{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:45:44Z","timestamp":1770741944674,"version":"3.49.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Comprehensive regular foot self-care is one of the most critical self-management behaviors for people with diabetes to prevent foot ulcer development and related complications. Yet, adequate foot self-care is only practiced by very few of those affected. To improve diabetic foot syndrome prevention, a valid and reliable instrument for measuring daily foot-care routines in patients with diabetes is needed. However, no such instrument is currently available in the German language. This study, therefore, aims to translate and cross-culturally adapt the \"Diabetic Foot Self-Care Behavior Scale\" (DFSBS) into German (DFSBS-D) and evaluate its validity and reliability.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Material and methods<\/jats:title>\n<jats:p>The DFSBS was translated from English into German using a forward-backward procedure as per previous recommendations. Factor analysis was used to study structural validity. To establish construct validity, 21 a priori hypotheses were defined regarding the expected correlation between scores on the new German version (i.e., DFSBS-D) and those of the following questionnaires measuring related constructs: (1) German version \"Diabetes Self-Care Activities Measure\" (SDSCA-G), (2) \"Frankfurter Catalogue of Foot Self-Care\" (FCFSP), and (3) \"Short Form 36\" (SF-36) and tested in 82 patients. To assess test-retest reliability, patients completed the DFSBS-D again after a 2-week interval. Test-retest reliability was assessed from stable patients\u2019 data (n = 48) by calculating two-way random-effects absolute agreement ICCs with 95% CI and Bland and Altman analyses. In addition, Cronbach\u2019s alpha was calculated as internal consistency measure.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The 7-item DFSBS-D showed good structural validity. Its single factor explains 57% of the total sample variance. Of the 21 predefined hypotheses, 13 (62%) were confirmed. The DFSBS-D\u2019s internal consistency was good (Cronbach\u2019s alpha = 0.87). Test-retest reliability over a 2-week interval was also good (ICC 0.76).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The DFSBS was successfully translated into German. Statistical analyses showed good DFSBS-D structural validity, test-retest reliability, and internal consistency. Yet, construct validity may be debated.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0269395","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T17:26:01Z","timestamp":1654277161000},"page":"e0269395","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Validity and reliability of the German translation of the Diabetes Foot Self-Care Behavior Scale (DFSBS-D)"],"prefix":"10.1371","volume":"17","author":[{"given":"Linda","family":"Lecker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Thienel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Djordje","family":"Lazovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inge","family":"van den Akker-Scheek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-9151","authenticated-orcid":true,"given":"Gesine H.","family":"Seeber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"pone.0269395.ref001","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.diabres.2018.02.023","article-title":"IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045","volume":"138","author":"NH Cho","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"issue":"1","key":"pone.0269395.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/193229680900300101","article-title":"The increasing incidence of diabetes in the 21st century","volume":"3","author":"DC Klonoff","year":"2009","journal-title":"J Diabetes Sci Technol"},{"issue":"Suppl1","key":"pone.0269395.ref003","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00508-019-1487-4","article-title":"Diabetische Neuropathie und diabetischer Fu\u00df (Update 2019)","volume":"131","author":"M Lechleitner","year":"2019","journal-title":"Wien Klin Wochenschr"},{"key":"pone.0269395.ref004","unstructured":"M\u00fcller-Wieland D, Ickrath M, Bitzer B. Digitale Transformation in der Diabetologie? In: Deutsche Diabetes Gesellschaft (DDG) und diabetes DE\u2013Deutsche Diabetes-Hilfe; eds. Deutscher Gesundheitsbericht Diabetes 2019. Die Bestandsaufnahme. Mainz: Kirchheim Verlag. 