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Martínez-Tofé J, Ausili D, Soto-Ruiz N, Santolalla-Arnedo I, Durante A, di Nitto M, Lysanets Y, de Viñaspre-Hernández RR, Tejada-Garrido CI, Sánchez Barba M, Gea-Caballero V, Juárez-Vela R. Transcultural adaptation and theoretical models validation of the Spanish version of the Self-Care of Diabetes Inventory. Front Med (Lausanne) 2024; 11:1423948. [PMID: 39318591 PMCID: PMC11420126 DOI: 10.3389/fmed.2024.1423948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/30/2024] [Indexed: 09/26/2024] Open
Abstract
Background For patients with diabetes mellitus, self-care is crucial because it prevents complications and helps preserve quality of life. Clinicians and researchers require effective tools for assessing self-care behaviors across various dimensions to identify individual needs and maximize resource allocation. The aim of this study was to evaluate the validity and reliability of the Spanish version of the Self-Care of Diabetes Inventory (SCODI). Methods Two hundred eighteen participants with DMT1 and DMT2 who were recruited through convenience sampling from a university hospital participated in our cross-sectional study. After translation and cultural adaptation, the enrolled patients answered the questions. We performed an exploratory factor analysis (EFA) on each of the SCODI scales and Confirmatory factor analysis (CFA) was performed using our models which appropriate fit indices. Results The original structure of the four-dimensions tool was confirmed. The overall consistency across the four scales was assessed by Cronbach's alpha: self-care maintenance (0.766), self-care monitoring (0.790), self-care management (0.771), and self-care confidence (0.936). The model fit yielded a chi-square index of 1.028 with 773 degrees of freedom. Confirmatory factor analysis showed a good fit, thereby affirming the reliability of the model. Conclusion The internal consistency and reliability of the SCODI Spanish version are deemed adequate. This tool is appropriate when it is desired to evaluate the self-care practices of Spanish persons suffering from diabetes due to its good psychometric qualities.
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Affiliation(s)
- Jesús Martínez-Tofé
- Doctoral Program in Health Sciences, Public University of Navarra, Pamplona, Spain
- Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
| | - Davide Ausili
- Department of Medicine and Sugery, Università degli Studi di Milano-Bicocca, Milan, Italy
| | - Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarra (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Iván Santolalla-Arnedo
- Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
| | - Angela Durante
- Sant’Anna School of Advanced Studies, Health Science Interdisciplinary Center, Pisa, Italy
- Fondazione Toscana “Gabriele Monasterio”, Pisa, Italy
| | - Marco di Nitto
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Yuliia Lysanets
- Department of Foreign Languages with Latin and Medical Terminology, Poltava State Medical University, Poltava, Ukraine
| | | | | | | | - Vicente Gea-Caballero
- Faculty of Health Sciences, Research Group Community and Health SALCOM, International University of Valencia, Valencia, Spain
| | - Raúl Juárez-Vela
- Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
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Madit W, Harnirattisai T, Hain D, Gaudio PA. Effect of a self-care promoting program on engagement in self-care behaviors and health-related outcomes among persons with type 2 diabetes and diabetic retinopathy: A single-blind randomized controlled trial. BELITUNG NURSING JOURNAL 2024; 10:272-284. [PMID: 38947309 PMCID: PMC11211747 DOI: 10.33546/bnj.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/04/2024] [Accepted: 06/03/2024] [Indexed: 07/02/2024] Open
Abstract
