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The purpose of this study was to validate the Insulin Treatment Appraisal Scale (ITAS) in the Cuban population with type 2 diabetes mellitus.A cross-sectional, multicentre analytical study was performed in Cuba from February 2020 to April 2021; 199 patients were surveyed in a hospital institution and in primary healthcare. We used the Insulin Treatment Appraisal Scale, consisting of 20 items, with a minimum score of 20 points and a maximum of 100, where the higher the score, the worse the perception of insulin therapy. The validity of the instrument was determined by means of an exploratory factor analysis. The internal consistency and reliability of the scale were calculated by means of Cronbach's alpha coefficient. A K-means cluster analysis was performed to establish a cut-off point for poor perception of insulin therapy.The exploratory factor analysis supported the validity of the instrument, with a Cronbach's alpha of 0.747. There were statistically significant differences between patients under insulin and non-insulin treatment in terms of the answers given in all items of the scale. The total mean score obtained was 51.96 ± 10.78, and it was lower in insulin users compared to those who used other drugs (49.79 ± 10.07 vs 55.09 ± 11.12). A score ≥65 was proposed as a cut-off point for poor perception of insulin therapy. A positive relationship was found between the body mass index values and the total score of the scale. Being female and current treatment not involving insulin were factors associated with low perception of insulin therapy.The instrument proved to be valid for the population in which it was applied. Insulin users turned out to be the ones with the best perception about its use. A cut-off point of ≥65 points for poor perception of insulin treatment was proposed for evaluation and comparison in future studies in other patient populations.

Introduction: Concern about becoming infected is a particularly relevant psychological aspect in the context of a pandemic, as it is associated with social reactions and behavioral changes. Objectives: The present study sought to determine some sociodemographic and health factors associated with concern about COVID-19 infection in Cuban patients with type 2 diabetes mellitus. Methods: 203 patients with type 2 diabetes mellitus, who attended nine primary care areas of four Cuban provinces belonging to different regions of the country (65.52% female, mean age 57.5, SD=19.2), selected through non-probabilistic sampling, participated in the study. A sociodemographic questionnaire, the COVID-19 contagion concern scale (PRE-COVID-19) and an evaluation of blood glucose level were applied. Bivariate associations were examined with a series of analyses of variance (ANOVA). Adjusted (multiple) regression with all predictors running simultaneously was also used. Results: Bivariate analyses showed that age, sex, education, occupation, having comorbidities, and having a family member or friend who had COVID-19 were significantly related to COVID-19 contagion concern. However, when all variables were included simultaneously, only age, technical education, having comorbidities, and having a friend or family member who had COVID-19 remained significant predictors of concern about COVID-19 infection. Conclusions: Male patients, with a technical level of education, with comorbidities and those who had infected family members or friends presented greater concern for the contagion of COVID-19. The public health policies should develop strategies to assess the mental health of people belonging to vulnerable groups and provide interventions to promote mental health in those who show concern about infection. Revisión por pares Los Olivos

Aims It is important to have valid and reliable measures to determine the psychological impact of COVID-19 in patients with diabetes; however, few instruments have been developed and validated for this population. Therefore, the aim of this study was to validate the Scale of Worry for Contagion of COVID-19 (PRE-COVID-19) in a sample of patients with diabetes mellitus (DM). Materials and methods A total of 219 patients (66.2% female, mean age 58.5 SD = 18.2) participated, selected through non-probabilistic sampling. The PRE-COVID-19 and the Generalized Anxiety Disorder Scale-2 were applied. Reliability analysis was performed for internal consistency, structural equation modeling and item response theory modeling. Results The results show that a unidimensional 5-item model presents satisfactory goodness-of-fit indices and excellent reliability values. Likewise, convergent validity between the PRE-COVID-19 and a measure of anxiety is evident. All items present adequate discrimination parameters, allowing for discerning between those patients with critical concern about COVID-19 contagion from those with severe concern. Conclusion It is concluded that the PRE-COVID-19 is an instrument with adequate psychometric properties to measure concern about COVID-19 infection and the emotional impact in patients with DM. Revisión por pares Los Olivos