of effective interventions, and determine the utility across age and racial/ethnic groups.
    The Diabetes Educator 11/2007; 33(6):1032-50; discussion 1051-2. DOI:10.1177/0145721707308412 · 1.79 Impact Factor
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    ABSTRACT: The aim of the present research was to indices and characteristics of scale validation for family problem solving scale. The sample size of 55 couples (110 people) were selected among married men and women in Tehran and assigned to adjusted/compatible and maladjusted/incompatible groups. ENRICH marital satisfaction scale and the new FPS scale was used as research tools. Analysis of the aspects revealed 2 aspects out of 30: communication and problem solving. Studying internal correlation of total scores of the scales and subscales showed the association rate between total score and the aspects of communication and problem solving was 0.95. Reliability index of total score re-test was 0.91 and that of communication and problem solving was 0.78 and 2.89, respectively. Internal correlation of total score, communication and problem solving was 0.91, 0.78 and 0.83, respectively. As this scale is significantly associated with ENRICH marital satisfaction scale, is permanent and can distinguish adjusted/compatible and maladjusted/incompatible couples, it can be applied for clinical and research purposes.
    Journal of Applied Sciences 12/2007; 7(24). DOI:10.3923/jas.2007.3958.3964
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    ABSTRACT: In Brief Problem solving is an essential skill for effective diabetes self-management. Evidence suggests that problem-solving therapy (PST) approaches, used in the context of broader diabetes educational or lifestyle interventions, may be effective for mood and select diabetes outcomes. As a stand-alone treatment, formal PST adapted for diabetes self-management is a promising behavioral intervention for improving health-related problem-solving, diabetes self-care behaviors, and disease control. Problem solving is a basic human thinking process. Many general coun-seling and psychotherapy approaches, such as cognitive behavioral therapy, include problem solving as a compo-nent of treatment for managing life problems and emotional disorders. 1 Similarly, educational and lifestyle interventions in diabetes often include elements of problem solving as part of broader intervention approaches. 2 Among diabetes educators, prob-lem solving is identified as necessary for patient mastery of diabetes self-management and as the skill most difficult to teach patients. 3 This article describes the origins of prob-lem-solving therapy (PST) as a formal, stand-alone intervention approach for behavior change; application of this technique to diabetes care; and evi-dence of its effectiveness in improving diabetes outcomes. Origins of Problem Solving as a Behavioral Treatment Problem solving, which has its origins in the behavioral and cognitive basic sciences, 4–8 is an identified interven-tion approach for behavior change. 9,10 Cognitive psychology defines prob-lem solving as involving the following components: the individual is goal-directed; reaching the goal requires a series of mental processes; and those processes are cognitive rather than automatic. 6,7 Problem solving can perhaps be described more simply as a series of cognitive operations used to figure out what to do when the way to reach a goal is not apparent.
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