Assessing the reliability and validity of the Slovenian version of the appraisal of diabetes scale (ADS-S) in type 2 diabetes patients

Mihevc, Matic (author), Miroševič, Špela (author), Mori-Lukančič, Majda (author), Virtič, Tina (author), Zavrnik, Črt (author), Petek Šter, Marija (author), Klemenc-Ketiš, Zalika (author), Poplas-Susič, Tonka (author)

Managing type 2 diabetes (T2D) effectively is a considerable challenge. The Appraisal of Diabetes Scale (ADS) has proven valuable in understanding how individuals perceive and cope with their condition. This study aimed to evaluate the psychometric properties of the Slovenian version of ADS (ADS-S). We recruited a sample of 400 adult individuals with T2D from three primary healthcare centers in Slovenia, ensuring an average of 57 cases per individual item. The psychometric evaluation included internal consistency, test-retest reliability, construct validity, and discriminant validity. Confirmatory factor analysis (CFA) was additionally performed to evaluate the fit of one- and two-factor models. After excluding incomplete questionnaires, 389 individuals participated, averaging 72.0±7.5 years, with 196 men and 193 women. ADS-S exhibited acceptable internal consistency (Cronbach's α = 0.70) and strong test-retest reliability (interclass correlation = 0.88, p <0.001). Criterion validity was established through significant correlations between ADS-S score and EQ-5D utility score (r = -0.34, p <0.001), EQ-VAS score (r = -0.38, p <0.001), and HbA1c >7.5% (r = 0.22, p = 0.019). Discriminant validity assessment found no significant correlation between ADS-S score and age, but a significant correlation with female gender (r = 0.17, p = 0.001). CFA results supported a two-factor structure (psychological impact of diabetes and sense of self-control) over a one-factor structure, as indicated by model fit indicators. ADS-S stands as a valid and reliable tool for assessing psychological impact and self-control in Slovenian T2D patients. Future research should explore adding items for capturing secondary appraisal of diabetes and studying the influence of female gender on ADS scores.

• Language: English
• Keywords: Diabetes Mellitus, type 2, Patients, psychometrics, surveys and questionnaires, Slovenia
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 12 str.
• Numbering: Vol. 19, iss. 3
• PID: 20.500.12556/RUL-183062
• UDC: 616.379
• ISSN on article: 1932-6203
• DOI: 10.1371/journal.pone.0300797
• COBISS.SI-ID: 191601667
• Publication date in RUL: 03.06.2026

Record is a part of a journal

• Title: PloS one
• Publisher: Public Library of Science
• ISSN: 1932-6203
• COBISS.SI-ID: 2005896

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: sladkorna bolezen, tip 2, bolniki, psihometrija, ankete in vprašalniki, Slovenija

Projects

• Funder: EC - European Commission
• Project number: 825432
• Name: SCale Up an integrated care package for diaBetes and hYpertension for vulnerable people in Cambodia, Slovenia and Belgium
• Acronym: SCUBY

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0339
• Name: Raziskave na področju javnega zdravja