2019. pp. 257\u2013262."},{"issue":"5","key":"pone.0269395.ref005","doi-asserted-by":"crossref","first-page":"929","DOI":"10.2337\/dci18-0012","article-title":"The Cost of Diabetes Care\u2014An Elephant in the Room","volume":"41","author":"MC Riddle","year":"2018","journal-title":"Diabetes Care"},{"key":"pone.0269395.ref006","unstructured":"Goyal R, Jialal I. Diabetes Mellitus Type 2. [Updated 2021 Sep 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK513253\/"},{"key":"pone.0269395.ref007","volume-title":"Duale Reihe Innere Medizin","author":"K Arast\u00e9h","year":"2009","edition":"2"},{"issue":"2\u20134","key":"pone.0269395.ref008","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1053\/j.semvascsurg.2019.02.001","article-title":"The diabetic foot: Pathophysiology, evaluation, and treatment","volume":"31","author":"DF Bandyk","year":"2018","journal-title":"Semin Vasc Surg"},{"issue":"9","key":"pone.0269395.ref009","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1302\/2058-5241.3.180010","article-title":"Current concepts for the evaluation and management of diabetic foot ulcers","volume":"3","author":"AF Mavrogenis","year":"2018","journal-title":"EFORT Open Rev"},{"issue":"12","key":"pone.0269395.ref010","doi-asserted-by":"crossref","first-page":"2617","DOI":"10.2337\/dc06-1550","article-title":"Patient Interpretation of Neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care","volume":"29","author":"L Vileikyte","year":"2006","journal-title":"Diabetes Care"},{"issue":"1","key":"pone.0269395.ref011","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/0145721704272859","article-title":"Diabetes Foot Self-care Practices in a Rural Triethnic Population","volume":"31","author":"RA Bell","year":"2005","journal-title":"Diabetes Educ"},{"issue":"12","key":"pone.0269395.ref012","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.2337\/diacare.20.12.1833","article-title":"Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects","volume":"20","author":"T R\u00f6nnemaa","year":"1997","journal-title":"Diabetes Care"},{"issue":"4","key":"pone.0269395.ref013","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1111\/j.1464-5491.1995.tb00491.x","article-title":"Evaluation of a structured teaching and treatment programme for type 2 diabetes in general practice in a rural area of Austria","volume":"12","author":"TR Pieber","year":"1995","journal-title":"Diabet Med"},{"issue":"1","key":"pone.0269395.ref014","doi-asserted-by":"crossref","first-page":"36","DOI":"10.7326\/0003-4819-119-1-199307010-00006","article-title":"Reduction of lower extremity clinical abnormalities in patients with non-insulin dependent diabetes mellitus. A randomized, controlled trial","volume":"119","author":"DK Litzelmann","year":"1993","journal-title":"Ann Intern Med"},{"issue":"6","key":"pone.0269395.ref015","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/0002-9610(89)90183-9","article-title":"Prevention of amputation by diabetic education","volume":"158","author":"JM Malone","year":"1989","journal-title":"Am J Surg"},{"issue":"1","key":"pone.0269395.ref016","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/jnr.0b013e3182828e59","article-title":"Development and validation of a diabetes foot self-care behavior scale","volume":"21","author":"YF Chin","year":"2013","journal-title":"J Nurs Res"},{"issue":"2","key":"pone.0269395.ref017","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.diabres.2003.10.014","article-title":"Knowledge and practice of foot care in people with diabetes","volume":"64","author":"RD Pollock","year":"2004","journal-title":"Diabetes Res Clin Pract"},{"key":"pone.0269395.ref018","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s12955-014-0185-1","article-title":"Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G)","volume":"12","author":"M Kamradt","year":"2014","journal-title":"Health Qual Life Outcomes"},{"key":"pone.0269395.ref019","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/1477-7525-11-138","article-title":"The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control","volume":"11","author":"A