Problem Areas In Diabetes (PAID-20) Scale

Clinical intent

The Problem Areas In Diabetes (PAID) scale is a well validated, psychometrically robust questionnaire with 20 items. It is sometimes referred to as the PAID-20, to distinguish it from the eleven-item (PAID-11), five-item (PAID-5), and one-item (PAID-1) short forms.

Calculation

Respondents are asked to indicate the degree to which each of the items is currently a problem for them, from 0 (not a problem) to 4 (a serious problem). Clinically, the PAID can be used two ways:

1. Taking note of the higher scoring items and using these to start a conversation (sources of diabetes distress).
2. Calculating a total score (e.g., to assess change over time). The total score provides an indication of the severity of diabetes distress.

Clinical interpretation

The scores for each item are summed, then multiplied by 1.25 to generate a total score out of 100.

1. Individual items scored 3 or 4: moderate to severe distress; to be discussed during the appointment following completion of the questionnaire.
2. Total scores of 40 and above: severe diabetes distress.

References

[1] Polonsky WH, Anderson BJ, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18(6):754-60. [2] Stanulewicz N, Mansell P, et al. PAID-11: A brief measure of diabetes distress validated in adults with type 1 diabetes. Diabetes Research and Clinical Practice. 2019 149:27-38. [3] McGuire BE, Morrison TG, et al. Short-form measures of diabetes-related emotional distress: The Problem Areas In Diabetes Scale (PAID)-5 and PAID-1. Diabetologia. 2010;53(1):66-9. [4] Snoek FJ, Kersch NYA, et al. Monitoring of Individual Needs in Diabetes (MIND): baseline data from the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) MIND study. Diabetes Care. 2011;34(3):601-3.