Diabulimia Knowledge Level Scale

Abstract

The Diabulimia Knowledge Level Scale (Çetinkaya Özdemir, Semerci, & Sönmez Sarı, 2023) was developed to ascertain nurses’ knowledge regarding diabulimia. Its content was formulated through a comprehensive literature review, drawing from sources such as Hoffmann (2019), Markowitz et al. (2010), and Ruth-Sahd et al. (2009), and was subsequently refined through rigorous psychometric analyses. The final instrument, comprising 19 items, was assessed using a sample of Turkish nurses, with reported results on factor analysis, reliability, and validity. The scale aims to quantify nurses’ understanding of diabulimia and to contribute to enhancing their awareness and knowledge in this domain.

Keywords

Behaviors, Diabulimia Knowledge Levels, General Information, Nurses, Physiological Effects, Psychological Effects

Authors

Çetinkaya Özdemir, Serap; Semerci, Vahide; Sönmez Sarı, Ebru

Purpose

The primary purpose of this scale is to assess nurses’ knowledge levels about diabulimia, with the ultimate goal of fostering increased awareness and knowledge among this professional group regarding the condition.

Validity

Content Validity: The content validity of the scale was rigorously evaluated. The Content Validity Index (CVI) demonstrated high concordance across various aspects: 0.97 for relationships, 0.92 for simplicity, and 0.95 for clarity. These results collectively indicate that the revised item pool possesses sufficient validity.

Construct Validity: Construct validity was supported through the application of factor analysis.

Reliability

Internal Consistency: The internal consistency of the Diabulimia Knowledge Level Scale was assessed using Cronbach’s alpha, with values ranging from .70 to .92, indicating good to excellent internal consistency across the scale and its subscales.

Test-Retest Reliability: To evaluate the stability of the scale over time, a sub-sample of nurses completed the scale on two occasions, with a three-week interval between administrations. The test-retest correlations for the total and factor scores ranged from 0.44 to 0.76. A paired samples t-test revealed no significant difference between the first and second applications (p = 0.154), suggesting good temporal stability.

Factor Analysis

Exploratory Factor Analysis (EFA)/Principal Component Analysis: EFA was conducted using the principal components method with varimax rotation to establish the factor structure of the scale. The analysis revealed a four-factor structure that collectively accounted for 68.53% of the total variance. During this process, several items were removed: items 6, 7, 13, 15, 16, 25, 35, 36, and 38 were excluded due to a lack of significant loading on any factor. Additionally, items 8 and 24 were removed as they loaded on more than one factor. Items loading on potential factors with two or fewer items (items 4, 5, 9, 14, 26, 27, 28, and 37) were also eliminated. The final scale thus comprised 19 items distributed across 4 factors.

Confirmatory Factor Analysis (CFA): The hypothesized 4-factor structure was further evaluated using CFA. The model fit indices were reported as follows: χ2 = 448.853, df = 146, p = 0.000, χ2/df = 3.074, NFI = 0.82, CFI = 0.87, RMSEA = 0.104, RMR = 0.07, GFI = 0.78, RFI = 0.79, IFI = 0.87, and TLI = 0.85.

Instrument: Diabulimia Knowledge Level Scale

Test Type: Original Inventory/Questionnaire

Format: The scale is structured as a 5-point Likert-type scale, with response options ranging from 1 = Strongly disagree, 2 = Disagree, 3 = Undecided, 4 = Agree, to 5 = Strongly agree.

Language Available: Turkish. The language present in the provided documentation is English.

Population Group: Human (Male and Female).

Age Group: Adulthood (18 years & older).

Population Details: The study was conducted in Turkey, with nurses serving as the respondents.

Test Methodology: The development and validation of the scale involved several key methodologies: Test Validity (including Construct Validity and Content Validity), Test Reliability (including Internal Consistency and Test-Retest Reliability), and Factor Analysis (including Confirmatory Factor Analysis, Exploratory Factor Analysis, and Principal Component Analysis).

Keywords

Behaviors, Diabulimia Knowledge Levels, General Information, Nurses, Physiological Effects, Psychological Effects

Authors

Author ORCID Identifier:

• Çetinkaya Özdemir, Serap: http://orcid.org/0000-0001-7706-4748

• Semerci, Vahide: http://orcid.org/0000-0003-3481-9500

• Sönmez Sarı, Ebru: http://orcid.org/0000-0001-7337-4853

Affiliation:

• Çetinkaya Özdemir, Serap: Sakarya University, Faculty of Health Sciences, Department of Internal Medicine Nursing

• Semerci, Vahide: Bayburt University, Faculty of Health Sciences, Department of Nursing

• Sönmez Sarı, Ebru: Bayburt University, Faculty of Health Sciences, Department of Nursing

Email Addresses:

• Çetinkaya Özdemir, Serap: [email protected]

• Semerci, Vahide: No data is Available

• Sönmez Sarı, Ebru: No data is Available

Correspondence Address:
Çetinkaya Özdemir, Serap: Sakarya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Sakarya, Turkey, 54050, [email protected]

Permissions & Fee and Test Year

Permissions: The scale may be used for research and teaching purposes.
Commercial Use: No.
Fee: No fee is required for its use.
Test Year: 2023.

References

Çetinkaya Özdemir, S., Semerci, V., & Sönmez Sarı, E. (2023). Development of the Diabulimia Knowledge Level Scale. Archives of Psychiatric Nursing, 46, 139–145. https://doi.org/10.1016/j.apnu.2023.09.003
Hoffmann, M. (2019). No data is Available
Markowitz, L. A., & Friedman, J. D. (2010). No data is Available
Ruth-Sahd, L. A., & Power, S. (2009). No data is Available

Items of the Diabulimia Knowledge Level Scale

This is a 19-item scale.
Factors and Subscales: The scale is structured around four subscales:

• General information

• Behaviors

• Psychological effects

• Physiological effects

The specific items comprising the scale are available in Table 5, Page 144 of the source reference: Çetinkaya Özdemir, S., Semerci, V., & Sönmez Sarı, E. (2023). Development of the Diabulimia Knowledge Level Scale. Archives of Psychiatric Nursing, 46, 139–145.

Items

1. Individuals with diabulimia intentionally skip insulin doses

2. Diabulimia occurs among type 1 diabetics

3. Diabulimia is more common during adolescence

4. Individuals with diabulimia skip meals to lose weight

5. Individuals with diabulimia may use laxatives (medications causing bowel movements) to lose weight

6. Individuals with diabulimia may intentionally induce vomiting to lose weight

7. Individuals with diabulimia are not satisfied with their bodies

8. Individuals with diabulimia care very much about their appearances

9. Individuals with diabulimia may display depressive behaviors

10. The self-esteem of individuals with diabulimia is low

11. Individuals with diabulimia may display obsessive behaviors

12. Lack of concentration can be observed in individuals with diabulimia

13. The moods of individuals with diabulimia change constantly

14. Diabulimia can cause growth deficiency in adolescents

15. Individuals with diabulimia have weakness/fatigue

16. Urinary tract infections can be seen in individuals with diabulimia

17. Muscle loss can be seen in individuals with diabulimia

18. Individuals with diabulimia may have osteoporosis (bone resorption) in the long term

19. Menstrual irregularities can be seen in women with diabulimia

Note. Items are rated from 1=Strongly disagree to 5=Strongly agree.