Adaptation and Validation of the Problem Solving Scale for Patients with Type 2 Diabetes Mellitus

Objective: To test the psychometric properties of the health problem solving scale (HPSS) adapted for adults with type 2 diabetes mellitus (T2DM).

Study Design: Cross sectional study, scale validation.

Methodology: 238 T2DM patients from 18 to 70 years of age (Mean =64.81 years, SD =11.186) participated in diabetes monitoring at the Mexican Diabetes Association in Monterrey Nuevo León. To validate the content of the scale, the Delphi method of consultation of experts was used. The construct validity was determined by confirmatory factor analysis.

Results: The adaptation of the Problem Solving in Diabetes Self-Management Scale consisted of a scale with 19 items distributed in three dimensions. Prior to factor analysis, the assumptions of normality, homoscedasticity, and linearity were made, and a sample size larger than 50 subjects was obtained. The measurement of sample adequacy was above the maximum acceptable value of 0.50, with a value of .853. Bartlett’s test of sphericity was significant (X2 =1301.040, gl =171, p <.001). In the confirmatory factor analysis by principal components with orthogonal method rotation of 19 items, three factors were found with eigenvalues greater than 1, which together explained 48.9% of the total variance. The first component explained 27.6% of the variance, the second component explained 13.3%, and the third component explained 7.9%.

Conclusion: The scale is brief and easy to apply and could be used in health and community institutions to understand how T2DM patients solve problems, either in an effective (positive) or a careless/avoidant or impulsive (negative) manner. It could also be useful to guide the design of strategies that can direct patients to cope with the problems that they face when caring for their diabetes.