Background Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, leading to visual impairment and eventual blindness. Promoting self-care behaviors is crucial in controlling DR progression and preventing blindness. Objective This study aimed to investigate the effects of a Self-Care Promoting Program (SCPP) on engagement in self-care behaviors, HbA1c levels, visual acuity (VA), severity of DR, and vision-related quality of life (VRQoL) among individuals with type 2 diabetes and DR. Methods This study employed a single-blind randomized controlled trial design to compare SCPP with conventional diabetic care interventions (standard care). The SCPP was based on the Self-Care of Chronic Illness Theory, Self-efficacy theory, and the Association of Diabetic Care and Education Specialist (ADCES) guidelines incorporating health education, self-care maintenance, monitoring, and management skills training over 12 weeks. Ninety-eight participants were randomly allocated to the experimental or control group (n = 49 per group). While the experimental group received SCPP alongside standard care, the control group received standard care alone. Data collection occurred between May 2022 and March 2023 and included demographic information, the Self-Care of Diabetes Index questionnaire (SCODI), the self-care for diabetes eye care questionnaire (SCFDE), the impact of visual impairment questionnaire (IVI-Thai version), and retinal images for DR severity grading. Data analysis utilized descriptive statistics, Chi-Square tests, t-tests, and MANOVA. Results Following 8 and 16 weeks of SCPP, the experimental group had significantly higher mean scores in engagement with self-care and eye-care behaviors compared to the control group (p <0.001). The highest scores were observed in self-care and eye-care confidence behaviors, followed by maintenance, monitoring, and management. Furthermore, HbA1c levels and VRQoL significantly decreased and were lower than those of the control group at week 16 (p <0.001 and p <0.05, respectively). However, there were no significant differences in VA, and DR severity increased in both groups by week 16. Conclusion SCPP benefits individuals with DR, enhancing their confidence and ability to perform, monitor, and manage self-care behaviors. These strategies contribute to improved diabetes management, enhanced quality of life, and reduced DR-related blindness. Integrating SCPP into routine DR management is recommended, with nurses playing a pivotal role in overseeing and driving this integration, highlighting the critical role of nurses in managing this widespread global disease. Trial Registry Number Thai Clinical Trials Registration (TCTR20230302002).
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Affiliation(s)
- Wimol Madit
- Faculty of Nursing, Thammasat University, Pathum Thani, Thailand
| | | | - Debra Hain
- Christine E. Lynn College of Nursing, Florida Atlantic University, United States
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Yu J, Wang H, Zhu M, Zhou M, Xu J. Patient-Centered Positive Factors Influencing Glycemic Control in Adolescents with Type 1 Diabetes Mellitus in China: A Cross-Sectional and Longitudinal Study. Patient Prefer Adherence 2024; 18:1039-1046. [PMID: 38826503 PMCID: PMC11141705 DOI: 10.2147/ppa.s460104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/08/2024] [Indexed: 06/04/2024] Open
Abstract
Objective This study aimed to explore the stable longitudinal patient-centered self-protective factors of glycosylated hemoglobin (HbA1c) in adolescents with type 1 diabetes mellitus (T1DM). Methods We used both cross-sectional and longitudinal datasets at the Diabetes Education Center and National Endocrine and Metabolism Centre of a university hospital in China from April 2020 to July 2022. Participants were assessed using the Adolescent Diabetic Behavior Rating Scale (DBRS), Diabetes Strengths and Resilience Measure for Adolescents (DSTAR-Teen). HbA1c and other clinical variables were obtained from the medical record at the same time. 266 adolescents (131 male, age 14.1±3.9 years) completed the cross-sectional assessments and 131 (62 male, age 14.6±3.3 years) participated in a follow-up at a 1-year visit interval. Results Logistic regression analysis of cross-sectional data of 266 cases showed that there were significant positive effects between pump treatment (β=0.090, OR 2.460, P=0.005), DBRS scores (β=2.593, OR 13.366, P=0.002) and the meeting of standard HbA1c (<7.5%, 58 mmol/mol). Disease duration (β=-0.071, OR 0.932, P=0.033) was negatively correlated with it. The longitudinal multivariate generalized estimation equation model showed that DBRS scores (β=3.165, OR 23.681, P=0.009) and DSTAR-Teen scores (β=0.050, OR 1.051, P=0.012) had a positive influence on the meeting of standard HbA1c over one year time of 131 cases. Conclusion Self-care and resilience had higher cross-temporal stability in influencing glycemic control over time. To reach a better glycemic control and improve long-term health outcomes, attention should be paid to the detection and enhancement of these patient-centered promoters.
