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A new 13-item scale effectively measures decisional balance for insulin injection in type 2 diabetes patients. This tool aids healthcare providers in discussing insulin therapy and improving patient adherence.

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Area of Science:

  • Endocrinology and Metabolism
  • Behavioral Science in Medicine
  • Psychometrics

Background:

  • Patient reluctance and poor adherence to insulin therapy are significant challenges in type 2 diabetes (T2DM) management.
  • Understanding patient attitudes toward insulin injection is crucial for developing effective interventions.
  • The concept of decisional balance offers a framework for assessing these attitudes, but a specific scale for insulin injection was lacking.

Purpose of the Study:

  • To develop and validate a Decisional Balance for Insulin Injection (DBII) scale.
  • To assess the psychometric properties of the DBII scale in both insulin-naive and insulin-treated patients with T2DM.
  • To provide a tool for evaluating patient attitudes towards insulin therapy.

Main Methods:

  • A cross-sectional study involving 95 insulin-naive and 237 insulin-treated T2DM patients in Taiwan.
  • Development of an 18-item DBII scale, refined to a 13-item version based on factor analysis.
  • Validation through exploratory and confirmatory factor analysis, concurrent validity assessment (stages of change, HbA1c), and reliability testing (internal consistency, test-retest).

Main Results:

  • A 13-item DBII scale was successfully developed and validated using factor analysis.
  • The DBII scale demonstrated significant associations with stages of behavioral change and HbA1c levels in both patient groups.
  • Reliability was confirmed, with Cronbach's alpha values ranging from .78 to .92.

Conclusions:

  • The 13-item DBII scale is a valid and reliable instrument for assessing decisional balance regarding insulin injection in T2DM patients.
  • The scale is concise and suitable for use with both insulin-naive and insulin-treated individuals.
  • Healthcare providers can utilize the DBII scale to facilitate clinical discussions and improve insulin therapy management.