{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:18:46Z","timestamp":1777501126411,"version":"3.51.4"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Problem Areas in Diabetes (PAID) scale is a reliable and valid tool that is widely used for diabetes-distress screening, but the Arabic version of the scale lacks validity and reliability analysis in primary healthcare (PHC) patients. Our study aimed to evaluate the psychometric properties of the Arabic version of the PAID (AR-PAID) scale among Egyptian patients with type 2 diabetes mellitus (T2DM) in PHC settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross-sectional study on a convenience sample of 200 patients from six rural PHC settings in the Ismailia governorate. The confirmatory factor analysis (CFA) was performed to test the goodness-of-fit to the predefined models of the PAID. Convergent construct was evaluated through correlations with the Arabic versions of the Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and 5-item World Health Organization Well-Being Index (WHO-5), additionally glycated hemoglobin (HbA1c) levels. Discriminant validity was evaluated through associations with patients' sociodemographic and clinical characteristics. Reliability was evaluated through internal consistency (Cronbach's \u03b1) and test-retest reliability analysis (intraclass correlation coefficient, ICC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The CFA demonstrated the best fit for a four-factor model. The AR-PAID was significantly correlated with the following measures: PHQ-9 (rho = 0.71, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), GAD-7 (rho = 0.50, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), WHO-5 (rho = \u22120.69, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), and HbA1c (rho = 0.36, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), supporting sound convergent validity. Discriminant validity was satisfactory demonstrated. Internal consistency was excellent (\u03b1 = 0.96) and test-retest reliability was stable (ICC = 0.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The AR-PAID scale is a valid and reliable instrument for diabetes-distress screening in primary care patients with T2DM that can be used in clinical settings and research. Further research is needed to validate short forms of the AR-PAID scale.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.843164","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T05:54:03Z","timestamp":1645768443000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Psychometric Properties of the Arabic Version of the Problem Areas in Diabetes Scale in Primary Care"],"prefix":"10.3389","volume":"10","author":[{"given":"Hazem A.","family":"Sayed Ahmed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samar Farag","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally Fawzy","family":"Elotla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Mostafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaffer","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Mahmoud","family":"Fouad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"B1","unstructured":"BrusselsInternational Diabetes Federation2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1111\/dme.13448","article-title":"The prevalence of diabetes-specific emotional distress in people with type 2 diabetes: a systematic review and meta-analysis","volume":"34","author":"Perrin","year":"2017","journal-title":"Diabet Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.2337\/dc09-2175","article-title":"The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes","volume":"33","author":"Fisher","year":"2010","journal-title":"Diabetes Care."},{"key":"B4","doi-asserted-by":"publisher","first-page":"259","DOI":"10.2337\/dc11-1572","article-title":"When is diabetes distress clinically meaningful?: establishing cut points for the diabetes distress scale.","volume":"35","author":"Fisher","year":"2012","journal-title":"Diabetes Care."},{"key":"B5","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/S2213-8587(15)00135-7","article-title":"Constructs of depression and distress in diabetes: time for an appraisal","volume":"3","author":"Snoek","year":"2015","journal-title":"Lancet Diabetes Endocrinol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1111\/dme.13967","article-title":"Addressing diabetes distress in clinical care: a practical guide","volume":"36","author":"Fisher","year":"2019","journal-title":"Diabet Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"542","DOI":"10.2337\/dc06-1614","article-title":"Clinical depression versus distress among patients with type 2 diabetes: not just a question of semantics","volume":"30","author":"Fisher","year":"2007","journal-title":"Diabetes Care."},{"key":"B8","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1111\/j.1464-5491.2007.02028.x","article-title":"Association of diabetes-related emotional distress with diabetes treatment in primary care with type 2 diabetes","volume":"24","author":"Delahanty","year":"2007","journal-title":"Diabet Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.2337\/dc09-1238","article-title":"Diabetes distress but not clinical depression or depressive symptoms is associated with glycemic control in both cross-sectional and longitudinal analyses","volume":"33","author":"Fisher","year":"2010","journal-title":"Diabetes Care."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2472","DOI":"10.2337\/dc12-0181","article-title":"Prospective associations between emotional distress and poor outcomes in type 2 diabetes","volume":"35","author":"Aikens","year":"2012","journal-title":"Diabetes Care."},{"key":"B11","doi-asserted-by":"publisher","first-page":"10","DOI":"10.2337\/cd20-as01","article-title":"Standards of medical care in diabetes-\u22122020 abridged for primary care providers","volume":"38","year":"2020","journal-title":"Clin Diabetes."},{"key":"B12","doi-asserted-by":"publisher","first-page":"754","DOI":"10.2337\/diacare.18.6.754","article-title":"Assessment of diabetes-related distress","volume":"18","author":"Polonsky","year":"1995","journal-title":"Diabetes Care."},{"key":"B13","doi-asserted-by":"publisher","first-page":"760","DOI":"10.2337\/diacare.20.5.760","article-title":"The problem areas in diabetes scale. 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