Development and Validation of the Rumination Assessment Scale for Type-2 Diabetes Patients

Abstract

This study aimed to develop and validate a rumination assessment scale specifically designed for individuals diagnosed with Type-2 diabetes. Rumination is defined as repetitive and negative thinking that is closely associated with psychological distress and poor disease self-management in chronic conditions. However, existing rumination scales do not capture the unique content and themes relevant to the experience of living with Type-2 diabetes. Using a mixed-method design, the study involved item generation based on literature review and qualitative interviews, followed by expert validation and a psychometric evaluation on a sample of 200 Type-2 diabetes patients. Exploratory factor analysis revealed a five-factor structure comprising Health-focused Rumination, Self-blame and Regret, Future-oriented Worry, Social Comparison and Isolation, and Emotional Distress, capturing the multidimensional nature of rumination in Type-2 diabetes. The scale showed good internal consistency (Cronbach’s α > 0.85), good test-retest reliability (r= 0.924, p < .001), and significant correlations with existing measures of rumination, supporting convergent validity (r = .725, p < .001). The findings suggest that the Rumination Assessment Scale for Type-2 Diabetes (RAS-T2D) is a reliable and valid tool for assessing cognitive-emotional patterns relevant to diabetes-related psychological distress. Its multidimensional framework allows for comprehensive assessment, making it useful for clinical, research, and community-based health settings.