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Affiliation(s)
- Jian Yu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210029, People’s Republic of China
| | - Hong Wang
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210029, People’s Republic of China
| | - Min Zhu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210029, People’s Republic of China
| | - Meijing Zhou
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210029, People’s Republic of China
| | - Jingjing Xu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210029, People’s Republic of China
- Department of Nursing, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Nanjing, LA, 210036, People’s Republic of China
- School of Public Health, Nanjing Medical University, Nanjing, LA, 210036, People’s Republic of China
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Johnsson N, Strandberg S, Tuvesson H, Fagerström C, Ekstedt M, Lindberg C. Delineating and clarifying the concept of self-care monitoring: a concept analysis. Int J Qual Stud Health Well-being 2023; 18:2241231. [PMID: 37506372 PMCID: PMC10392281 DOI: 10.1080/17482631.2023.2241231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
AIM To delineate and clarify the meaning of the concept of self-care monitoring from a patient perspective. METHODS A systematic search was performed in the databases ASSIA, CINAHL, PsycInfo, and PubMed (January 2016-September 2021). A selection of 46 peer-reviewed articles was included in the study and analysed using Rodgers' Evolutionary Method for Concept Analysis. RESULTS The following four attributes were identified: Tracking symptoms, signs, and actions, Paying attention, Being confident, and Needing routines, creating a descriptive definition: "Self-care monitoring is an activity that means a person has to pay attention and be confident and needs routines for tracking symptoms, signs, and action." The antecedents of the concept were shown to be Increased knowledge, Wish for independence, and Commitment. The concepts' consequences were identified as Increased interaction, Perceived burden, and Enhanced well-being. CONCLUSIONS This concept analysis provides extensive understanding of self-care monitoring from a patient perspective. It was shown that the concept occurs when a person practices self-care monitoring at home either with or without devices. A descriptive definition was constructed and presented with exemplars to encourage practice of the concept in various healthcare settings and could be of relevance to people with chronic illnesses or other long-term conditions.
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Affiliation(s)
- Natali Johnsson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | | | - Hanna Tuvesson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Cecilia Fagerström
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Mirjam Ekstedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
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Durán-Gómez N, López-Jurado CF, Martín-Parrilla MÁ, Montanero-Fernández J, Pérez-Civantos D, Cáceres MC. Self-care nursing assessment: cross-cultural adaptation and validation of the Spanish version of the Self-care of chronic illness inventory. BMC Nurs 2023; 22:442. [PMID: 37993838 PMCID: PMC10664672 DOI: 10.1186/s12912-023-01605-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Self-care is the primary means of caring for a chronic condition. Therefore, it is necessary to assess it by using a good validity and reliability instrument. The Self-Care of Chronic Illness Inventory (SC-CII) is a generic instrument developed to measure self-care processes behaviors using three separate scales in patients with chronic illness. The original cross-cultural assessment concluded the need for future studies sampling patients from different sites to increase the generalizability of the psychometric evaluation results. It was unclear whether this tool had sound psychometrics properties in the context of Spanish culture. The purpose of this study was to cross-culturally adapt the SC-CII, test its psychometric properties and validate its use among Spanish people with chronic diseases. METHODS A cross-cultural translation of the SC-CII was performed from English to Spanish. The psychometric evaluation was conducted in a sample