In 2003 , we developed and psychometrically tested the Chinese version of the Diabetes Empowerment Scale with 20 items (C-DES-20) (1) in 207 patients. It was cross-culturally adapted from the Diabetes Empowerment Scale, which was previously established in the U.S. (2–4) to measure the psychosocial self-efficacy of people with diabetes. The C-DES-20 (α = 0.86) contains five subscales: overcoming barriers (four items; α = 0.89), determining suitable methods (five items; α = 0.79), achieving goals (four items; α = 0.78), obtaining support (four items; α = 0.78), and coping (four items; α = 0.76). The test-retest reliability of the C-DES-20 was good (intraclass correlations = 0.75, 95% CI 0.43–0.91). There was criterion validity between the C-DES-20 and HbA1c (r = −0.17, P = 0.03).
To further determine the validity of the C-DES-20, we asked an additional 102 community-dwelling individuals with type 2 diabetes to administer the scale using structured interviews, along with a previously validated Chinese version of the General Self-Efficacy scale (C-GSE10), which contains 10 items (5,6). A sample item is “I can always manage to solve difficult problems if I try hard enough.” The Cronbach’s α of this scale for the current sample was 0.93.
Subjects were recruited using convenience sampling from a patient-led nongovernment organization that provided peer support services. The subjects ranged from 38 to 81 years of age, and the mean (±SD) age was 58 ± 12 years. Half of the sample was female. The majority of subjects had a primary to secondary level of education, and 17% were illiterate. Thirty-nine percent were employed. The mean length of time since diagnosis was 9 ±7 years. The Pearson correlation coefficient of the two scales, C-DES-20 and C-GSE-10, was 0.63 (P = 0.001). The positive correlation remained r = 0.48 (P = 0.001), after controlling for age, education level, and adequacy of self-management knowledge, indicating concurrent validity.
These findings add another piece of evidence to support that the C-DES-20 is a valid and reliable measure. Considering its brevity and easy administration, the C-DES-20 offers a useful instrument of the psychosocial self-efficacy of Hong Kong residents with diabetes. Further study with different Chinese populations will be required to confirm the factor structure of the scale.
