Please cite this article in press as: M.M. Allam, et al., Cross-Cultural Reliability of an Arabic Version of the Self-Efﬁcacy for Managing Chronic Disease 6-Item Scale in Arab Patients with Diabetes mellitus, Prim. Care Diab. (2019), https://doi.org/10.1016/j.pcd.2019.11.001 ARTICLE IN PRESS G Model PCD-840; No. of Pages 6 Primary Care Diabetes xxx (2019) xxx–xxx Contents lists available at ScienceDirect Primary Care Diabetes journal homepage: http://www.elsevier.com/locate/pcd Original research Cross-Cultural Reliability of an Arabic Version of the Self-Efﬁcacy for Managing Chronic Disease 6-Item Scale in Arab Patients with Diabetes mellitus Magdy Mohamed Allam a , Hanaa Tarek El-Zawawy b , Ismail Ibrahim Ismail c , Ramy Mohamed Ghazy d a Internal Medicine department, Alexandria University Student Hospital (AUSH), Egypt b Internal Medicine department, Faculty of Medicine, Alexandria University, Egypt c Psychiatry & Neurology department, Ibn Sina Hospital, Ministry of Health, Kuwait d Tropical Health department, High Institute of Public Health, Alexandria University, Egypt a r t i c l e i n f o Article history: Received 4 August 2019 Received in revised form 15 October 2019 Accepted 2 November 2019 Available online xxx Keywords: Diabetes mellitus self-efﬁcacy Arabic a b s t r a c t Introduction: Arab nations have the second highest diabetes mellitus (DM) prevalence in the world. There is a growing interest in self-management programs that emphasize patient’s central role in managing type 2 DM. Aim of the study: To validate an Arabic version of the Self-Efﬁcacy for Managing Chronic Disease 6- Item Scale (SEM6S) among Arab type 2 DM patients and to explore factors associated with self-efﬁcacy measured with the SEM6S. Methods: Cross-sectional study on 302 Arab patients with T2DM of three different nationalities (Egyptian, Saudi, Kuwaiti).The SEM6S was translated using forward–backward method, and its reliability was deter- mined by calculating Cronbach’s alpha. A regression model was used to examine variables associated with self-efﬁcacy in Arab patients with T2DM. Results: Questionnaire was successfully translated without language or content-related problem. The mean age of participants was 47.71 ± 14.7 years with equally represented sexes. The mean total score of the SEM6S was 5.99 ± 1.86. The scale psychometric properties was reproducible (ICC = 0.61–0.71) with good reliability (Cronbach’s alpha = 0.79). Statistically signiﬁcant increase in self-efﬁcacy was observed in patients <30 years, uncomplicated DM, DM with hypertension, and in patients who had physical activity > 60 min per day. Also, a bimodal increase in self-efﬁcacy was detected in patients with DM < 5 years and 10.1-15 years. After regression analysis, physical activity was signiﬁcantly positively correlated with self-efﬁcacy ( = 0.8, P = 0.01), and duration of diabetes was signiﬁcantly negatively correlated with self- efﬁcacy ( = -0.23, P = 0.03). Conclusion: Arabic SEM6S is acceptable, reliable and repeatable metric for self-efﬁcacy. © 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. 1. Introduction Diabetes Mellitus (DM) is the most common endocrinological disease with a very high prevalence worldwide. The latest IDF report showed that the Middle East North African region has the second highest DM prevalence in the world, yet 50% of patients with diabetes in these countries are still undiagnosed. The expand- ing prevalence of DM and various patients living with DM & its comorbidities with increased life expectancy have brought about new multilevel burdens & socioeconomic challenges [1]. DM is one of the greatest health problems which is associated with serious complications that threatens human life, even in its earlier stages (prediabetes) it is known to be associated with various complica- tions including increased cardiovascular risk [2]. Self-efﬁcacy, a widely used psychological concept, refers to an individual’s perception or belief in his ability to carry out cer- tain activities [3]. Self-efﬁcacy has been recognized as an essential prerequisite of effective self-care of chronic diseases. The role of self-care as a signiﬁcant factor in DM management is increasingly acknowledged. Self-care for diabetes occurs on a continuum, rang- ing from increasing awareness of living with diabetes to more active involvement in a management process [4]. Estimating self-efﬁcacy for self-care practices in patients with diabetes is a signiﬁcant advance towards improving control of DM. Self-efﬁcacy theory holds that the successful achievement of the https://doi.org/10.1016/j.pcd.2019.11.001 1751-9918/© 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.