A Psychometric Evaluation of the Hypoglycemia Problem-Solving Scale (HPSS) in Turkish Older Adults with Diabetes

Introduction: Hypoglycemia is a significant complication in diabetes management and presents an even greater risk for older adults. These individuals are particularly vulnerable to hypoglycemic episodes, which can result in serious health consequences. The Hypoglycemia Problem-Solving Scale (HPSS) evaluates problem-solving skills related to hypoglycemia; however, it has not yet been validated in Türkiye. This study aimed to evaluate the validity and reliability of the Turkish adaptation of the HPSS. Materials and Methods: A descriptive, methodological, and cross-sectional study was conducted with 623 older adults (aged 65 and above) diagnosed with Type 2 diabetes and with a history of hypoglycemic episodes. The HPSS was adapted into Turkish, and its psychometric properties were assessed through content validity, Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and reliability analyses. Results: The mean age of participants was 72 ± 5.5 years. Expert agreement on the items was high (Kendall's W = 0.83, p < 0.05), and all items had a Content Validity Ratio (CVR) above 0.56. The overall Content Validity Index (CVI) was 0.97. Exploratory Factor Analysis (EFA) revealed seven factors explaining 74.22% of the total variance. The Kaiser-Meyer-Olkin (KMO) value was 0.85, and Bartlett's test of sphericity was significant (χ² = 7590.85, p < 0.001). Confirmatory Factor Analysis (CFA) demonstrated acceptable model fit (CFI = 0.952; χ²/df = 2.536). The scale demonstrated high internal consistency (Cronbach's alpha = 0.88) and excellent test-retest reliability (r = 0.99, p < 0.001). Discussion/Conclusions: The Turkish version of the Hypoglycemia Problem-Solving Scale is a valid and reliable instrument for evaluating problem-solving skills related to hypoglycemia in older adults with diabetes. It can be effectively utilized in clinical practice to support better hypoglycemia management and improve overall diabetes care.