Adaptation and Validation of the Indonesian Version of the Problem Areas in Diabetes Scale Among People With Type 2 Diabetes: An Exploratory and Confirmatory Factor Analysis

AIM: To adapt and validate the Problem Areas in Diabetes scale in type 2 diabetes patients in Indonesia. DESIGN: This was a cross-sectional study. METHODS: The study with 1044 participants was conducted at public health centers. The construct validity used an exploratory factor analysis to measure the scale structure, and a confirmatory factor analysis was used to assess model suitability. Reliability was calculated using Cronbach's alpha, composite reliability, average variance extracted and test-retest results. The sample was divided into equal numbers for the exploratory factor analysis and confirmatory factor analysis. RESULTS: The exploratory factor analysis showed that the Kaiser-Meyer-Olkin test was 0.899, and Bartlett's test of sphericity was significant. Three factors were obtained with a factor loading of > 0.34. Cronbach's alpha for all items was 0.858, and individual factors ranged from 0.636 to 0.864. An interclass correlation coefficient and test-retest reliability analysis of all question items exhibited good results. Pearson correlations for all items or each factor showed significant results. The confirmatory factor analysis showed that the instrument had an acceptable model fit. PATIENT OR PUBLIC CONTRIBUTION: Type 2 diabetes patients and nurses in charge at public health centers were involved in this study. The findings show that the instrument is valid and reliable; it can be an option for measuring the stress diabetes mellitus. The subscales in this instrument can be used simultaneously or separately, according to each individual's needs. Indonesian PAID can be used for stress screening in diabetes mellitus patients starting from the primary health service level so that initial treatment can be provided more quickly.