Perceived Benefits and Barriers Regarding CSII Treatment: Development and Psychometric Evaluation of the Insulin Pump Attitudes Questionnaire (IPA-Questionnaire)

Dominik Bergis; Timm Roos; Dominic Ehrmann; Andreas Schmitt; Melanie Schipfer; Thomas Haak; Bernhard Kulzer; Norbert Hermanns

doi:10.1055/a-0899-4980

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2021; 129(08): 566-573
DOI: 10.1055/a-0899-4980

Article

Perceived Benefits and Barriers Regarding CSII Treatment: Development and Psychometric Evaluation of the Insulin Pump Attitudes Questionnaire (IPA-Questionnaire)

Dominik Bergis

¹Division of Endocrinology & Diabetes, Department of Internal Medicine 1, Goethe University Hospital, Frankfurt am Main, Germany

,

Timm Roos

²Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany

,

Dominic Ehrmann

²Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany

³Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany

,

Andreas Schmitt

⁴Diabetes Akademie Bad Mergentheim, e.V., Bad Mergentheim, Germany

,

Melanie Schipfer

⁶Profusa, Inc., 345 Allerton Ave, South San Francisco, CA 94080, USA

,

Thomas Haak

²Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany

⁵Diabetes Clinic Mergentheim, Bad Mergentheim, Germany

,

Bernhard Kulzer

²Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany

³Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany

⁵Diabetes Clinic Mergentheim, Bad Mergentheim, Germany

,

Norbert Hermanns

²Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany

³Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany

⁵Diabetes Clinic Mergentheim, Bad Mergentheim, Germany

› Author Affiliations

Abstract

Background Continuous subcutaneous insulin infusion is the most advanced and demanding form of insulin therapy. Various positive and negative expectations, attitudes and experiences can occur, influencing adherence to and efficacy of continuous subcutaneous insulin infusion therapy. A new questionnaire was developed to systematically assess perceived benefits, perceived barriers and handling of continuous subcutaneous insulin infusion therapy.

Methods The Insulin Pump Attitude Questionnaire was tested in two samples (n=265/452) comprising pump users and non-pump users. Reliability was assessed using Cronbach’s Alpha estimation. Exploratory and confirmatory factor analyses were conducted to establish the factorial structure. Correlations with other questionnaires as well as group differences between pump users and non-pump users were used to assess validity.

Results Exploratory factor analysis revealed 26 items comprising six subscales: “Glycaemic Control”, “Flexibility”, “Impaired Body Image”, “Technology Dependency”, “Ease Of Use” and “Functionality”. Confirmatory factor analysis confirmed this factor structure. The IPA sum score correlated significantly with diabetes distress (r=−0.30), self-efficacy (r=0.22), diabetes empowerment (r=0.36), psychological well-being (r=0.16) and treatment dissatisfaction (r=−0.24), supporting criterion validity with small to medium effect sizes. Furthermore, the IPA was able to differentiate between pump users and non-pump users with higher scores for pump users regarding “Glycaemic Control”, “Flexibility”, “Ease of use” and “Functionality” and lower scores for pump users regarding “Impaired Body Image” and “Technology Dependency”.

Conclusions The Insulin Pump Attitude Questionnaire is a reliable and valid new instrument to assess attitudes towards continuous subcutaneous insulin infusion. With six scales, the Insulin Pump Attitude Questionnaire provides a comprehensive analysis of possible benefits, barriers, and handling problems of continuous subcutaneous insulin infusion therapy. In clinical practice, the Insulin Pump Attitude Questionnaire might be used to address the different attitudes in pump users but also in people considering continuous subcutaneous insulin infusion therapy.

Key words

insulin therapy - diabetes mellitus - psychometry - psychometric validation - human factors - psychosocial aspects

Full Text

References

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