Cross-cultural assessment of the Self-Care of Chronic Illness Inventory: A psychometric evaluation

Abstract

Background. Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions.Objective. The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. Methods. This cross-sectional study enrolled 1,629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited.Results. Participants were mostly males (54.3%), older adults (68.9%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [χ 2 (50) = 63.

Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory

“…To test construct validity, we developed three hypothesis based on previous studies. Findings from studies of self-care measures suggest that the Self-Care Maintenance and Self-Care Management scales would have two factors while the Self-Care Monitoring scale would have one factor [ 8 , 22 ] (Hypothesis 1) . Moreover, we expected higher positivity [ 16 ] and lower stress levels [ 17 ] would be significantly associated with higher self-care maintenance, monitoring, and management (Hypothesis 2) .…”

“…In the last decade, international research on self-care has focused on chronic diseases [ 6 ] with the development of several instruments to measure it, either with a general illness [ 7 , 8 ] or a disease specific focus [ 9 – 11 ]. In chronic illness, higher levels of self-care have been associated with better health outcomes [ 12 , 13 ] including decreased hospitalization, costs, and mortality [ 14 , 15 ].…”

Self-Care of African Immigrant Adults with Chronic Illness

“…The global reliability index for the self-care maintenance, monitoring, and management scales were 0.67, 0.81, and 0.71 respectively, while content validity was 0.89, 0.88, and 0.96 respectively (Riegel et al, 2018). The SC-CII captures fundamental views of self-care regardless of the cultural background of the person completing the inventory (De Maria et al, 2021). The SC-CII have been translated into numerous languages and found to be useful in both individualistic and collectivist societies where family involvement overrides individual decision making (Herber et al, 2020).…”

Cross-cultural adaptation and validation of the caregiver contribution to self-care of chronic illness inventory in China: a cross-sectional study

“…De Maria et al 9 proposed that managing chronic illnesses required mastering self-care, which was fundamental in managing chronic diseases. 10 In the middle-range theory of self-care of chronic illness, self-care refers to a process of maintaining health through health promotion and disease management.…”