Development and validation of the Diabetes Management Orientation Scale (DMOS): Assessing culturally related approaches to diabetes self-management

Aims: Self-management behaviours of type 2 diabetes are improved by self-efficacy while the role of culture is not well understood. This study explored cultural individualist and collectivist aspects of self-management and their relationship to diabetes control. Methods: 94 Adults with type 2 diabetes for over 1 year and Chinese spoken as a first language at home recruited through healthcare providers completed the newly developed Diabetes Management Orientation Scale (DMOS), and a validated Diabetes Self-Efficacy Scale (DSES). Exploratory factor analysis and logistic regression was used to examine the factor structure and relationship to glycemic control. Results: Three factors were extracted from the DMOS: Individualist, Collectivist, and Balanced Personal Responsibility (BPR) Orientations to self-management. BPR orientation was the only significant psychosocial predictor of glycemic control in this population (odds ratio of 2.85 for having good diabetes control; HbA1c < 7.0). Self-efficacy did not predict glycemic control in our sample. Conclusions: Self-management education and clinical care that builds on BPR orientation may be more important than a sole focus on strengthening self-efficacy. The DMOS has external validity and is potentially useful for both practice and research. Future research should explore how BPR orientation is developed, and whether it predicts glycemic control within more individualist cultures. (C) 2009 Elsevier Ireland Ltd. All rights reserved.