Measures of Perceived Control of Diabetes

The Perceived Control of Diabetes Scales were originally designed in the early 1980s to be used alongside measures of health beliefs described elsewhere in this Handbook by Lewis and Bradley. The scales were included in a Sheffield based prospective study of insulin-requiring patients who were involved in a feasibility study of continuous subcutaneous insulin infusion (CSII) pumps. Patients were given a choice between two different intensities of injection regimen or CSII pumps (Bradley et al., 1984). The new scales proved useful in understanding patients’ preferences for the treatment options and individual differences between patients in the efficacy of the various treatments after twelve months on the chosen treatment regimen (Bradley et al., 1987). The scales also proved useful in understanding the reasons for the marked increase in diabetic ketoacidosis (DKA) among users of CSII pumps (Bradley et al., 1986). The scales have since been modified for use with patients treated with tablets rather than insulin (Bradley et al., 1990) and for use by health care professionals (Gamsu and Bradley, 1987). Comparison of the perceptions of control over diabetes made by health care professionals and patients has highlighted predicted biases in professionals’ perceptions that differ from those of patients in a way that is likely to be damaging to the therapeutic relationship (Gamsu and Bradley, 1987, 1992). Subsequent studies have evaluated interventions aimed to help professionals to appreciate patients’ perceptions (Gillespie and Bradley, 1988; Gillespie, 1989) and recommendations have been made for improving therapeutic collaboration between professionals and their patients (Gillespie and Bradley, 1985; Bradley, 1989). Applying a speculative typology suggested by Wallston and Wallston (1982), the Perceived Control of Diabetes Scales were found to be significantly associated with HbA₁, percentage ideal body weight, well-being and satisfaction with treatment for patients with tablet-treated diabetes (Bradley et al., 1990).