| BackgroundDiabetes is a metabolic syndrome as the main features of high bloodglucose. It can cause many complications such as retinopathy, kidney, nephropathy, cardiovascular. Most of diabetic patients are type 2 diabetes. Type 2 diabetes were mainly seen in adults and elderly people. In China, the prevalence of diabetes rose rapidly. According to the reports of National Development Reform Commission and Centre of Public Nutrition and Development in 2003, diabetes prevalence of 40,000 adults was 3.62%. Compared with the report in 1980, it increased by 5.4 times. Experts estimate that there are more than 92 million diabetic patients who are over 20 years old in China. IGT International Forum,2002 Lisbon, reported that by 2025 almost every three people with diabetes will live in India or China.There is no method to cure the diabetes. Diabetes is a chronic disease that requires long-time treatment. International Diabetes Federation recommend that the best therapy of diabetes include diet, exercise, drugs, self-monitoring and health education. American Diabetes Control and Complications trial (DCCT) also showed that:diabetes education can increase the active cooperation of patients. Therefore, to improve the awareness, knowledge and skills about diabetes can help patients achieve good control of diabetes.As the self-care of diabetes is very complicated, it will increase the psychological suffering of people with diabetes. Studies showed that diabetic incidence of depression was between 18-35%. The condition of diabetic patients with depression were worse than patients without depression in the functional, self-management, and merger complications. Recent studies have also found that diabetic patients who did not get depression has a strong psychological burden. Diabetes-related conflict with loved ones may develop, and relationships with health care providers may become strained. The risk of depression is elevated also. As a result, motivation for self-care may be impaired. So it is very important to measure the psychological burden of diabetic patients. This study aim to tap the range of emotional responses of diabetes.Although many clinicians now regularly screen for depression among their patients with diabetes. But as now there is no time-efficient tool for use in the clinical setting that can be used to screen patients for diseaserelated distress. Ideally, such a clinically useful instrument would be brief, easy to score, and could lead directly to intervention. Diabetes Distress scale (DDS) was developed to address these needs by William H. Polonsky, etc in 2005. There are 17 items in the DDS. The scale yields 4 reliable subscales that target different areas of potential diabetes-specific distress to help clinicians and patients identify areas where interventions might be helpful: emotional burden, physician-related distress, regimenrelated distress, and interpersonal distress. In this study we will translate DDS and assessment the reliability and validity of the Chinese version of the DDS.ObjectiveTo develop a brief diabetes distress screen instrument for using in clinical settings.MethodPartâ… , we translated the English version of Diabetes Distress Scale (DDS) into Chinese.Partâ…¡, we tested the reliability and validity of the Chinese version of DDS. We selected 99 cases at Aug2009-Feb 2010 in the top three hospital in Guangzhou. (selected criteria:adults over 18 years old; according with the clinic evaluation standard of diabetes of the WHO; agreed to participate in this study; exclusion criteria:a language or communication barriers; serious diabetes-related complications). Researchers distributed a questionnaire to patients, if patients were illiterate or unable to fill it, the researchers completed the questionnaire by verbal report. After completed questionnaires were taken back on the spot, Researchers checked whether the questionnaire were all filled. If missing item were found, the patients were asked to add immediately.Partâ…¢, we investigated the situation of the diabetes-related distress. The general situation (age, marital status, residence, education, etc.), treatment, metabolic parameters (blood glucose, blood lipids, blood pressure, etc.) of people with diabetes were analysised. And then the main reasons of diabetes-related distress were researched.The data were analyzed by SPSS 15.0, using many methods which included descriptive analyses, Cronbach's Alpha coefficient,2 independent samples tests, principal components/factor analysis, Chi-square test, Mann Whitney test et al. There was statistical significance according to the P<0.05 in all results. Result1. Cronbach's a coefficient of the DDS and 4 subscale was between 0.842-0.951, The internal consistency reliability coefficient of the scale was high. Factor loading was approximately consistent with the structure and content of three of the sub-scales: emotional burden subscale (EB); physician-related distress subscale(PD); diabetes-related interpersonal distress subscale (ID). But the regimen-related distress subscale (RD) was not consistent with the structure and content.2. The clinical practice of DDS:The result of self-rating depression scale showed that there was one patient with depression. The result of DDS showed that there are 8 patients with diabetes-relate distress.Conclusion1. The Chinese version of the DDS had good reliability and validity. The scale was simple, short and easy to score. DDS may serve as a valuable measure of diabetes-related emotional distress for using in research and clinical practice.2. Health care providers should pay attention to the emotional burden and diabetes-related interpersonal distress. And the education about dietd and exercise therapy was importent. To educate the families of diabetic patient are very useful to self-management of diabetes.
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