Psychometric assessment and application of the Chinese version of the Compliance with Annual Diabetic Eye Exams Survey in people with diabetic retinopathy. Issue 1 (18th August 2019)

• Record Type: Journal Article
• Authors: Zhu, X.; Xu, Y.; Xu, X.; Zhu, J.; He, X.; Lu, L.; Zou, H.
• Is Part Of: Diabetic medicine. Volume 37:Issue 1(2020)
• Page Start: 84
• Page End: 94
• Publication Date: 2019-08-18
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14092
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aim: To translate the Compliance with Annual Diabetic Eye Exams Survey (CADEES) into Chinese, allowing assessment of its reliability and validity, and to identify variables that predict attendance at annual eye examinations. Methods: People with vision‐threatening diabetic retinopathy were recruited from the Shanghai Diabetic Eye Study. The study involved three phases: (1) translation and cross‐cultural adaptation, (2) a pilot study ( n = 496) to evaluate the psychometric properties of the Chinese‐CADEES, and (3) a primary cross‐sectional survey ( n = 3818) to assess self‐reported attendance at annual eye examinations. Factors related to non‐attendance were identified using univariate analysis, and then a multiple logistic regression model. Finally, a component model and individual item models were built to predict attendance. Results: The Chinese‐CADEES had satisfactory reliability and validity. The issue of low attendance at annual eye examinations was serious. In addition to 13 health belief items, living in semi‐urban suburban areas, shorter duration of diabetes, poor glucose control, lower education level, better presenting visual acuity and milder diabetic retinopathy diagnosis were significantly related to non‐attendance. The multivariate predictive model was able to predict, with 64.7% accuracy, whether or not participants were going to attend annual eye examinations and explained ~ 11.3% of the variance in attendance. Conclusions: The Chinese‐CADEES showed good reliability and validity for predicting attendance at annual eye examinations in people with diabetic retinopathy. Clinicians and researchers can improve attendance by addressing modifiable characteristics and increasing education on diabetic retinopathy and the importance of eye health in people with diabetes. What's new?: This is the first time that the Compliance with Annual Diabetic Eye Exams Survey (CADEES) has been applied to a compliance study in a large sample of people with vision‐threatening diabetic retinopathy recruited from communities in Shanghai. The Chinese‐CADEES showed satisfactory psychometric properties in our pilot study. Our cross‐sectional survey found that the issue of low adherence was serious. People's awareness of diabetes and diabetic retinopathy, attention to self‐health care and awareness of self‐health status, rather than financial or medical accessibility obstacles, severely affected attendance at annual eye examinations in Shanghai.