Psychometric Evaluation of the Arabic Version of the Swedish National Diabetes Registers Instrument for...

Background: Healthcare quality is increasingly dependent on the patients' perspective to ensure care aligns with patients' needs and experiences, especially for those living with chronic conditions such as diabetes. The Swedish National Diabetes Register instrument (NDR) combines patient-reported experiences and outcomes to evaluate patient-centered diabetes care, but it has not yet been accessible in Arabic. This study aimed to assess the validity and reliability of the Arabic version of the Swedish National Diabetes Register questionnaire among patients with diabetes. Methods: A cross-sectional study was carried out from July to August 2023 at 47 primary healthcare centers in Saudi Arabia, involving 594 adult patients with diabetes. Reliability was measured with Cronbach's alpha and composite reliability. Construct validity was tested using confirmatory factor analysis, and discriminant validity was assessed through the Heterotrait-Monotrait Ratio. Data analysis was performed using SPSS (version 28) and the lavaan package in R (version 4.3.2). Results: The Arabic version showed high internal consistency, with Cronbach's α ranging from 0.716 to 0.886 and CR between 0.663 and 0.855. It also exhibited good model fit indices, including χ²/df of 2.72, RMSEA of 0.054, SRMR of 0.073, and a CFI above 0.90. All item loadings were statistically significant (p < 0.01). The HTMT values were below 0.85, confirming adequate discriminant validity. Conclusions: The Arabic version of the NDR instrument is a valid and reliable tool for measuring patient-reported experiences and outcomes among Arabic-speaking patients with diabetes, which supports its application in diabetic care across the Arab region. Health policymakers in the region are recommended to incorporate this validated Arabic tool into their national diabetes initiatives.