How to Assess Diabetes Distress – Scott's Diabetes

[00:08:57] Dr. Bill Polonsky: So again, you can still use the PAID as you've always used it. You can still use the DDS (Diabetes Distress Scale). What we think is a better choice is this eight-item core scale, the core scale that was developed for the T1-DDAS and the T2-DDAS. One of the reasons we like this scale so much is that it's very short.

[00:09:22] Dr. Bill Polonsky: Eight items. That's it. You could use more items, but for a mixed sample, stick with these eight items. This is what more and more busy researchers are doing. They just don't want to overwhelm people with too many items. And this eight-item core scale is very valuable. And by the way, some of you may have used, and I hate to say it, another thing that we developed many years ago, which is a two-item screener, the diabetes distress screener.

[00:09:50] Dr. Bill Polonsky: If I remember correctly, these are items taken from the DDS (Diabetes Stress Scale), and we've seen this two-item screener used in various studies and in the field. We don't think it's a very good idea. People take this two-item scale (it's hard for me to call it a scale) and think it's measuring diabetes stress.

[00:10:14] Dr. Bill Polonsky: But this is just a screener. If you want to keep it very brief because you're doing a research study or you're worried about burdening your patients, use the core scale at the end of this slide. Susan, I think you're very much in favor of that idea.

[00:10:32] Dr. Bill Polonsky: Any thoughts on that?

[00:10:35] Dr. Susan Guzman: Well, I think if we use just two items to indicate whether a person is in distress, we miss a lot of people. In fact, I would argue that we should use the whole subscale. I know that in a lot of situations, or maybe in studies, that's not realistic, but I know that people will elevate one source scale and that could be worthy of a conversation.

[00:11:04] Dr. Susan Guzman: And rather than thinking of measuring distress as a sign of pathology or mental disorder, but rather thinking of someone saying, “I'm having difficulties” with respect to the emotional aspects of diabetes. And these difficulties are worth having a conversation about. So in terms of the clinical dialogue, I think we want people to be assessed in a more holistic way.

[00:11:31] Dr. Bill Polonsky: Yes, perfectly fine. To be fair, if you think about that first slide that I showed you, I had all seven scales there, but I said I would focus on the first five. There are other reasons why people still go back to and use PAID and DDS and T1 DDS. It has to do with other things.

[00:11:51] Dr. Bill Polonsky: Perhaps you want to use this scale in a study in another language. For these scales, our new scales, the T1 and T2 DDAS, are new. They're not available in many other languages. Spanish, maybe one more. But the DDS, for example, has been around for 20 years and is available in almost 40 languages.

[00:12:12] Dr. Bill Polonsky: All of these are available on the behavioraldiabetes.org website. All of them are freely available to people with diabetes and researchers, and can be used wherever and however you like. Please visit the behavioraldiabetes.org website.

[00:12:33] Dr. Bill Polonsky: PAID is not on our website. It is the only device that we do not own the copyright for. If you are interested in doing research with PAID, please contact the copyright holder, which is my former employer, Joslin Diabetes Center in Boston. One other thing I want to mention here is something that we are really proud of. If you would like to try these devices out, rather than just go to our website and download them and check them out, there is one other thing that I mentioned briefly before that is very interesting to know about. I'll show you one more slide so you can see what that page looks like.

[00:13:11] Dr. Bill Polonsky: It's called DiabetesDistress.org. DiabetesDistress.org is proud to announce that the first five scales, the other four are all free to use, except for the paid ones. You can check it out now, use it, and get feedback. To access the scale, go to this website, and complete the scale by simply touching the numbers on the right. When you fill it out, enter numbers that are meaningful to you. You can check it out at any time. It will be scored automatically and you will be given a small summary page where you can see your score for the tool you selected, including the total score, the sub-scales, the source scales, and the core scales. The website offers everything in English and Spanish.