The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was first Full Guidelines, including scoring instructions, are available to Licensees on request. A change version of the DTSQ (DTSQc) is compared here with the original status (now called . Diabetes Treatment Satisfaction Questionnaire in its orig-. PDF | The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as they should also focus on The Diabetes Treatment Satisfaction Questionnaire (DTSQ) has been Download full-text PDF.
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E Items included in the Diabetes Treatment Satisfaction Questionnaire (DTSQ ). The following questions are concerned with the treatment of your diabetes. A change version of the DTSQ (DTSQc) is compared here with the original status The Diabetes Treatment Satisfaction Questionnaire change version (DTSQc). DownloadPDF MB. The Diabetes Treatment Satisfaction Questionnaire ( DTSQ) has been specifically designed to measure satisfaction.
However, in a resource-limited environment such as Nigeria, diabetes treatment satisfaction, medication adherence, and glycemic control probably may be lower than that reported in advanced nations of the world. In Nigerian Africans, diabetes treatment satisfaction remains a significant challenge particularly at primary care settings and is likely to affect adherence with medication and invariably blood glucose control. It is based on this premise that the authors were motivated to determine the role of diabetes treatment satisfaction in medication adherence and glycemic control among ambulatory type 2 diabetic Nigerians in a primary care clinic of a tertiary hospital situated in a resource-limited environment of Southeast Nigeria.
Umuahia is the capital of Abia State, Southeast Nigeria.
DTSQ - Diabetes Treatment Satisfaction Questionnaire
Abia State is endowed with abundant mineral and agricultural resources with supply of professional, skilled, semi-skilled, and unskilled workforce. Economic and social activities are low compared to industrial and commercial cities such as Onitsha, Port Harcourt, and Lagos in Nigeria.
Until recently, the capital city and its environ have witnessed an upsurge in the number of banks, hotels, schools, markets, industries, junk food restaurants, in addition to the changing dietary and social lifestyles.
The Department of Family Medicine serves as a primary care clinic within the tertiary hospital setting of the medical center.
All adult patients excluding those who need emergency health-care services, pediatric patients, and antenatal women are first seen at the Department of Family Medicine where diagnoses are made. Patients who need primary care are managed and followed up in the clinic while those who need other specialists care are referred to the respective core specialist clinics for further management. This was to ensure that the study population was familiar with prescribed oral hypoglycemic medications.
The exclusion criteria included critically ill patients and diabetic patients who were on insulin medication.
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Sample size estimation was determined using the formula  for estimating minimum sample size for descriptive studies and had been explained in previous publication by the authors. The eligible patients for the study were consecutively recruited for the study based on the inclusion criteria until the sample size of was achieved.
The study instrument consisted of sections on sociodemographic data, information on medication adherence, diabetes treatment satisfaction, and blood glucose control in the previous 1 month. Medication adherence was assessed by the use of pretested, interviewer-administered questionnaire on 30 days self-administered and reported therapy.
At the end of the study visit, the adherence section of the data collection tool was administered. The information collected at the end of the study visit included: i How many times per day do you take your blood glucose medication?
Diabetes treatment satisfaction was studied using questionnaire tool that was designed by the authors to suit Nigerian environment through review of relevant literature on outpatient treatment satisfaction  ,  ,  ,  ,  ,  and diabetes treatment satisfaction.
Pretesting of the diabetic treatment satisfaction and medication adherence section of the study instrument was done at the Family Medicine Clinic of the FMC, Umuahia. Five diabetic patients were haphazardly used for the pretesting of the diabetic treatment satisfaction and medication adherence questionnaires which lasted for 1 day. The pretesting was done to assess the applicability of the questionnaire tools.
All the patients used for the pretesting of the questionnaire instrument gave valid and reliable responses confirming the clarity and applicability of the questionnaire tools and questions were interpreted with the same meaning as intended. The baseline fasting blood glucose was recorded at the time of recruitment for each patient recruitment visit and subsequently at the end of the study visit.
Overall dissatisfaction referred to those who scored 0—2 points in all the domains examined, whereas specific dissatisfaction to the subscales of items of satisfaction referred to those that scored 0—2 points in specific domain.
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The ethical clearance was obtained from the Ethics Committee of the hospital. Consent was also obtained from the patients.
