OBJECTIVES: Health satisfaction may help predict adherence to T2DM self-care behaviors, a cornerstone of optimal T2DM management. The CHES-Q was developed to assess T2DM-related health satisfaction and knowledge among people living with T2DM. Because renal impairment is a frequent complication of T2DM, we aimed to better understand the experiences of people with T2DM and comorbid CKD and their interpretation of CHES-Q items.
METHODS: In-depth interviews were conducted with 20 adults with T2DM and CKD (stages 1-5) to explore the content and clarity of the 14-item CHES-Q. Each interview included a brief discussion about the participant’s experiences and impact of T2DM and CKD. Then, participants were asked to “think out loud” about their process for answering each item and to identify words or concepts that were unclear. Probes were used to obtain additional feedback about whether any important concepts were missing. Interview responses were grouped and summarized.
RESULTS: The mean age of participants was 59 years, half were female, 45% were white, and 75% completed at least some college. Fifty-five percent had stage 5 CKD, 45% were on dialysis, and 2 had received a kidney transplant. Average disease duration was 15 years for T2DM and 7.7 years for CKD. All participants found the instructions and items clear and relevant. Items that did not specifically refer to T2DM or blood sugar were interpreted by participants as relating to their health in general. Concepts reported as missing from the CHES-Q included erectile dysfunction, concern with diet, and stress, which were each mentioned by 1 to 3 participants.
CONCLUSIONS: Health satisfaction is an important concept to consider when developing individualized strategies for managing T2DM because it may predict adherence to self-care. The CHES-Q assesses T2DM-related health satisfaction and is appropriate for use among people with T2DM and comorbid CKD.