of 350 patients with chronic conditions through a multicenter cross-sectional study based on the STROBE guideline. Data were collected from face-to-face interviews during 2022. Internal validity was assessed with Confirmatory Factor Analysis, internal consistency reliability with Cronbach alpha for unidimensional scales and McDonald's Omega reliability coefficient for multidimensional scales. RESULTS Most (63.4%) participants were older adults aged 65 years or older with a mean age of 65.45 ± 14.97. The average number of chronic conditions reported was 2.81%; the most common conditions were hypertension (52.3%), musculoskeletal disorders (46.3%) and diabetes (38.9%). Patients reported adequate self-care behaviors in all three scales of the SC-CII. The Self-Care Maintenance and Management scales were multidimensional, and the Self-Care Monitoring scale was unidimensional. In Confirmatory Factor Analysis, the Self-Care Maintenance and Monitoring scales had satisfactory fit indices. The Self-care Management scale had acceptable fit indices. The Omega reliability coefficient for multidimensional scales was 0.75 (Self-Care Maintenance) and 0.72 (Self-Care Management). The Cronbach alpha coefficient of the Self-Care Monitoring scale was 0.85. Item-total correlations were all significant except one. Test-retest reliability showed an intraclass correlation coefficient of 0.92. CONCLUSIONS The SC-CII has appropriate psychometrics characteristics and is a culturally suitable and reliable instrument for assessing to the self-care behaviors of patients with chronic disease in Spain. The scale provides a simple and rapid solution to assess the self-care process.
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Affiliation(s)
- Noelia Durán-Gómez
- Departamento de Enfermería, Universidad de Extremadura, Facultad de Medicina y Ciencias de La Salud, 06006, Badajoz, Spain.
| | - Casimiro Fermín López-Jurado
- Departamento de Enfermería, Universidad de Extremadura, Facultad de Medicina y Ciencias de La Salud, 06006, Badajoz, Spain
| | - Miguel Ángel Martín-Parrilla
- Departamento de Enfermería, Universidad de Extremadura, Centro Universitario de Plasencia, 10600, Plasencia, Spain
| | - Jesús Montanero-Fernández
- Departamento de Matemáticas, Universidad de Extremadura, Facultad de Medicina y Ciencias de La Salud, 06006, Badajoz, Spain
| | - Demetrio Pérez-Civantos
- Facultad de Medicina y Ciencias de La Salud, Universidad de Extremadura Hospital Universitario de Badajoz, 06006, Badajoz, Spain
| | - Macarena C Cáceres
- Departamento de Enfermería, Universidad de Extremadura, Facultad de Medicina y Ciencias de La Salud, 06006, Badajoz, Spain
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Luciani M, Bigoni C, Canesi M, Masotto M, Fabrizi D, Di Mauro S, Ausili D. Self-Care of Adults with Type 2 Diabetes During the COVID-19 Pandemic: A Qualitative Interpretive Description Study. Clin Nurs Res 2023; 32:73-83. [PMID: 36196898 PMCID: PMC9535453 DOI: 10.1177/10547738221125991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Due to coronavirus disease 2019 (COVID-19), diabetes services have been disrupted, causing difficulties for people with type 2 diabetes mellitus (T2DM), and understanding their experience could help improve diabetes care. Therefore, we used a qualitative interpretive description to explore the experience of self-care of adults with T2DM during the COVID-19 pandemic. Data were collected using semi-structured interviews and analyzed theoretically. The sample (N = 30) was composed of 7 females and 23 males, with a mean age of 69.9 years (60-77) and 19.4 mean years (3-40) of people living with T2DM. Our findings show reduced physical activity and increased smoking and alcohol consumption affected that self-care. Increased food consumption and stress eating, with greater stress and anxiety, caused worsening of glycemic values. Participants were able to contact healthcare professionals via eHealth or telephone. Others, even those with complications, were not able to receive care or advice. These results suggest that easier contact with health providers, continuous engagement, eHealth solutions, and formal peer support could help self-care in T2DM. Advanced nursing roles and services could solve many issues reported in this study during and after the pandemic.
