The Adolescent Patient Experiences of Diabetes Care Questionnaire (APEQ-DC): Reliability and Validity in a Study Based on Data from the Norwegian Childhood Diabetes Registry

Figures & data

Table 1 Sample Characteristics (N=335)

	N	Value
Gender
Male	141	50.9%
Female	136	49.1%
Mean age	277	14.8 years
Mean age when diagnosed with diabetes	277	9.0 years
Mean period with diabetes	277	5.8 years
Mean HbA1c level	252	8.2%
Number of consultations during previous year (mean: 6.2)
1–3	60	24.0%
4–6	77	30.8%
7–9	88	35.2%
10–21	25	10.0%
Shared residence
Yes	50	18.3%
No	223	81.7%
General condition today
Very poor	1	0.3%
Rather poor	7	2.1%
Both and	63	19.0%
Rather good	147	44.3%
Very good	114	34.3%
Norwegian
Yes	256	92.4%
No	21	7.6%

Table 2 Item Descriptives

	N	Missing (%)	Not Applicable/Do not Know (%)	Mean*	Ceiling (%)
Are you greeted well when you arrive at the paediatric department?	335	0.0	–	4.36	46.0
Do you think you spend a lot of time waiting at the paediatric department?	335	0.0	–	3.75	15.8
Do you meet the same nurses every time you visit the paediatric department?^†	333	0.0	0.6	4.23	36.3
Do the nurses talk to you in a way you understand?	335	0.0	–	4.52	56.4
Does it seem like the nurses are knowledgeable about diabetes and diabetes care?	335	0.0	–	4.57	64.8
Do you feel safe raising difficult issues with the nurses?	289	0.0	13.7	4.14	40.5
Do you meet the same doctor every time you visit the paediatric department?^†	333	0.0	0.6	4.25	47.1
Does the doctor talk to you in a way you understand?	331	0.3	0.9	4.49	56.8
Does it seem like the doctor is knowledgeable about diabetes and diabetes care?	332	0.0	0.9	4.70	75.0
Do you feel safe raising difficult issues with the doctor?	298	0.0	11.0	4.21	43.3
Do you get good help choosing the right insulin dosage?	334	0.3	–	4.33	46.4
Are you involved in deciding what to follow up before the next consultation?	302	0.0	9.9	3.94	35.8
Does it seem that those working at the outpatient clinic understand what it’s like to be young and have diabetes?	322	0.3	3.6	3.83	26.1
Do you have enough time in the consultation with the doctor or nurse?	334	0.3	–	4.43	55.1
Do you get good information and counselling on food intake?	333	0.6	–	3.47	18.0
Do you get good information and counselling on physical activity/exercise?	318	0.0	5.1	3.19	13.8
Are you involved in deciding what equipment to use?	331	0.3	0.9	4.03	44.4
Do you get good training in how to use the equipment?	328	0.6	1.5	4.29	46.0
Overall, has the follow-up at the outpatient clinic helped you with your diabetes?	334	0.3	-	4.29	47.3

Notes: *Most items were scored on a 5-point response scale ranging from 1 (“not at all”) to 5 (“to a very large extent”). ^†Items scored on a 5-point response scale ranging from 1 (“never”) to 5 (“always”).

Table 3 Factor Loadings and Reliability Statistics

	Factor Loading	Corrected Item-Total Correlation Coefficient	Cronbach’s Alpha
Consultation			0.77
Do you get good training in how to use the equipment?	0.70	0.58
Are you greeted well when you arrive at the paediatric department?	0.65	0.50
Do you get good help choosing the right insulin dosage?	0.57	0.52
Are you involved in deciding what to follow up before the next consultation?	0.51	0.53
Does it seem that those working at the outpatient clinic understand what it’s like to be young and have diabetes?	0.50	0.49
Do you have enough time in the consultation with the doctor or nurse?	0.50	0.45
Are you involved in deciding what equipment to use?	0.48	0.46
Information on food and physical activity/exercise			0.82
Do you get good information and counselling on food intake?	0.97	0.69
Do you get good information and counselling on physical activity/exercise?	0.67	0.69
Nurse contact*			0.69
Do the nurses talk to you in a way you understand?	0.71	0.55
Does it seem like the nurses are knowledgeable about diabetes and diabetes care?	0.66	0.51
Do you feel safe raising difficult issues with the nurses?	0.64	0.51
Doctor contact*			0.75
Does the doctor talk to you in a way you understand?	0.76	0.62
Do you feel safe raising difficult issues with the doctor?	0.72	0.60
Does it seem like the doctor is knowledgeable about diabetes and diabetes care?	0.69	0.58
Outcome			–
Overall, has the follow-up at the outpatient clinic helped you with your diabetes?	–	–	–

Note: *Separate factor analysis for nurse contact and doctor contact.

