Translation and Psychometric Evaluation of the Diabetes Self-Management Questionnaire in Hebrew (H-DSMQ) for Adults With Type 2 Diabetes in Israel

Abstract

Type 2 diabetes (T2D) is a growing global health concern, including in Israel. Effective Diabetes self-management (DSM) is critical for achieving glycemic targets and preventing complications. While several tools exist to assess DSM, none have been translated for Hebrew-speaking populations. This study aimed to translate the Diabetes Self-Management Questionnaire (DSMQ) into Hebrew (H-DSMQ) and evaluate its psychometric properties. The DSMQ was translated into Hebrew using a standard forward–backward translation procedure. A convenience sample of 220 community-dwelling adults with T2D in Israel was recruited via PANEL4ALL. Internal consistency was tested with Cronbach's α. Construct validity was examined via Confirmatory Factor Analysis and known-groups validity, and criterion validity through correlations between H-DSMQ scores, HbA1c, and BMI. The H-DSMQ construct validity was supported by CFA. In addition, known-groups validity was established, with participants with less than 7% reporting significantly higher self-management in glucose monitoring, dietary control/nutrition management, and healthcare use compared to those with above 7.1% HbA1c levels. Criterion validity was demonstrated by significant negative correlations between HbA1c and healthcare use/glucose monitoring, and between BMI and nutrition management/physical activity. The reliability of the H-DSMQ subscales ranged from poor (healthcare use, α = 0.461) to good (physical activity, α = 0.83). The H-DSMQ is a reliable and valid tool for clinical and research purposes to assess self-care behaviors related to blood glucose management in Hebrew-speaking adults with T2D. The H-DSMQ may support nurses by encouraging constructive and comprehensive dialog for assessing DSM.