Schmitt","year":"2013","journal-title":"Health Qual Life Outcomes"},{"issue":"Suppl","key":"pone.0269395.ref020","first-page":"137","article-title":"Entwicklung und \u00dcberpr\u00fcfung des neu entwickelten Fragebogens, Frankfurter Aktivit\u00e4tenkatalog der Selbstpflege\u2013Pr\u00e4vention Diabetisches Fu\u00dfsyndrom (Kurzform: FAS-Pr\u00e4DiFu\u00df)","volume":"14","author":"S Schmidt","year":"2005","journal-title":"Diabetes und Stoffwechsel: Zeitschrift f\u00fcr angewandte Diabetologie"},{"key":"pone.0269395.ref021","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511996214","volume-title":"Measurement in Medicine: practical guides to biostatistics and epidemiology","author":"HCW De Vet","year":"2011"},{"issue":"24","key":"pone.0269395.ref022","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the process of cross-cultural adaptation of Self-Report measures","volume":"25","author":"DE Beaton","year":"2000","journal-title":"Spine"},{"issue":"1","key":"pone.0269395.ref023","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","article-title":"Quality criteria were proposed for measurement properties of health status questionnaires","volume":"60","author":"CB Terwee","year":"2007","journal-title":"J Clin Epidemiol"},{"key":"pone.0269395.ref024","doi-asserted-by":"crossref","DOI":"10.1002\/9780470165195","volume-title":"Design, evaluation, and analysis of questionnaires for survey research","author":"WE Saris","year":"2007"},{"issue":"7","key":"pone.0269395.ref025","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2337\/diacare.23.7.943","article-title":"The summary of diabetes self-care activities measure: results from 7 studies and a revised scale","volume":"23","author":"DJ Toobert","year":"2000","journal-title":"Diabetes Care"},{"issue":"1","key":"pone.0269395.ref026","doi-asserted-by":"crossref","first-page":"73","DOI":"10.4025\/actascihealthsci.v36i1.16251","article-title":"Analysis of the self-care of diabetics according to by the Summary of Diabetes Self-Care Activities Questionnaire (SDSCA)","volume":"36","author":"SS Freitas","year":"2014","journal-title":"Acta Scientiarum Health Science"},{"issue":"Suppl 2","key":"pone.0269395.ref027","first-page":"176","article-title":"Krankheitsbedingte Selbstpflege zur Pr\u00e4vention eines Diabetischen Fu\u00dfsyndroms","author":"E Panfil","year":"2005","journal-title":"Z Wundheilung"},{"issue":"21","key":"pone.0269395.ref028","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1111\/j.1365-2702.2008.02352.x","article-title":"Diabetes foot self-care practices in the German population","volume":"17","author":"S Schmidt","year":"2008","journal-title":"J Clin Nurs"},{"key":"pone.0269395.ref029","unstructured":"Panfil EM, Schmidt S, Deufert D, et al. Hessisches Institut f\u00fcr Pflegeforschung, 2013. Entwicklung und \u00dcberpr\u00fcfung des neu entwickelten Fragebogens, Frankfurter Aktivit\u00e4tenkatalog der Selbstpflege\u2013Pr\u00e4vention Diabetisches Fu\u00dfsyndrom (Kurzform: FAS-Pr\u00e4DiFu\u00df\u201c). https:\/\/www.hessip.de\/app\/download\/9390671\/Entwicklung_und_%C3%9Cberpr%C3%BCfung_des_neu_entwickelten_Fragebogens_FAS_Pr%C3%A4DiFu%C3%9F_Abstract.pdf"},{"key":"pone.0269395.ref030","unstructured":"Schmidt S, Mayer H, Panfil EM. Health-deviation self-care for the prevention of diabetic foot ulcers: A cross-sectional study [abstract]. 6th Scientific meeting of the Diabetic Foot Study Group of the EASD; 2006 Sep 10\u201313; Elsinore, Denmark."},{"issue":"10","key":"pone.0269395.ref031","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/0277-9536(95)00115-N","article-title":"German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment","volume":"41","author":"M. Bullinger","year":"1995","journal-title":"Soc Sci Med"},{"issue":"4","key":"pone.0269395.ref032","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s00038-002-8217-8","article-title":"The SF-36 questionnaire and its usefulness in population studies: results of the German Health Interview and Examination Survey 1998","volume":"47","author":"BM Kurth","year":"2002","journal-title":"Soz Pr\u00e4ventivmed"},{"key":"pone.0269395.ref033","volume-title":"How to Score Version Two of the SF-36 Health Survey","author":"JE Ware","year":"2000"},{"key":"pone.0269395.ref034","unstructured":"Bullinger M, Ravens-Sieberer U, Siegrist J. Gesundheitsbezogene Lebensqualit\u00e4t in der Medizin\u2013Eine Einf\u00fchrung. In: Bullinger M, Ravens-Sieberer U, Siegrist J. Lebensqualit\u00e4tsforschung aus medizinpsychologischer und soziologischer Perspektive. Jahrbuch der Medizinischen Psychologie\u2014Band 18. Hogrefe, G\u00f6ttingen 2000."