Design and psychometric evaluation of self-care behavior assessment tool in diabetic patients

Diabetes is the most common metabolic disease with an increasing prevalence throughout the world due to the changes in lifestyle. Appropriate self-care promotes the life condition of people with chronic illnesses and reduces the side effects of such diseases, so this study was designed to develop a scale for evaluating self-care in middle-aged patients diabetes.

In this methodological study, the following 4 steps were conducted for design and psychometric measurement of the questionnaire: 1) Data collection was carried out during a supplementary cross-sectional survey of the qualitative study; 2) determining the face validity (the assessment of facility, difficulty, and ambiguity of the items and their importance for patients) and content validity of the questionnaire (the assessment of appropriateness and necessity of items by experts opinions and measuring CVR and CVI; 3) the internal consistency of the questionnaire was evaluated by determining the Cranach's alpha coefficient (α = 0.85), and 4) test-retest of the scale with a 2-weeks interval confirmed appropriate stability for the scale (ICC = 0.81). The normality of data was also evaluated using skewness and kurtosis. CFA was performed using AMOS version 24 software.

The first version of this questionnaire was produced with 71 items, of which 27 items were deleted during the process of validity and reliability confirmation. The final version of the questionnaire was provided with 44 items. For this study, 460 samples were used to examine the psychometric properties of the self-care scale.The confirmatory factor analysis showed a good fit to the data. Before the performing CFA, KMO and Bartlett's test of sphericity were evaluated and the results indicated an adequate sample (KMO = 0.956 and Bartlett's test: χ2 = 14,288.048, df = 946, P < 0.001).

The findings showed that the designed questionnaire could assess self-care in patients with diabetes. This is a short, easy-to-use questionnaire that helps you understand what the patient needs to perform self-care behaviors.