Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory

Abstract

BackgroundSelf-care is essential for patients with diabetes mellitus. Both clinicians and researchers must be able to assess the quality of that self-care. Available tools have various limitations and none are theoretically based. The aims of this study were to develop and to test the psychometric properties of a new instrument based on the middle range-theory of self-care of chronic illness: the Self-Care of Diabetes Inventory (SCODI).MethodsForty SCODI items (5 point Likert type scale) were developed based on clinical recommendations and grouped into 4 dimensions: self-care maintenance, self-care monitoring, self-care management and self-care confidence based on the theory. Content validity was assessed by a multidisciplinary panel of experts. A multi-centre cross-sectional study was conducted in a consecutive sample of 200 type 1 and type 2 diabetes patients. Dimensionality was evaluated by exploratory factor analyses. Multidimensional model based reliability was estimated for each scale. Multiple regression models estimating associations between SCODI scores and glycated haemoglobin (HbA1c), body mass index, and diabetes complications, were used for construct validity.ResultsContent validity ratio was 100%. A multidimensional structure emerged for the 4 scales. Multidimensional model-based reliabilities were between 0.81 (maintenance) and 0.89 (confidence). Significant associations were found between self-care maintenance and HbA1c (p = 0.02) and between self-care monitoring and diabetes complications (p = 0.04). Self-care management was associated with BMI (p = 0.004) and diabetes complications (p = 0.03). Self-care confidence was a significant predictor of self-care maintenance, monitoring and management (all p < 0.0001).ConclusionThe SCODI is a valid and reliable theoretically-grounded tool to measure self-care in type 1 and type 2 DM patients.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12902-017-0218-y) contains supplementary material, which is available to authorized users.

Two new tools for self‐care in ostomy patients and their informal caregivers: Psychosocial, clinical, and operative aspects

“…The analysis showed a hierarchical structure for two scales composed by two factors for each scale: the self‐care maintenance for patient and caregiver and the self‐care management for patient and caregiver. As in some previous Italian studies, factor analysis revealed similar results …”

“…Unlike other studies conducted in Italy on chronic populations with different clinical conditions, the level of self‐care of the ostomy patients and their caregivers was good . This result probably reflects the high support to self‐care performed by stomatherapist nurses.…”

“…Third, further analysis is needed to assess advanced psychometric properties of the instruments. For example, we could have conducted factor analysis using the exploratory structural equation modelling approach, as in research on the Self‐Care of Diabetes Inventory, and we could have used a more appropriate reliability coefficient that takes into account the multidimensionality of the scale as the global reliability index for multidimensional scales . Also, psychometric testing could show differences and peculiarity in the subgroups (kind of ostomy).…”

“…Further, all analyses were conducted by strictly abiding by the instructions provided by authors who have previously developed and tested self‐care instruments based on Riegel's theory …”

“…Patients' inclusion criteria were (a) having an elective or urgent ostomy of any type (ie, ileostomy, colostomy, urostomy) for more than 1 month Further, all analyses were conducted by strictly abiding by the instructions provided by authors who have previously developed and tested self-care instruments based on Riegel's theory. 20,35,36…”