Cultural Adaptation and Validation of the Malay Chronic Kidney Disease Self-Management Instrument (MCKD-SM)

Abstract

Background: There is growing evidence that self‐management behaviour can improve outcomes for patients with chronic kidney disease (CKD). However, there are no measures available in Malay to effectively assess self-management of CKD. The aim of this study was to translate, culturally adapt, and validate the Malay Chronic Kidney Disease Self-Management (MCKD-SM) for Malay-speaking health professionals and patients. Methods: This study was carried out in two phases: translation and cultural adaptation, and validation. Instruments were translated from English to Malay then adapted and validated in a sample of 337 patients with CKD stages 3-4 attending a nephrology clinic in a tertiary hospital in Malaysia. Construct validity was evaluated by exploratory factor analysis. Reliability of the instrument was assessed by internal consistency and test‐retest reliability. The correlations between MCKD-SM and kidney disease knowledge, MCKD-SM and self-efficacy were hypothesised a priori and investigated. Results: The Malay version of the Chronic Kidney Disease Self-Management instrument has 29 items grouped into three factors: “Understanding and Managing my CKD”, “Seeking Support” and “Adherence to Recommended Regimen”. The three factors accounted for 56.3 % of the total variance. Each factor showed acceptable internal reliability with Cronbach’s α from 0.885-0.960. 2-week intra-rater test-retest reliability intraclass correlation coefficient values for all items ranged between 0.938 to 1.000. MCKD-SM scores significantly correlates with kidney disease knowledge (r = 0.366, p < 0.01) and self-efficacy (r = 0.212, p < 0.01).Conclusion: The Malay version of the CKD-SM was found to be a valid and reliable patient‐reported outcome measure of pre-dialysis CKD self-management behaviour in the Malay-speaking population.