Words and Meaning: A Cautionary Tale for Diabetes Educators

The authors developed a Diabetes Attitude Survey (DAS) to measure the attitudes of health care professionals toward diabetes. After examining the results of an initial survey using the DAS, the authors felt that it would be useful to know something about the attitudes of patients regarding these same diabetes-related issues. The DAS was reworded to eliminate technical terms and to make it appropriate for patients with diabetes. To assess the impact of these wording changes, both versions of the DAS were sent to a sample of physicians, nurses, and dietitians. The wording changes produced changes in scores on the majority of the items that had been modified. The paper discusses some of the reasons for the changed scores and the impact of modifying the wording of assessment and evaluation instruments.