Instrumentations
Acceptance of Illness Scale (AIS)
AIS was improved by Felton and Revenson [14]. The scale has 5-point likert type and consist of 8 items. The 6th item of the scale is scored inversely. The total point that is collected changes between 8-40. Low scores indicate the lack of acceptance of the illness and high score indicate presence of acceptance of the illness. The Cronbach’s α value of the scale is 0.83, and it was found 0.70 in this study.
Problem Areas in Diabetes (PAID) Scale
The PAID Scale is designed to reduce the spread of emotional responses to DM and to provide taking clinical and research screening measures in DM and consists of 20 items [15]. The scale is a 5-point Likert type and is scored between 0 (no problem) and 4 (serious problem). The scores obtained from the scale are added up, multiplied by 1.25 and converted into 0-100 points. High scores in the scale indicate emotional distress [16]. The cut-off point was determined as ≥33 [17]. The Cronbach’s α value of the scale is 0.95 [15], and it was found 0.87 in this study.
Beck Depression Scale (BDS)
BDS was developed by Beck et al. [18] to determine the level of depression. The scale consists of 21 items. Depression-related behaviors and symptoms are defined in sentences and these sentences are scored between 0 and 3 using a 4-point likert type. Thus, each item consists of sentences from 0-3, from mild to severe form. The total score on the scale ranges from 0-63. The scale; 10-16 = mild, 17-29 = moderate, 30-63 = severe depression [19, 20]. In this study, Cronbach’s α value was found 0.84.
SF-36
SF-36 is one of the most widely used general health measures in quality of life studies with proven validity and reliability [21]. Designed by Ware and Sherbourne [22] to be used in clinical practice and research, health policy evaluations, and general population studies, the SF-36 is a 36-item scale that evaluates eight health concepts. These eight subcomponents; physical function (10 items), social functionality (2 items), usual role difficulties due to physical health problems (4 items), role difficulties due to emotional problems (3 items), mental health (5 items), energy/vitality (4 items) item), pain (2 items) and general perception of health (5 items) [22]. The scale gives a separate total score for each subcomponent, and the subcomponents evaluate health between 0-100. It indicates poor health status as 0 and good health status as 100, and it is understood that the quality of life is good as the score increases. Also, physical function, physical role difficulty, pain, and general health perception can be evaluated as physical component summary (PCS); energy/vitality, social functionality, emotional role difficulty, and mental health can be evaluated as mental component summary (MCS) [23].
Healthy Eating Index-2010 (HEI-2010)
Food consumption was measured by 24-hour diet recall. Energy and nutrient intake was calculated using the Computer Aided Nutrition Program, Nutrition Information System (BeBiS) program [24]. All food groups, energy and nutrient intakes were created from diet records using this program.The HEI-2010 is a measure for assessing whether a range of foods comply with the Dietary Guidelines for Americans (DGA). HEI-2010 consists of 12 items. The amounts for the points to be obtained from these items are determined as maximum and minimum [25]. These 12 components are, respectively; total fruit, whole fruit, total vegetables, dark green leafy vegetables and legumes, whole grains, dairy group, total protein foods, seafood and vegetable proteins, fatty acids, refined grains, sodium and empty energy sources (i.e. energy from fats, alcohol and added sugars). The last 3 components are groups that should be consumed in moderation, and lower intakes of these components result in higher score intake. Thus, higher scores for all components reflect better dietary quality [26]. In HEI-2010, component scores are added up to obtain a total score [25]. In this scale, which scored between 0 and 100 in total, ≤50 was determined as ”bad diet”, >50-≤80 as ”diet quality required to be improved” and >80-100 as ”good diet” quality [26].