Charilaos Lygidakis1,2, Jean Paul Uwizihiwe3,4, Michela Bia5, Per Kallestrup4, Damas Dukundane6, Brenda Asiimwe-Kateera3,7, Simon Pierre Niyonsenga8, Claus Vögele9. 1. Department of Behavioural and Cognitive Sciences, University of Luxembourg, Porte des Sciences 11, 4366, Esch-sur-Alzette, Luxembourg. lygidakis@gmail.com. 2. College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda. lygidakis@gmail.com. 3. College of Medicine and Health Sciences, University of Rwanda, Huye, Rwanda. 4. Centre for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark. 5. Luxembourg Institute of Socio-Economic Research (LISER), Esch-sur-Alzette, Luxembourg. 6. Butaro Cancer Centre of Excellence, Burera, Rwanda. 7. AIDS Healthcare Foundation (AHF) Rwanda, Kigali, Rwanda. 8. Rwanda Biomedical Center, Kigali, Rwanda. 9. Department of Behavioural and Cognitive Sciences, University of Luxembourg, Porte des Sciences 11, 4366, Esch-sur-Alzette, Luxembourg.
Abstract
BACKGROUND: High prevalence rates in diabetes-related distress have been observed in several studies; however, in the region of Sub-Saharan Africa evidence is lacking as is, for example, the case for Rwanda, where diabetes prevalence is expected to increase over the next decade. The aim of this study is to report on the translation and cultural adaption of the problem areas in diabetes (PAID) questionnaire into Kinyarwanda and its psychometric properties. METHODS: The questionnaire was translated following a standard procedure. Interviews were conducted with 29 participants before producing a final version. For the psychometric evaluation, a sample of 266 patients with diabetes mellitus, aged 21-64 years old were examined. Participants either came from a separate cluster-randomised controlled trial or were recruited ad-hoc for this study. The evaluation included testing internal consistency, known groups validity, and construct validity. A series of confirmatory factor analysis were conducted investigating seven previously established factorial structures. An exploratory factor analysis (EFA) was also carried out to examine the structure further. RESULTS: The full scale showed good internal reliability (Cronbach's α = 0.88). A four-factor solution previously tested in Spain with subdimensions of emotional, treatment, food-related and social-support problems demonstrated adequate approximate fit (RMSEA = 0.056; CFI = 0.951; TLI = 0.943). The EFA revealed a four-factor structure; however, two of these factors were not as homogeneous and easily interpretable as those of the Spanish model. CONCLUSIONS: The psychometric properties of the Kinyarwanda version of PAID are acceptable. The questionnaire can be helpful in research and clinical practice in Rwanda, however certain cross-cultural differences should be taken into account.
BACKGROUND: High prevalence rates in diabetes-related distress have been observed in several studies; however, in the region of Sub-Saharan Africa evidence is lacking as is, for example, the case for Rwanda, where diabetes prevalence is expected to increase over the next decade. The aim of this study is to report on the translation and cultural adaption of the problem areas in diabetes (PAID) questionnaire into Kinyarwanda and its psychometric properties. METHODS: The questionnaire was translated following a standard procedure. Interviews were conducted with 29 participants before producing a final version. For the psychometric evaluation, a sample of 266 patients with diabetes mellitus, aged 21-64 years old were examined. Participants either came from a separate cluster-randomised controlled trial or were recruited ad-hoc for this study. The evaluation included testing internal consistency, known groups validity, and construct validity. A series of confirmatory factor analysis were conducted investigating seven previously established factorial structures. An exploratory factor analysis (EFA) was also carried out to examine the structure further. RESULTS: The full scale showed good internal reliability (Cronbach's α = 0.88). A four-factor solution previously tested in Spain with subdimensions of emotional, treatment, food-related and social-support problems demonstrated adequate approximate fit (RMSEA = 0.056; CFI = 0.951; TLI = 0.943). The EFA revealed a four-factor structure; however, two of these factors were not as homogeneous and easily interpretable as those of the Spanish model. CONCLUSIONS: The psychometric properties of the Kinyarwanda version of PAID are acceptable. The questionnaire can be helpful in research and clinical practice in Rwanda, however certain cross-cultural differences should be taken into account.
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