Validity and Reliability of the Chinese Version of the Diabetes Treatment Burden Questionnaire (DTBQ) Among Patients with Type 2 Diabetes

Figures & data

Table 1 Factor Load and Communalities of Each Item in DTBQ of 18 Items (n=329)

Item	F1	F2	F3	Commonalities
Q9	0.750	−0.141	−0.089	0.590
Q2	0.731	0.115	0.397	0.705
Q5	0.720	0.242	0.016	0.577
Q7	0.691	−0.054	−0.130	0.497
Q1	0.680	0.106	0.367	0.608
Q4	0.676	0.252	0.107	0.533
Q3	0.637	0.173	0.411	0.605
Q6	0.599	0.094	−0.141	0.388
Q10	0.557	−0.128	−0.177	0.358
Q8	0.493	0.068	0.011	0.248
Q17	0.029	0.032	0.853	0.729
Q16	−0.018	0.073	0.840	0.711
Q15	−0.087	0.081	0.804	0.661
Q14	0.027	0.126	0.752	0.582
Q18	0.032	−0.064	0.735	0.545
Q12	0.156	0.846	0.016	0.740
Q11	0.188	0.814	0.034	0.700
Q13	−0.055	0.597	0.104	0.370

Notes: Statistically significant values are shown in bold.

Table 2 Factor Load and Communalities of Each Item in DTBQ of 15 Items (n=329)

Item	F1	F2	F3	Commonalities
Q2	0.797	0.062	0.348	0.759
Q1	0.733	0.054	0.325	0.645
Q5	0.723	0.240	−0.018	0.580
Q9	0.712	−0.107	−0.120	0.533
Q3	0.699	0.115	0.369	0.637
Q4	0.689	0.236	0.072	0.536
Q7	0.676	−0.035	−0.165	0.485
Q17	0.074	0.014	0.850	0.727
Q16	0.02	0.072	0.843	0.717
Q15	−0.075	0.108	0.817	0.684
Q14	0.038	0.154	0.758	0.600
Q18	0.057	−0.057	0.735	0.547
Q12	0.143	0.859	0.024	0.760
Q11	0.178	0.838	0.041	0.735
Q13	−0.003	0.566	0.101	0.330

Notes: Statistically significant values are shown in bold.

Table 3 Evaluation Fitness of DTBQ Model

Model	CMIN/DF	NFI	RFI	IFI	TLI	CFI	PNFI	PCFI
Initial model	7.066	0.750	0.703	0.778	0.734	0.776	0.631	0.653
Modified model	3.575	0.888	0.860	0.917	0.900	0.916	0.711	0.733
Standard value	<5.000	>0.900	>0.900	>0.900	>0.900	>0.900	>0.500	>0.500

Abbreviations: CMIN/DF, Chi-Square Degree of Freedom; NFI, Normed Fit Index; RFI, Relative Fit Index; IFI, Incremental Fit Index; TLI, Tucker Lewis Index; CFI, Comparative Fit Index; PNFI, Parsimonious Normed-of-Fit Index; PCFI, Parsimonious Comparative-of-Fit Index.

Figure 1 Standardized three-factors structural model of the Chinese version of the 18-item DTBQ (n=329); F1(Implementation burden, 7 items), F2(Flexibility burden, 3 items), and F3(BG control burden, 5 items).

Figure 2 Standardized three-factors structural model of the Chinese version of the 15-item DTBQ (n=329); F1(Implementation burden, 7 items), F2(Flexibility burden, 3 items), and F3(BG control burden, 5 items).

