Designing and Psychometric Properties of Self-Care Tool for Adults With Pre-Diabetes: Exploratory Sequential Mixed...

Area of Science:

• Endocrinology and Metabolism
• Behavioral Medicine
• Health Psychology

Background:

• Self-care is vital for preventing type 2 diabetes, especially for adults with pre-diabetes who face significantly elevated risks.
• Over 70% of adults with pre-diabetes develop type 2 diabetes without effective self-care behaviors.
• This highlights the urgent need for validated tools to assess and promote self-care in this population.

Purpose of the Study:

• To design a comprehensive self-care questionnaire tailored for adults with pre-diabetes.
• To rigorously evaluate the psychometric properties of the developed self-care tool.

Main Methods:

• A sequential exploratory mixed-methods approach was employed, starting with qualitative interviews (n=39 adults with pre-diabetes, n=6 healthcare workers).
• Directed content analysis guided by Riegel et al.'s theory informed the initial item generation.
• Subsequent quantitative phases involved psychometric evaluations, including validity, reliability, and feasibility testing on a larger sample (n=207).

Main Results:

• The initial 57-item tool was refined to a 19-item, three-subscale questionnaire after rigorous item analysis and factor analysis (explaining 38% of variance).
• Confirmatory factor analysis confirmed an acceptable model fit.
• The final questionnaire demonstrated excellent internal consistency (Cronbach's alpha > 0.7) and reliability (ICC > 0.90), with no ceiling or floor effects.

Conclusions:

• The developed self-care questionnaire possesses robust psychometric properties for assessing self-care in adults with pre-diabetes.
• This validated tool can effectively measure self-care behaviors, supporting clinical practice and research in diabetes prevention.