Development and Psychometric Testing of the Inventory of Self-Care Decision-Making Styles of Older Adults

Understanding how older adults make decisions about their self-care is essential for designing tailored interventions that promote autonomy and well-being. However, no instrument currently exists to specifically measure self-care decision-making styles in this population. The study aimed to develop and test the psychometric properties of the Self-Care Decision-Making Styles of Older Adult (DECIDE) Inventory, a new instrument designed to assess styles of self-care decision-making among older adults. A three-phase process was undertaken: (i) instrument development based on theory and previous studies; (ii) content validity evaluation with 10 experts and cognitive interviews with 10 older adults; and (iii) psychometric testing, including assessment of structural and construct validity, internal consistency, and test-retest reliability. A convenience sample of 350 older adults from various Italian regions participated in the validation phase. The study followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) reporting guidelines. Following content validation, an instrument was finalized, assessing four decision-making styles-independent, responsible, self-neglected, and guided-, with five items per scale. Confirmatory factor analyses supported the structural validity of the four-scale model. Construct validity was confirmed through hypothesis testing. Reliability indicators, including Omega coefficients, factor score determinacy, item-total correlations, and intraclass correlation coefficients, ranged from adequate to optimal across all scales. The Self-Care Decision-Making Styles of Older Adult Inventory demonstrated good validity and adequate reliability for assessing self-care decision-making styles in older adults. Further refinement and cross-cultural validation are recommended before its use in clinical practice.