# Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation

## TL;DR

This study validated an English version of a questionnaire to assess self-care behaviors in diabetic foot disease patients, ensuring it is reliable and useful for clinical and research purposes.

## Contribution

The study provides a cross-culturally adapted and psychometrically validated English version of the Diabetic Foot Self-Care Questionnaire.

## Key findings

- The English version (DFSQ-UMA-En) showed excellent internal consistency (Cronbach’s α = 0.889–0.981) and reliability (ICC = 0.854–0.959).
- The questionnaire demonstrated good criterion validity (r = 0.429–0.844) and acceptable construct validity (Kaiser-Meyer-Olkin = 0.752).
- The tool has good readability and comprehension features, making it suitable for clinical and research use.

## Abstract

The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease.

The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase.

An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach’s α =0.889–0.981), and reliability was excellent (ICC = 0.854–0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752.

DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.