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New Study Validates NASA Task Load Index for Type 1 Diabetes Management

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In a groundbreaking study, researchers have examined the efficacy of the NASA Task Load Index (TLX) for evaluating the daily workload experienced by adults with Type 1 diabetes. The study, which involved 164 participants from diverse backgrounds, aimed to establish the reliability and validity of the TLX as a comprehensive measure of daily workload. This research could pave the way for improved occupational therapy interventions, enhancing the well-being of individuals managing chronic conditions.

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Study Design and Participants

Conducted across three outpatient endocrinology clinics in the United States, the study involved 164 adults with Type 1 diabetes, with a demographic breakdown of 42% Latino and 30% White participants. Using a combination of cross-sectional measures, ecological momentary assessments (EMA), and daily diaries over two weeks, researchers assessed the reliability of the whole day TLX across different subgroups, such as workers and non-workers.

Reliability and Validity Assessment

The reliability of the average whole day TLX was found to be between 2 and 6 days, varying by subgroup. Validity was confirmed through multilevel confirmatory factor analysis and tests of convergent and divergent validity, correlating with patient-reported outcomes and blood glucose measures. Significant associations were found between the average whole day TLX and both average stress levels (r = .63) and time in target blood glucose range (r = -.25), reinforcing the measure’s validity.

From a market access perspective, the availability of a reliable and valid workload assessment tool like the TLX can significantly impact the management of Type 1 diabetes. It opens up new avenues for healthcare providers to track and mitigate the daily burdens faced by patients, enabling more personalized and effective care strategies.

Key Inferences from the Study

  • The whole day TLX provides a nuanced understanding of daily workload, incorporating both health management and routine responsibilities.
  • Occupational therapists can utilize this tool to better tailor interventions aimed at reducing overall workload, thereby promoting better health outcomes.
  • This measure could be particularly useful in identifying periods of high stress and workload, allowing for timely adjustments in diabetes management strategies.

Overall, the study underscores the potential of the NASA Task Load Index as a reliable and valid indicator of daily workload for individuals with Type 1 diabetes. By integrating this tool into routine care, healthcare providers can better address the multifaceted challenges faced by these patients, ultimately enhancing their quality of life.

Original Article:

Am J Occup Ther. 2024 Sep 1;78(5):7805205120. doi: 10.5014/ajot.2024.050527.

ABSTRACT

IMPORTANCE: Typical whole day workload is a metric with potential relevance to the occupational balance and well-being of individuals with chronic conditions.

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OBJECTIVE: To examine the reliability and validity of using multiple daily NASA Task Load Index measures (whole day TLX) as an indicator of typical whole day workload experienced by adults with Type 1 diabetes (T1D).

DESIGN: Participants with T1D completed cross-sectional measures and 2 wk of ecological momentary assessments (EMA) and daily diaries. Reliability was assessed across subgroups (e.g., workers vs. nonworkers); validity was evaluated with multilevel confirmatory factor analysis and with tests of convergent and divergent validity with patient-reported outcomes and blood glucose measures.

SETTING: Three outpatient endocrinology clinics in the United States.

PARTICIPANTS: Data from 164 U.S. adults with T1D (42% Latino, 30% White).

OUTCOMES AND MEASURES: Measures used included the whole day TLX (assessed via 2 wk of daily diaries), time in target blood glucose range (assessed with a continuous glucose monitor), illness intrusiveness (measured cross-sectionally), and stress (measured cross-sectionally and with EMA).

RESULTS: Number of days required for at least 0.70 reliability of the average whole day TLX ranged between 2 and 6 days depending on the subgroup. Results supported convergent and divergent validity of the average of the whole day TLX, including associations with average stress (r = .63, p < .001) and time in target blood glucose range (r = -.25, p = .002).

CONCLUSIONS AND RELEVANCE: The whole day TLX was a reliable and valid indicator of typical whole day workload. Plain-Language Summary: The health management responsibilities for Type 1 diabetes can be extremely burdensome. When these responsibilities are experienced, in addition to duties such as work and caregiving, the totality of demands experienced (i.e., whole day workload) can create further issues, such as unhealthy physiological changes and interference with self-care. We tested the psychometric properties of a measurement tool that assesses the typical level of workload people experience. This measure, referred to as the NASA Task Load Index (whole day TLX), was found to be a reliable and valid indicator of typical whole day workload. Occupational therapists may use the whole day TLX to track progress in interventions focused on reducing clients’ whole day workload exposure to promote their health and well-being. Occupational therapists’ expertise in areas such as activity analysis, task adaptation, and energy conservation makes them especially well-suited to intervene on whole day workload.

PMID:39029102 | DOI:10.5014/ajot.2024.050527


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