Reliability and Validity of Swedish Versions of the Diabetes Self-Management Questionnaire and the Diabetes Distress Scale.

Authors

Cecilia Josefsson, Ulrika Pöder, Mariann Hedström, Erik M G Olsson

Published in

Value in health regional issues. Pages 101660. Jun 29, 2026. Epub Jun 29, 2026.

Abstract

Self-management is essential in diabetes care but can be demanding. Diabetes distress may impair glycemic control, increase complications, and reduce quality of life. This study evaluated the psychometric properties of the Swedish versions of the Diabetes Self-Management Questionnaire (DSMQ) and the Diabetes Distress Scale (DDS-17).
Adults with type 2 diabetes (n = 192) participated in this cross-sectional study with a test-retest design. The instruments were translated using forward-backward translation and tested with Cronbach's alpha (α), intraclass and Spearman's correlation coefficients, and confirmatory factor analysis.
Cronbach's α for the DSMQ was 0.82 (subscales 0.10-0.79). The subscale Healthcare use had an α of 0.10. Cronbach's α for the DDS was 0.93 (subscales 0.85-0.89). Test-retest reliability measured with the intraclass correlation coefficient showed an agreement of 0.87 for the DSMQ and 0.84 for the DDS. Convergent validity tested with Spearman's rank correlation coefficient showed a small correlation between the DSMQ total score and HbA1c (r = -0.23). The DDS showed a moderate correlation with the Perceived Stress Scale (r = 0.38). Structural validity was assessed with confirmatory factor analysis and showed an acceptable fit for the tested 3-factor solution of the DSMQ (comparative fit index 0.899, Tucker-Lewis Index 0.858, root mean square error of approximation 0.082, and standardized root mean square residual 0.060) and for the proposed 4-factor solution of the DDS (comparative fit index 0.917, Tucker-Lewis Index 0.900, root mean square error of approximation 0.091, and standardized root mean square residual 0.063).
The DSMQ appears reliable and valid, with reservations regarding 1 subscale, whereas the DDS-17 appears both reliable and valid, demonstrating satisfactory psychometric properties for the Swedish type 2 diabetes population.

PMID:
42376714
Bibliographic data and abstract were imported from PubMed on 30 Jun 2026.

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