Table 4 Discriminant Validity Analysis of the Chinese version of the 15-item DTBQ (n = 329)

Item	Low-Score Group	High-Score Group	CR(t)	P
	Mean ± SD	Mean ± SD
Q1	2.06±0.96	5.16±0.37	29.597	<0.001
Q2	2.58±1.30	5.51±0.50	57.265	<0.001
Q3	2.10±1.05	5.13±0.40	49.116	<0.001
Q4	1.55±1.10	4.57±0.64	38.893	<0.001
Q5	2.24±1.01	5.09±0.36	71.698	<0.001
Q7	2.43±0.99	5.09±0.29	84.555	<0.001
Q9	1.89±0.99	4.46±0.57	9.734	<0.001
Q11	1.75±0.83	4.34±0.62	2.935	<0.001
Q12	1.64±0.64	4.02±0.74	1.279	<0.001
Q13	1.62±0.67	4.28±0.58	3.662	<0.001
Q14	1.81±0.50	4.21±0.85	16.225	<0.001
Q15	1.83±0.46	4.34±0.81	29.970	<0.001
Q16	1.82±0.56	4.34±0.80	20.038	<0.001
Q17	1.81±0.52	4.64±0.83	55.421	<0.001
Q18	1.76±0.54	4.90±0.94	96.178	<0.001

Note: P: significance coefficient.

Abbreviations: SD: Standard Deviation; CR: Critical Ratio.

Table 5 Item-Total Score Pearson Correlation Analysis Results in the Chinese version of the 18-item DTBQ (n=329)

Item	Questions Abbreviated	r	P
Q1	Medication on time	0.700	<0.001
Q2	Medication during busy hours	0.768	<0.001
Q3	Time ensure for medication	0.715	<0.001
Q4	Pain associated with medication	0.652	<0.001
Q5	To feel that I should not miss a dose	0.637	<0.001
Q6	To feel guilty when I miss a dose	0.350	<0.001
Q7	Medication away from home	0.470	<0.001
Q8	Concern about hypoglycemia	0.343	<0.001
Q9	Not to flexibly adjust the time for medication	0.529	<0.001
Q10	To worry about future	0.367	<0.001
Q11	Short time and small effort for medication	0.442	<0.001
Q12	Medication without time pressure	0.414	<0.001
Q13	To allow me to take a missed dose	0.238	<0.001
Q14	To feel that my diabetes is getting better	0.484	<0.001
Q15	To allow me to control BG with small effort	0.405	<0.001
Q16	To feel less burden to follow diet therapy	0.458	<0.001
Q17	To feel less burden to continue diabetes treatment	0.477	<0.001
Q18	Satisfied with my current BG control	0.424	<0.001

Notes: r: correlation coefficient; P: significance coefficient.

Table 6 Item-Total Score Pearson Correlation Analysis Results in the Chinese version of the 15-item DTBQ (n=329)

Item	Questions Abbreviated	r	P
Q1	Medication on time	0.703	<0.001
Q2	Medication during busy hours	0.782	<0.001
Q3	Time ensure for medication	0.729	<0.001
Q4	Pain associated with medication	0.633	<0.001
Q5	To feel that I should not miss a dose	0.606	<0.001
Q7	Medication away from home	0.427	<0.001
Q9	Not to flexibly adjust the time for medication	0.465	<0.001
Q11	Short time and small effort for medication	0.448	<0.001
Q12	Medication without time pressure	0.416	<0.001
Q13	To allow me to take a missed dose	0.293	<0.001
Q14	To feel that my diabetes is getting better	0.526	<0.001
Q15	To allow me to control BG with small effort	0.453	<0.001
Q16	To feel less burden to follow diet therapy	0.516	<0.001
Q17	To feel less burden to continue diabetes treatment	0.533	<0.001
Q18	Satisfied with my current BG control	0.466	<0.001

Notes: r: correlation coefficient; P: significance coefficient.

Table 7 Comparison of Cronbach’s Alpha of DTBQ

	Factors	Cronbach’s Alpha
Original 18-item scale	Implementation burden	0.887
	Flexibility burden	0.775
	BG control burden	0.862
	Overall	0.885
Chinese 18-item scale	Implementation burden	0.855
	Flexibility burden	0.665
	BG control burden	0.873
	Overall	0.829
Chinese 15-item scale	Implementation burden	0.863
	Flexibility burden	0.665
	BG control burden	0.873
	Overall	0.831