Background. Self-care is essential for patients with diabetes mellitus (DM). Both clinicians and researchers must be able to assess the quality of that self-care. Available tools are not based on theory. Aim. To develop a new Self-Care of Diabetes Index (SCODI) based on the Middle-range Theory of Chronic Illness and test its psychometric performance. Methods. The 40 SCODI items (5 points Likert type) were developed based on the most recent evidence-based clinical recommendations and grouped into 4 dimensions: self-care maintenance (12 items), self-care monitoring (8 items), self-care management (9 items) and self-care confidence (11 items) 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 from Italy. Construct validity was evaluated by explorative factor analysis. Single factor and multidimensional model based reliability was estimated for each scale. Multiple regression models estimating associations between SCODI scores and glycated haemoglobin (HbA1c), body mass index (BMI), and presence of diabetes complications, were used for criterion validity. Test-retest reliability was assessed in a sub-group of 20 patients. Results. Content validity ratio was 100%. A multidimensional structure emerged for the 4 scales (factor loadings range = 0.31 – 0.99). Single factor reliabilities were between 0.72 and 0.99. 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 maintenance, monitoring and management (all p < 0.0001) confirming the theory. Intra-class correlation coefficient was > 0.9 for each of the 4 scales. Conclusion. The SCODI is a valid and reliable theoretically-grounded tool to measure self-care in type 1 and type 2 DM patients. It can be used both in research and clinical practice. SCODI testing in US (English version) and Brazilian (Portuguese version) diabetes populations is ongoing.
Ausili, D., Barbaranelli, C., Rossi, E., Rebora, P., Fabrizi, D., Coghi, C., et al. (2016). DEVELOPMENT AND PSYCHOMETRIC TESTING OF THE SELF-CARE OF DIABETES INVENTORY. Intervento presentato a: Federation of European Nurses in Diabetes (FEND) Conference, Munich.
DEVELOPMENT AND PSYCHOMETRIC TESTING OF THE SELF-CARE OF DIABETES INVENTORY
AUSILI, DAVIDE LUIGI
;ROSSI, EMANUELA;REBORA, PAOLA;Fabrizi, D;DI MAURO, STEFANIA;
2016
Abstract
Background. Self-care is essential for patients with diabetes mellitus (DM). Both clinicians and researchers must be able to assess the quality of that self-care. Available tools are not based on theory. Aim. To develop a new Self-Care of Diabetes Index (SCODI) based on the Middle-range Theory of Chronic Illness and test its psychometric performance. Methods. The 40 SCODI items (5 points Likert type) were developed based on the most recent evidence-based clinical recommendations and grouped into 4 dimensions: self-care maintenance (12 items), self-care monitoring (8 items), self-care management (9 items) and self-care confidence (11 items) 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 from Italy. Construct validity was evaluated by explorative factor analysis. Single factor and multidimensional model based reliability was estimated for each scale. Multiple regression models estimating associations between SCODI scores and glycated haemoglobin (HbA1c), body mass index (BMI), and presence of diabetes complications, were used for criterion validity. Test-retest reliability was assessed in a sub-group of 20 patients. Results. Content validity ratio was 100%. A multidimensional structure emerged for the 4 scales (factor loadings range = 0.31 – 0.99). Single factor reliabilities were between 0.72 and 0.99. 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 maintenance, monitoring and management (all p < 0.0001) confirming the theory. Intra-class correlation coefficient was > 0.9 for each of the 4 scales. Conclusion. The SCODI is a valid and reliable theoretically-grounded tool to measure self-care in type 1 and type 2 DM patients. It can be used both in research and clinical practice. SCODI testing in US (English version) and Brazilian (Portuguese version) diabetes populations is ongoing.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
