In 2000 we developed the Diabetes Empowerment Scale (DES) to measure the psychosocial self-efficacy of people with diabetes. The original questionnaire contained 37 items representing eight conceptual dimensions (i.e., assessing the need for change, developing a plan, overcoming barriers, asking for support, supporting oneself, coping with emotion, motivating oneself, and making diabetes care choices appropriate for one’s priorities and circumstances). Using factor analyses the questionnaire was reduced to the current 28-item DES (α = 0.96) containing three subscales (1). The three subscales are: 1) managing the psychosocial aspects of diabetes with 9 items (α = 0.93), 2) assessing dissatisfaction and readiness to change with 9 items (α = 0.81), and 3) setting and achieving goals with 10 items (α = 0.91). In addition to providing an overall assessment of diabetes-related psychosocial self-efficacy, the three subscales of the DES allow for an examination of its underlying components.

To allow for a brief overall assessment of diabetes-related psychosocial self-efficacy, we developed an eight-item short form of the DES (the DES-SF). The DES-SF was created by choosing the item from the remaining 28 items with highest item to subscale correlation from each of the original eight conceptual domains. The reliability of the DES-SF using the original dataset was α = 0.85. We have subsequently administered the DES-SF to 229 subjects in a new study. The reliability of the DES-SF using the data from the new sample was α = 0.84. The content validity of the DES-SF was supported in the new study by the fact that both DES-SF scores and HbA1c levels changed in a positive direction after the 229 subjects completed a 6-week problem-based patient education program (2). The change in DES-SF scores and HbA1c levels were not correlated, suggesting that these two measures vary independently.

These data provide preliminary evidence that the DES-SF is a valid and reliable measure of overall diabetes-related psychosocial self-efficacy. The DES and the DES-SF, scoring information, and permission to use them can be downloaded from the Michigan Diabetes Research and Training Center web site at:

Anderson RM, Funnell MM, Fitzgerald JT, Marrero DG: The diabetes empowerment scale: a measure of psychosocial self-efficacy.
Diabetes Care
Anderson RM, Funnell MM, Nwankwo R, Gillard ML, Fitzgerald JT, Oh M: Evaluation of a problem-based, culturally specific, patient education program for African Americans with diabetes (Abstract).
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Address correspondence to Robert M. Anderson, Department of Medical Education, G1100 Towsley Center, 1500 East Medical Center Dr., Ann Arbor, MI 48109-0201. E-mail: