Validating the Emotional Well-Being Questionnaire in Type 2 Diabetes: A Pilot Confirmatory Factor Analysis

Area of Science:

• Psychiatry
• Endocrinology
• Psychometrics

Background:

• Emotional distress, including depression and anxiety, is prevalent in type 2 diabetes (T2D).
• Mental health issues in T2D can negatively impact patient adherence to treatment and overall health outcomes.
• Screening tools are needed to identify emotional well-being concerns in T2D populations.

Purpose of the Study:

• To provide preliminary validation evidence for the six-factor model of the Emotional Well-Being Questionnaire (EWQ).
• To evaluate the reliability and convergent validity of the EWQ in a cohort of adults with T2D.
• To assess the EWQ's suitability for mental health screening in T2D patients.

Main Methods:

• A pilot cross-sectional study involving 240 adults (122 with T2D, 118 controls).
• Participants completed the Emotional Well-Being Questionnaire (EWQ) and the nine-item Patient Health Questionnaire (PHQ-9).
• Confirmatory factor analysis (CFA) was used to assess the EWQ's six-factor model fit and convergent validity was examined against PHQ-9 scores.

Main Results:

• Confirmatory factor analysis indicated an acceptable-borderline fit for the EWQ's six-factor structure in the T2D sample.
• The EWQ demonstrated good internal consistency (Cronbach's α = 0.79) within the T2D group.
• Significant positive correlation between EWQ and PHQ-9 scores (r = 0.652, p < 0.001) supported convergent validity.

Conclusions:

• The EWQ's six-factor structure is preliminarily adequate for use in adults with T2D.
• While reliability and convergent validity are supportive, overall model fit requires cautious interpretation.
• Further validation in larger, diverse samples is recommended before widespread clinical implementation.