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Multicenter Study
. 2017 Oct 16;17(1):66.
doi: 10.1186/s12902-017-0218-y.

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

Davide Ausili  1   2 , Claudio Barbaranelli  3 , Emanuela Rossi  4 , Paola Rebora  4 , Diletta Fabrizi  5 , Chiara Coghi  6 , Michela Luciani  7 , Ercole Vellone  8 , Stefania Di Mauro  7 , Barbara Riegel  9
Affiliations
Multicenter Study

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

Davide Ausili et al. BMC Endocr Disord. .

Abstract

Background: Self-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).

Methods: Forty 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.

Results: Content 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).

Conclusion: The SCODI is a valid and reliable theoretically-grounded tool to measure self-care in type 1 and type 2 DM patients.

Keywords: Chronic disease; Diabetes mellitus; Middle range theory; Psychometric testing; Self-care; Self-efficacy.

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Conflict of interest statement

Ethics approval and consent to participate

The Institutional Review Board of each centre where patients were recruited approved the study. All participants provided written informed consent.

Consent for publication

Not applicable

Competing interests

None of the authors have a conflict of interest related to this study. Non-commercial use of the SCODI is free to clinicians and researchers seeking to improve care and science internationally. If the SCODI is to be used in a funded trial or commercially, specific arrangements will be negotiated upon request. SCODI Italian, English, Chinese and Portuguese Versions are available on the website: self-care-measures.com. Further SCODI translations require agreement by the authors. Results were partially presented during the 21st Foundation of European Nurses in Diabetes – FEND Conference (Munich, 9–10 September 2016) and the study was awarded with the FEND Annual best research Award.

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