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Diabetes distress
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Diabetes distress was measured by the Problem Areas in Diabetes (PAID)-5 scale, a validated and reliable short form of the full 20-item PAID scale [28]. Each item has five possible response options, from “not a problem” (0 points) to “a serious problem” (4 points). The sum score of this scale ranges from 0–20, with a higher score indicating more severe diabetes distress. The PAID-5 scale was previously widely used in Chinese youths (8–24 years old) and showed excellent reliability and validity [29]. The Cronbach’s α of the PAID-5 scale in this study was 0.893.
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