Key result
Shortened 13-item Problem Areas in Diabetes scale shows ~0.94 correlation with the original version.
Why the study?
The Problem Areas in Diabetes scale is used to measure diabetes-related emotional distress, but consensus on its internal structure is lacking.
Cross-Sectional (n=185)
The shortened 13-item Problem Areas in Diabetes scale (PAID-13) is a valid and structurally appropriate tool for assessing emotional distress in Brazilian patients with diabetes.
Answers are grounded in this paper and cite their sources.
Supports PAID-13 for diabetes distress assessment in Brazil; leaves open prospective validation of clinical utility.
BACKGROUND: The Problem Areas in Diabetes scale (PAID) is used to measure emotional distress levels related to diabetes mellitus (DM). However, consensus on its internal structure is lacking. OBJECTIVES: To compare the different internal structures of the PAID and propose a shortened version for Brazilian patients with diabetes. DESIGN AND SETTING: Structural and criterion validity study. METHODS: We included Brazilian patients with type 1 DM (DM1) and type 2 DM (DM2) in this study. In accordance with the international consensus recommendations, we assessed the structural validity using confirmatory factor analysis (CFA) and used the following indices to evaluate model fit: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR), chi-square/degrees of freedom (DF), Akaike information criterion (AIC) and sample-size adjusted Bayesian information criterion (SABIC). Modification indices and factor loadings were used to reduce the number of items. RESULTS: One hundred eighty-five patients, most of whom included women with DM2, participated in the study. The reduction in the PAID generated a unidimensional structure with 13 items (PAID-13). The PAID-13 presented the best-fit indices (chi-square/DF = 2.15, CFI = 0.989, TLI = 0.986, RMSEA = 0.079, and SRMR = 0.049). When the PAID versions with 13 and 20 items (original version) were correlated, a strong correlation was observed (rho = 0.941, P < 0.001). CONCLUSION: The short version of the PAID scale with 13 items presented a more appropriate internal structure for Brazilian patients with diabetes.
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Rocha et al. (2025) conducted a cross-sectional in Type 1 and Type 2 Diabetes Mellitus (n=185). PAID-13 (Short version of the Problem Areas in Diabetes scale) vs. PAID-20 (Original version) was evaluated on Criterion validity (correlation between PAID-13 and PAID-20) (rho 0.941, p=<0.001). The short version of the Problem Areas in Diabetes scale with 13 items (PAID-13) presented an appropriate internal structure and correlated strongly (rho = 0.941) with the original 20-item version.
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