Percentages and frequencies were compared by Chi-square test. Results Of the diabetic patients studied, More so, 87 Furthermore, 74 Table 1: Diabetic treatment satisfaction, medication adherence, and blood glucose control among the study participants Of the diabetic patients that were satisfied with treatment, 80 Table 2: Association between overall diabetic treatment satisfaction and medication adherence Of the diabetic patients that were satisfied with treatment, 69 Table 3: Association between overall diabetic treatment satisfaction and blood glucose control Discussion This study has shown that Although the overall treatment satisfaction was high, it was skewed toward the lower end of satisfaction subscales.
The finding of this study is in tandem with the reports that satisfied diabetic patients had better medication adherence and glycemic control than their dissatisfied counterparts.
It was also expected that treatment satisfaction would be greater with insulin glargine given its longer action and constant release of insulin without a pronounced peak, achieved with only one daily injection compared with NPH insulin which even with two injections daily provides variable release of insulin. Both forms of the DTSQ are suitable for use by people with type 1 or type 2 diabetes.
Six items Qs. These are summed to produce a total Treatment Satisfaction score. On these two items, low scores represent good perceived blood glucose control. The most common factor structures seen for the DTSQs show all the Satisfaction items loading together on factor 1 this is the only important aspect of the questionnaire structure indicating a coherent scale measuring treatment satisfaction , with the Perceived Hyper- and Hypoglycaemia items items 2 and 3 loading together on factor 2 or separately on factors 1 and 2 or on 2 and 3.
It was predicted that the same pattern would be seen with the DTSQc with all six treatment satisfaction items loading on factor 1. The wording of the items themselves is the same for both the status and change versions, the small exception being part of the wording of item 7 recommending the treatment. The important differences lie in the wording of the response options and instructions, which, in the DTSQc, direct the respondent to compare their experience of the current treatment with their experience of treatment before the study began.
The original English is evaluated here UK and S. Africa for the first time and the German is used here for the first time in Germany and Switzerland as well as Austria.
The Status version was completed by patients at both baseline and endpoint. The Change version was completed only at endpoint. At endpoint patients completed the Status measure before completing the Change version.
Patients The subset of patients from the first two European trials to provide DTSQc data included: patients with type 1 diabetes and patients with type 2 diabetes. The two datasets were analysed separately. Patients were randomised to insulin glargine or NPH insulin. In the type 1 study, in addition to insulin glargine or NPH, regular human insulin was administered before each meal.
Table 1 shows the whole sample, broken down by their main demographic and clinical characteristics. Table 1 Demographic and clinical characteristics of the whole sample Full size table Data analysis Prior to performing psychometric analyses, the combinability of the subgroups defined by country and type of diabetes was tested by a method described elsewhere [ 18 ], which confirmed the acceptability of combining the samples.
Psychometric analysis Psychometric analysis was carried out to check the validity and reliability of the English- and German-speaking versions separately for language, pooled for type of diabetes , using factor analysis with principal components as the extraction method with Varimax rotation.
The criterion for the number of factors extracted in the unforced analysis was the number of principal components with eigenvalues greater than 1. A three-factor structure was subsequently forced. Reliability analysis including Cronbach's alpha was conducted on the six items intended to form the Treatment Satisfaction scale. Thus, increases in treatment satisfaction produced positive scores and decreases negative scores.
The two scales being compared have different widths. For Perceived Hyperglycaemia and Hypoglycaemia, positive scores indicate an increase in Perceived Hyperglycaemia or Hypoglycaemia and hence deterioration in these outcomes.
Other scores are referred to as Not at Ceiling and Not at Floor.This study, therefore, brings to the fore the need for improved diabetes management through periodic evaluation of treatment satisfaction as well as strengthening the standard of diabetic care aimed at enhancing medication adherence and good glycemic control. Patients were randomised to insulin glargine or NPH insulin.
In addition, the sample size for the study was relatively small, but this was the number of patients seen within the duration of the study. Participants were Japanese patients with type 2 diabetes treated at these centers.
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We cannot rule out these facts as potential sources of bias. Skewed satisfaction scores reflect a real phenomenon and not a failure of the scale, so changing the scale is not a good solution. However, in a resource-limited environment such as Nigeria, diabetes treatment satisfaction, medication adherence, and glycemic control probably may be lower than that reported in advanced nations of the world.
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