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diabetes mellitus, role strain, women with diabetes



  1. Huang, Chiu-Ling MS, RN
  2. Chen, Shi-Yu RN
  3. Hsu, Hui-Chun PhD, RN
  4. Wang, Ruey-Hsia PhD, RN


Background: Women with diabetes (type 1 and type 2) have excessive risk of developing cardiovascular disease compared with men with diabetes, so optimizing diabetes control is crucial for women to reduce this risk. Women with diabetes experience role strain, and a scale to measure role strain in the context of diabetes control could help healthcare providers improve diabetes control in women with diabetes.


Objective: The aims of the study were to develop a short-form scale for measuring role strain in Taiwanese women with diabetes and test its psychometric properties.


Methods: This study was conducted from October 2018 to May 2019 and used a cross-sectional design. Based on literature reviews and results of focus groups, a 28-item role strain scale was developed and administered to 519 women with diabetes in Taiwan. Item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability testing were used to examine the psychometric characteristics of the scale.


Results: A 9-item role strain scale including subscales for role guilt and role conflict, supported by exploratory factor analysis and confirmatory factor analysis, was produced. High role strain significantly correlated with high depression (r = 0.399, P < .001) and high hemoglobin A1c levels (r = 0.169, P < .001). The overall and subscale Cronbach's [alpha] ranged between 0.78 and 0.86, with test-retest reliability ranging between 0.64 and 0.81.


Conclusions: The role strain scale for women with diabetes is reliable and valid and can be used to evaluate role strain in women with diabetes.