Scale for Assessing Understanding of Benefits and Risks of Using Complementary Therapies in Diabetes Management: Psychometric Evaluation

BACKGROUND: The lack of a comprehensive assessment tool to evaluate patient understanding of the benefits and risks of complementary therapies (CTs) in diabetes management may lead to the unsafe use of CTs alongside conventional treatments, increased risk of misinformed decision-making, potential adverse interactions, and compromised health outcomes. PURPOSE: In this study, an instrument was developed to assess patient understanding of the benefits and risks of using CTs in diabetes management and its psychometric properties were evaluated. METHODS: A two-phase design, including scale development and psychometric validation, was used. In Phase 1, the initial scale items were revised and confirmed by a panel of experts for content validity. In Phase 2, a cross-sectional survey was conducted to assess the scale's psychometric properties, including reliability and validity analyses. A sample of 307 outpatients with diabetes who had used CTs all completed a sociodemographic, clinical characteristics, and CT usage data sheet, as well as the Understanding the Benefits-Risks of CT Use in Diabetes Scale and the Diabetes Empowerment Scale. The developed scale was validated using exploratory and confirmatory factor analyses that used structural equation modeling to confirm construct validity, Person correlation to confirm criterion-related validity, and Cronbach's α coefficient to confirm reliability. RESULTS: The initial 16-item Understanding the Benefits-Risks of CT Use in Diabetes Scale was assessed as having a content validity index of .88. Factor analyses reduced the scale to 15 items in four dimensions, including the patient's medical condition for CT use (four items), the benefit-risk assessment of CTs use (four items), the suitability of CT use (five items), and the support from health care professionals (two items). The model met all goodness-of-fit indices (GFI=.90, AGFI=.90, CFI=.94, NFI=.926, RMSEA=.08, and χ 2 / df =3.14). The reliability analysis indicated good internal consistency (α=.912) and correlation with the Diabetes Empowerment Scale ( r =.425). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Understanding the Benefits-Risks of CT Use in Diabetes Scale offers valuable insights for both patients and health care professionals. By providing a comprehensive assessment of patient knowledge and awareness of their CT use, this tool helps health care professionals identify gaps in patient understanding, tailor patient education, and ensure safe and effective integration of CTs into diabetes management programs.