},{"key":"pone.0269395.ref035","first-page":"46","volume-title":"The SF-36 Health Survey: Manual and interpretation guide","author":"JE Ware","year":"1993"},{"issue":"3\u20134","key":"pone.0269395.ref036","first-page":"76","article-title":"Gesundheitsbezogene Lebensqualit\u00e4t und subjektive Gesundheit: \u00dcberblick \u00fcber den Stand der Forschung zu einem neuen Evaluationskriterium in der Medizin","volume":"47","author":"M. Bullinger","year":"1997","journal-title":"Psychother Psychosom Med Psychol"},{"key":"pone.0269395.ref037","first-page":"143","article-title":"SF-36. Fragebogen zum Gesundheitszustand","volume":"28","author":"M Bullinger","year":"1999","journal-title":"Zeitschrift f\u00fcr Klinische Psychologie und Psychotherapie"},{"issue":"5","key":"pone.0269395.ref038","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1055\/s-0032-1308075","article-title":"Assessment SF-36. Lebensqualit\u00e4t transparent machen","volume":"5","author":"HJ L\u00fcthi","year":"2007","journal-title":"Physiopraxis"},{"issue":"4","key":"pone.0269395.ref039","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s11136-011-9960-1","article-title":"Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist","volume":"21","author":"CB Terwee","year":"2012","journal-title":"Qual Life Res"},{"key":"pone.0269395.ref040","volume-title":"Discovering Statistics Using IBM SPSS Statistics","author":"A. Field","year":"2017","edition":"5"},{"issue":"2","key":"pone.0269395.ref041","doi-asserted-by":"crossref","first-page":"79","DOI":"10.20982\/tqmp.09.2.p079","article-title":"A beginner\u2019s guide to factor analysis: focusing on exploratory factor analysis","volume":"9","author":"AG Yong","year":"2013","journal-title":"Tutor Quant Methods Psychol"},{"issue":"5","key":"pone.0269395.ref042","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1007\/s11136-018-1798-3","article-title":"COSMIN guideline for systematic reviews of patient-reported outcome measures","volume":"27","author":"CAC Prinsen","year":"2018","journal-title":"Qual Life Res"},{"key":"pone.0269395.ref043","volume-title":"Physical therapy research: principles and applications","author":"E. Domholdt","year":"2000","edition":"2"},{"issue":"7","key":"pone.0269395.ref044","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.jclinepi.2010.02.006","article-title":"The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes","volume":"63","author":"LB Mokkink","year":"2010","journal-title":"J Clin Epidemiol"},{"key":"pone.0269395.ref045","volume-title":"Psychometric Theory","author":"JC Nunally","year":"1994","edition":"3"},{"issue":"8476","key":"pone.0269395.ref046","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"JM Bland","year":"1986","journal-title":"Lancet"},{"issue":"7","key":"pone.0269395.ref047","doi-asserted-by":"crossref","first-page":"29758","DOI":"10.3402\/dfa.v7.29758","article-title":"Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature","volume":"17","author":"T Bonner","year":"2016","journal-title":"Diabet Foot Ankle"},{"issue":"1","key":"pone.0269395.ref048","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.apnr.2009.03.007","article-title":"Using message framing to achieve long-term behavioral changes in persons with diabetes","volume":"24","author":"JL Grady","year":"2011","journal-title":"Appl Nurs Res"},{"key":"pone.0269395.ref049","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1159\/000439409","article-title":"The Diabetic Foot: The Never-Ending Challenge","volume":"31","author":"B. Peter-Riesch","year":"2016","journal-title":"Endocr Dev"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T17:26:40Z","timestamp":1654277200000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269395"}},"subtitle":[],"editor":[{"given":"Xian-liang","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,6,3]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0269395","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,3]]}}}