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1 Support Environment scale for Diabetics; SED r r SED r SED r SED r SED r SED SED SED SED SED Social SupportSS SS SS Schafer, McCaul & Glasgow, Wang & Fenske,

2 Eriksson & Rosenqvist, Connell, Davis, Gallant & Sharpe, Bailey, QOL Aalto, Uutela, & Aro, Rose, Burkert, Scholler, Schirop, Danzer & Klapp, SS SS Brandt & Weinert, SS SS SS SS SS SS SS SS Connell et al. SS Bailey

3 i SS SS SS SS Table 1 SS SS SS SS Table 1

4 ii SS Riessman

5 SS SS SS Figure 1 Figure 1

6 SS SS Table 3 Table 6 iii iv Table 2 Table 2 SD SD SD SD HbA1c

7 $$$$$$ $$$ $$$$$$$ $$$ $$$$$$$$$ $$$$$$$$$ Table 3 Table 6 Support Environment scale for Diabetics ; SED v Ver. A Ver. B vi Ver. A SED Ver. B SED

8 Table 3 a b c sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. sup.non-sup. Table 4 a b c sup. sup. sup. sup. sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. sup.non-sup.

9 Table 5 a b c sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. non-sup. non-sup. sup.non-sup. Table 6 a b c sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. sup. non-sup. non-sup. non-sup. non-sup. non-sup. non-sup. sup.non-sup.

10 Ver. AVer. B Table 7 Table 7 SD SD SD SD HbA1c HbA1c

11 Support Environment scale for Diabetics; SED Support Environment scale for Diabetics ; SED $$ $$$$$$$ $$$$$$$$$$$$$$ $$$$ $$$ $$$$$$$ $$$ $$$$$$ Zimetetal.Multidimensional Scale of Perceived Social Support; MSPSS MSPSS GHQ Client-Nurse Relationship Scale ; CNRSCNRS CNRS

12 SED Connell et al., SED

13 SED SED Table 8 Table 8 SED N128 SD SD SD SD

14 n SED SED Table 9 n Table 9 SED N142 SD SD SED SED Table 10

15 n Table 10 SED N121 SD SD SED SED Table 11 Table 11 SED SD SD

16 n SED SED MSPSS CNRS MSPSS CNRS SED MSPSS Table 12 SED SED SED SED SED SED SD MSPSS SD SD CNRS SD SD p p

17 CNRS MSPSS CNRS SED Table 12 SED SED SED CNRS SED Table 13 SED SED Table 13 SED SED HbA1c SED t x 2

18 Table 14 SED SED Fp SED F p Tukey HSD p p Table 14 SED SD SD SD SD F Tukey HSD SED SED p Table 15, Table 16 Table 15 SED t N SD N SD t SED SED SED p Table 16 SED t N SD N SD t SED SED SED p p p

19 t p SED t p SED tp t p SED tp SED tp Table 17 Fisher Fisher p p Table 17 SED SS SED SED SED SED SED Diabetes Family Behavior Checklist Schafer et al., 1986, Chronic Illness Resource SurveyGlasgow, Strycker, Toobert & Eakin, 2000; Glasgow, Toobert, Barrera & Strycker, 2005, Diabetes Social Support QuestionnaireLa Greca & Bearman, 2002; Bearman & La Greca, 2002 SED

20 SED Connell et al. SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED SED

21 SED SED SED SED SED SED SED p p SED SS SS

22 SS Support Environment scale for Diabetics ; SED SED SED Aalto, A.M., Uutela, A., Aro, A.R.1997: Health related quality of life among insulin-dependent diabetics: disease-related and psychosocial correlates. Patient Education & Counseling, 303, Bailey, B.J.1996: Mediators of depression in adults with diabetes. Clinical nursing research, 51, Bearman, K.J., La Greca, A.M.2002: Assessing friend support of adolescents' diabetes care: the diabetes social support questionnaire-friends version. Journal of Pediatric Psychology, 275, Brandt, P.A., Weinert, C.1981: The PRQ a social support measure. Nursing research, 305, Connell, C.M., Davis, W.K., Gallant, M.P., Sharpe, P.A.1994: Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes. Health psychology, 133, Eriksson, B.S., Rosenqvist, U.1993: Social support and glycemic control in non-insulin dependent diabetes mellitus patients: gender differences. Women & health, 204, CNRS

23 Glasgow, R.E., Strycker, L.A., Toobert, D.J., Eakin, E.2000: A social-ecologic approach to assessing support for disease self-management: the Chronic Illness Resources Survey. JournalofBehavioralMedicine, 236, Glasgow, R.E., Toobert, D.J., Barrera, M. Jr., Strycker, L.A.2005: The Chronic Illness Resources Survey: cross-validation and sensitivity to intervention. Health Education Research, 204, houdou/2008/12/h html -. La Greca, A.M., Bearman, K.J.2002: The Diabetes Social Support Questionnaire-Family Version: Evaluating Adolescents' Diabetes-Specific Support From Family Members. Journal of Pediatric Psychology, 278,

24 Riessman, F.1990: Restructuring help: A human services paradigm for the 1990s. American Journal of Community Psychology, 182, G.L.B. R.M. Kowalski, M.R. LearyEds Rose,M.,Burkert,U.,Scholler,G.,Schirop,T.,Danzer,G.,Klapp,B.F.1998: Determinants of the quality of life of patients with diabetes under intensified insulin therapy. Diabetes Care, 2111, Schafer,L.C.,McCaul,K.D.,Glasgow,R.E.1986: Supportive and nonsupportive family behaviors: relationships to adherence and metabolic control in persons with type I diabetes. Diabetes Care, 92, Wang, C.Y., Fenske, M.M.1996: Self-care of adults with non-insulin-dependent diabetes mellitus: influence of family and friends. The Diabetes educator, 225, i ii iii iv v vi Ver. A Ver. B

25 Development of Support Environment scale for DiabeticsSED. Wataru SHOJI Graduate Student, Graduate School of Education, Tohoku University Michiyo OHNO Research Assistant, School of Nursing, Shukutoku University Hideo AMBO Associate professor, Graduate School of Education, Tohoku University In the present study, we defined a constructive concept for Social Support in six points of view and developed Support Environment scale for DiabeticsSEDthat measure how much subjects receive specific support from family, friends, medical staff, fellow patients. Preliminary survey of 100 adults with diabetes on support needs had been conducted, and then main survey of 404 adults with diabetes was conducted to develop SED. The result revealed that SED-family version.89, test-retestsr.80was constructed of two factors;diet and medication support.89, r.80andexercise support.72, r.75, and SED-friends version.80, r.75, SED-medical staff version.94, r.89, and SED-fellow patients version.94, r.74have single factor structure. Furthermore the validity was examined by correlation between general support and SED-family, SEDfriends, or SED-fellow and between patient-medical staff relationship and SED-medical staff. In the result expected correlations was examined respectively, more specifically the SED has sufficient validity. Examining of correlation among diabetes specific supports that are measured with SED, glycemic control, and mental health is an issue in the future. Key words : diabetes, social support, adult. scale development, reliability and validity,

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