Assessing Diabetes Distress Among Type 2 Diabetes Mellitus in Malaysia Using the Problem Areas in Diabetes Scale

Objectives: To validate, from a psychometric perspective, the Problem Areas in Diabetes (PAID)questionnaire in patients with type 2 diabetes mellitus from Malaysia. Methods: A total of 497 patients with type 2 diabetes mellitus were recruited from public hospitals in the state of Selangor through convenience sampling. Construct validity was evaluated through confirmatory factor analysis. Internal consistency of the instrument was tested by Cronbach α. Criterion validity and discriminant validity were also used. Results: The PAID instrument consisted of 3 factors: social support problem, food-related problem, and emotional distress problem. The Cronbach α values of the 3 factors showed adequate internal consistency with α values greater than 0.90. The present confirmatory factor analysis model achieved a good fit with a comparative fit index value of 0.923. Satisfactory criterion validity was also demonstrated because there existed positive significant association between glycated hemoglobin A1c and diabetes duration. Conclusions: The PAID questionnaire in Malaysia was found to be a reliable and valid instrument exhibiting good psychometric properties.