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: The use of behavioral interventions has been shown to improve glycemic control, however, the effectiveness of different behavioral interventions in one of the most high risk populations, African Americans, remains unclear. Our systematic review identified and examined findings of published behavioral interventions targeted at African Americans to improve glycemic control. The goal of our study was to distinguish which interventions were effective and identify areas for future research. Medline, PsychInfo, and CINAHL were searched for articles published from January 2000 through January 2012 using a reproducible strategy. Study eligibility criteria included interventions aimed at changing behavior in adult African Americans with type 2 diabetes and measured glycemic control. Ten studies met the inclusion criteria, of which five showed a statistically significant change in HbA1c in the intervention group when compared to the control group. Summary information and characteristics of the reviewed studies are provided. Characteristics of successful interventions included using problem solving with the patient, culturally tailoring the intervention, and using a nurse educator. Limitations include the limited number of intervention studies available using glycemic control as the outcome measure. Clinical trials are needed to determine how best to tailor interventions to this largely underserved population and studies should describe details of cultural tailoring to provide information for future programs.
    Ethnicity & disease 09/2013; 23(4):401-8. · 1.00 Impact Factor
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