The Diabetes Self-Management Questionnaire is a 9-item, self-report questionnaire that measures adherence to diabetes self-management tasks. The Questionnaire demonstrated acceptable psychometric properties and construct validity. Diabetes Self-Management Questionnaire scores were highly correlated with Diabetes Self-Management Profile scores, as well as frequency of blood glucose monitoring. Diabetes Self-Management Questionnaire scores were also correlated with HbA1c
and other measures associated with adherence to and/or glycaemic control. While the Diabetes Self-Management Questionnaire demonstrated questionable internal consistency, we would not necessary expect internal consistency to be high for a brief measure of adherence that taps multiple domains, including blood glucose monitoring, diet, exercise and insulin administration, which are not always correlated. Reported internal consistency for the Diabetes Self-Management Profile is higher (0.76; [4
]); however, the Diabetes Self-Management Questionnaire is much shorter, which may negatively impact on its internal consistency. While the creation of the Diabetes Self-Management Questionnaire was underway, a new validation of the Self-Care Inventory was published [12
]. The Self-Care Inventory is a 14-item self-report measure that assesses diabetes adherence. Both the Self-Care Inventory and the Diabetes Self-Management Questionnaire were validated against the Diabetes Self-Management Profile and demonstrated good construct validity. While the Self-Care Inventory was validated with young people ages 11–18 years, the Diabetes Self-Management Questionnaire was validated in a younger population, ages 9–15 years. (The Self-Care Inventory was not included in the current study.)
There are a number of limitations to this study. First, the Diabetes Self-Management Questionnaire was adapted from the Diabetes Self-Management Profile, which included two versions based upon treatment regimen. We created a single version of the Diabetes Self-Management Questionnaire for use with all insulin regimens as a trade-off for ease of administration, with the potential loss of some regimen-specific adherence information. However, the correlations between the Diabetes Self-Management Questionnaire and the regimen-specific Diabetes Self-Management Profile versions were similar (). While the item wording used is consistent with that used in the Diabetes Self-Management Profile, some items may appear confusing or redundant to the respondent. Finally, we have assessed the utility of the Diabetes Self-Management Questionnaire in a younger population, including 9- to 11- year-olds, whereas the Diabetes Self-Management Profile was only validated among those of 11 years and older.
While the Diabetes Self-Management Questionnaire performed differently in those < 11 years and in those ≥ 11 years of age, it may have utility in both groups to identify problems with adherence. We hope that future studies and possible improvements to the questionnaire can confirm or refute its usefulness, readability and comprehension across this wider age range of young people.
The Diabetes Self-Management Questionnaire can be completed in less than 10 min, with both parents and young people able to complete the measure simultaneously, with few staff resources required. In addition, while HbA1c tells us how adherent a patient is in general, the Diabetes Self-Management Questionnaire can help identify specific difficulties for a patient. Because this sample was geographically, ethnically and racially diverse, it is likely representative of young people with Type 1 diabetes. This brief self-report questionnaire may have utility for periodic use with paediatric patients/parents in clinical and research settings in order to measure adherence to diabetes self-management.