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Psychometric properties of the Norwegian version of the Audit of Diabetes-Dependent Quality of Life

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To examine the psychometric properties of the Norwegian version of the Audit of Diabetes-Dependent Quality of Life version 18 (ADDQoL-18).


We assessed the reliability (Cronbach’s alpha and intraclass correlations) and construct validity (confirmatory factor analysis and Pearson’s correlation coefficients) of the instrument in a sample of 292 adults in Norway aged 42.3 (SD 14.2) years.


Internal consistency (Cronbach’s alpha 0.88) and 4-week test–retest stability (intraclass correlations = 0.87) were satisfactory. Confirmatory factor analysis indicated that the one-factor structure of the ADDQoL-18 fits moderately (χ 2/df ratio = 3.846, comparative fit index = 0.792, root mean square error of approximation = 0.099). Standardized coefficients showed that all domains loaded >0.4, except for one item. We found a satisfactory correlation between the ADDQoL-18 and the SF-36 Health Survey summary scales (physical health and mental health summary scales) and the Hospital Anxiety and Depression Scale. The total score was negatively associated with HbA1c (r = −0.18; P < 0.002), indicating that lower scores on the ADDQoL-18 were related to poorer glycemic control. Analysis regarding discriminant validity showed that the average weighted impact scores were mostly reduced among those reporting neuropathy and foot problems.


The Norwegian version of the ADDQoL-18 showed high internal consistency, good test–retest reliability, and similar construct validity as the original instrument. Overall, the results supported the ADDQoL-18 being feasible for use in Norway.

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Fig. 1



Audit of Diabetes-Dependent Quality of Life


Average weighted impact scores


Confidence interval


Degrees of freedom


Hospital Anxiety Depression Scale

HbA1c :

Glycosylated hemoglobin


Health-related quality of life


Intraclass correlation


Quality of life


Standard deviation


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We thank the patients for their kind participation in the study and the nurses at the ward, Ingvild Hernar, Kari Horn, Elisabeth Iversen, Berit M. Tarlebø and Elin Irrborg, for their dedicated participation in data collection. Bergen University College and the University of Bergen, Norway, kindly supported this research.

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Correspondence to Marjolein M. Iversen.

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Iversen, M.M., Espehaug, B., Rokne, B. et al. Psychometric properties of the Norwegian version of the Audit of Diabetes-Dependent Quality of Life. Qual Life Res 22, 2809–2812 (2013).

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