Study Instrument

The validated short version of the diabetic obstacle questionnaire (DOQ-30) was developed by researchers and was validated in six European countries (6). Permission was obtained to reuse from the corresponding author. The questionnaire consisted of a total of 30 questions that were divided in to nine sections addressing different issues: relationships with medical professionals (four items), support from friends and families (four items), knowledge of the disease (four items), lifestyle changes (four items), self-monitoring (four items), uncertainty about a consultation (two items), medication (two items), and insulin use (two items). A 4-point Likert scale (1 = Strongly disagree, 2 = Disagree, 3 = Agree, and 4 = Strongly agree) was used to obtain their responses. Before the questionnaire was administered to patients, it was first translated into Amharic by two of the investigators (EAG and TMA) and then back-translated to English by another investigator (TBA) to verify for accuracy. The translated questionnaire was pretested among 20 randomly selected DM patients for reliability and validity. No language problems and corrections were requested. The questionnaire was basically self-administered; however, in cases where the patients were not able to read and write interview method was employed. Sufficient time was given for the patients to fill the questionnaire during their waiting time. Any discrepancies were dealt with discussion. The internal reliability of the questionnaire was checked using Cronbach’s alpha and was found to be 92.5%.