ORIGINAL RESEARCH article
Front. Clin. Diabetes Healthc.
Sec. Diabetes Self-Management
Evaluating the Swedish translation of the Type 1 Diabetes Specific Health-Related Quality of Life Questionnaire (T1DAL) in young adults
Provisionally accepted
- 1Department of nursing, Umeå University, Umeå, Sweden
- 2Hospital Universitario de la Princesa, Madrid, Spain
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: Young adults living with type 1 diabetes face unique challenges as they transition to greater independence, balancing diabetes management in all other dimensions of life. In Sweden, the transfer from pediatric to adult diabetes care at the age of 18 adds to these challenges. This study aimed to translate and evaluate the Swedish version of the T1DAL (Type 1 Diabetes and Life) self-report questionnaire for young adults living with type 1 diabetes. Method and Materials: The T1DAL questionnaire was translated into Swedish and was completed by 191 young adults aged 18-25 who were registered at a diabetes clinic in three Swedish hospitals. An expert group tested content validity. To determine the number of underlying factors, a parallel analysis (PA) was conducted. The questionnaire's latent structure was further examined through exploratory factor analysis, in which the items were constrained to a four-factor solution as recommended and found in the original version. Results: The content validity index of the total score was 0.94. The response distribution analysis revealed the presence of floor or ceiling effects. An EFA with a four-factor solution was conducted, yielding a Model Fit Measure with a χ² of 326.68 and df = 249, resulting in a cmin/df of 1.31, an RMSEA of 0.04, and a TLI of 0.92. Internal consistency was assessed for the subscales suggested by the factor structure, based on the items that loaded onto each factor. Cronbach's alpha values ranged from 0.75 to 0.89, indicating acceptable to high internal consistency. The four-factor solution explained 45.04% of the total variance. Conclusion: The Swedish T1DAL questionnaire showed good factorial validity and reliability. The Swedish version requires further testing with potential item reduction; however, it is still expected to be valuable in assessing health-related quality of life among young adults living with type 1 diabetes. Clinical implications: The Swedish T1DAL questionnaire, particularly its domains related to emotional experiences, managing diabetes effectively, and peer relationships outlines the characteristics of young adulthood and can be used to empower the target group, and is expected to be feasible to implement in clinical practice.
Keywords: Evaluation, translation, type 1 diabetes, Diabetes-Specific Health-Related Quality of Life, young adults
Received: 08 Oct 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Carlsund, Olsson, Rudilla and Isaksson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sara Olsson, sara.olsson@umu.se
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.