Table 4 Correlations Between Items and Indicators

	Consul-tation	Information on Food and Physical Activity/Exercise	Nurse Contact	Doctor Contact	Outcome
Do you get good training in how to use the equipment?	0.73	0.36	0.49	0.42	0.48
Are you greeted well when you arrive at the paediatric department?	0.64	0.28	0.49	0.43	0.36
Do you get good help choosing the right insulin dosage?	0.69	0.38	0.45	0.47	0.49
Are you involved in deciding what to follow up before the next consultation?	0.71	0.39	0.43	0.41	0.36
Does it seem that those working at the outpatient clinic understand what it’s like to be young and have diabetes?	0.67	0.36	0.48	0.36	0.49
Do you have enough time in the consultation with the doctor or nurse?	0.62	0.34	0.44	0.44	0.34
Are you involved in deciding what equipment to use?	0.68	0.39	0.34	0.32	0.29
Do you get good information and counselling on food intake?	0.49	0.92	0.41	0.44	0.31
Do you get good information and counselling on physical activity/exercise?	0.51	0.93	0.43	0.49	0.33
Do the nurses talk to you in a way you understand?	0.48	0.35	0.76	0.56	0.34
Does it seem like the nurses are knowledgeable about diabetes and diabetes care?	0.53	0.38	0.76	0.45	0.39
Do you feel safe raising difficult issues with the nurses?	0.52	0.35	0.85	0.51	0.32
Does the doctor talk to you in a way you understand?	0.45	0.37	0.50	0.82	0.35
Do you feel safe raising difficult issues with the doctor?	0.53	0.44	0.59	0.87	0.37
Does it seem like the doctor is knowledgeable about diabetes and diabetes care?	0.46	0.40	0.46	0.77	0.42
Overall, has the follow-up at the outpatient clinic helped you with your diabetes?	0.59	0.33	0.45	0.47	1.00

Note: Correlations in bold show item to own scale correlations.

Table 5 Construct Validity Testing: Associations Between Indicators, Background Variables/Data of the Patient and Responses to Individual Questions in the Questionnaire

	Consultation	Information on Food and Physical Activity/Exercise	Nurse Contact	Doctor Contact	Outcome
Gender	*	***	ns	*	*
Male	80.94	62.59	86.79	88.64	85.11
Female	76.92	50.46	83.79	84.53	79.44
Waiting time	–0.25***	–0.22***	–0.20***	–0.22***	–0.25***
Same nurses	0.24***	0.18**	0.24***	0.16**	0.19***
Same doctor	0.19***	0.16**	ns	0.19**	0.12*
Number of consultations	***	***	**	**	***
Too few	69.24	40.44	78.80	82.84	78.68
Appropriate	80.68	60.59	86.81	87.97	84.11
Too many	76.90	56.00	81.33	80.33	67.00
Accessibility of a dietitian	*	**	ns	*	ns
Yes	81.27	64.27	86.83	89.26	85.23
No	69.92	42.76	76.75	81.80	76.32
Accessibility of a psychologist	**	ns	*	**	ns
Yes	81.03	60.54	85.75	88.20	84.18
No	67.14	47.50	75.56	76.39	73.33
Who completed the questionnaire	***	**	*	**	ns
Patient	81.69	61.66	86.88	88.65	82.63
Both patient and caregiver	73.00	49.69	82.52	82.51	81.71
Caregiver	78.46	57.03	83.33	85.16	78.13
General condition today	0.33***	0.25***	0.32***	0.26***	0.30***

Notes: ***p<0.001; **p<0.01; *p<0.05. Data are Spearman’s rank correlation coefficients (r values) for continuous variables. The independent-samples t-test was applied to gender, accessibility of a dietitian and accessibility of a psychologist. One-way ANOVA was applied to the number of consultations and who completed the questionnaire.

Abbreviation: ns, not significant.