women with T2DM, internal consistency reliability of the
combined DSC-R subscales excluding the psychological fatigue
subscale was acceptable (Cronbach’s alpha = 093)
(Fritschi et al. 2012). In the current study, Internal consistency
reliability was again supported for the combined
DSC-R subscales excluding the fatigue subscale (Cronbach’s
alpha = 092) and the separate psychological fatigue subscale
(Cronbach’s alpha = 088).
Diabetes distress was measured using the Diabetes Distress
Scale (DDS) (Polonsky et al. 2005). The DDS contains
17 items that measure four domains of diabetes-related
emotional distress: Emotional Burden, Physician-related
Distress, Regimen-related Distress and Diabetes-related
Intrapersonal Distress. Participants use a Likert-type scale
to rate the degree to which each item has been problematic
during the past month. The answers range from 1 = ‘no
problem’–6 = ‘serious problem. In this study, internal consistency
reliability for the DDS was acceptable (Cronbach’s
alpha = 092).
All of the item standardized coefficient factor loadings to
each component was acceptable (>005) for both the DSCR
and the DDS scales in this study.
Depression was measured dichotomously by self-report.
Participants were asked if they had ever been diagnosed with
depression or were currently being treated for depression.
Blood glucose control was measured using two point-ofcare
methods for A1C, both of which have demonstrated
high levels of accuracy in comparison with laboratory
methods using high-performance liquid chromatography