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Affiliation(s)
- Michela Luciani
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy,Luciani Michela, Department of Medicine and Surgery, University of Milano – Bicocca, Via Cadore 48, Monza 20900, Italy.
| | - Camilla Bigoni
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
| | - Marta Canesi
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
| | - Matteo Masotto
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
| | - Diletta Fabrizi
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano – Bicocca, Monza, Italy
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Baroni I, Caruso R, Dellafiore F, Arrigoni C, Fabrizi D, Luciani M, Rebora P, Ausili D. Diabesity in Adults With Type 2 Diabetes Mellitus: A Cross-sectional Study Exploring Self-care and Its Determinants. Can J Diabetes 2022; 46:S1499-2671(22)00072-7. [PMID: 35927172 DOI: 10.1016/j.jcjd.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The purpose of this study was to describe self-care maintenance, self-care monitoring, self-care management and self-care self-efficacy in adults with type 2 diabetes (T2DM) and body mass index (BMI)<30 kg/m2 and adults with T2DM and BMI≥30 kg/m2 ("diabesity"), and to identify their clinical and sociodemographic determinants. Self-care is one of the main treatments for adults with T2DM. However, self-care has been poorly described in people with diabesity, and differences in clinical and sociodemographic determinants of self-care between patients with diabesity and patients with T2DM and BMI<30 kg/m2 have, to our knowledge, not been assessed. METHODS A secondary analysis was performed of sociodemographic and clinical data using a multicentre, observational, cross-sectional design, wherein 540 adults diagnosed with T2DM were included in a consecutive and convenience sampling procedure. RESULTS Self-care maintenance and management were significantly lower among patients with diabesity (p<0.001 and p=0.025, respectively). Among patients with diabesity, low income (relative risk [RR]=3.27, p=0.01) and presence of diabetic neuropathy (RR=4.16; p=0.03) were strongly associated with inadequate self-care maintenance; completion of high school (RR=0.45; p=0.01), availability of a family caregiver (RR=0.52; p=0.04) and the use of insulin as the main treatment (RR=2.09; p=0.01) decreased the likelihood of inadequate self-care monitoring. CONCLUSIONS The unfavourable behavioural profile of patients with diabesity could be further worsened by their lower level of confidence in performing adequate self-care.
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Affiliation(s)
- Irene Baroni
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Federica Dellafiore
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Diletta Fabrizi
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Paola Rebora
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
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Luciani M, De Maria M, Page SD, Barbaranelli C, Ausili D, Riegel B. Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory. BMC Public Health 2022; 22:598. [PMID: 35346104 PMCID: PMC8960109 DOI: 10.1186/s12889-022-12913-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Self-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population. Methods Based on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores. Results The Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score. Conclusions The SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.
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Montali L, Zulato E, Cornara M, Ausili D, Luciani M. Barriers and facilitators of type 1 diabetes self-care in adolescents and young adults. J Pediatr Nurs 2022; 62:136-143. [PMID: 34561133 DOI: 10.1016/j.pedn.2021.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/12/2021] [Accepted: 09/12/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE This study explores the disease experience of adolescents and young adults with T1DM focusing on the barriers and facilitators that characterise their disease self-care. Self-care requires complex decision making and cooperation between patients, their families, the healthcare team, and the social support system. Personal and social factors affect self-care, and specific challenges impact adolescents and young adults, putting them at a higher risk of poor glycaemic control and more severe complications. DESIGN AND METHODS The study uses a qualitative description approach. Twenty-two people (15 women; 10-30 years old; 2-24 years from diagnosis) were purposefully recruited through snowballing techniques. Data were collected with semi-structured interviews and analysed inductively with semantic thematic analysis. RESULTS Four themes and nine subthemes conceptualise the patients' experience as a life-long journey that has its difficult beginning at the time of diagnosis and continues through the resolution of the initial crisis by integrating disease at the identity level and acquiring expertise. Technology and social environment act both as self-care barriers and facilitators. CONCLUSIONS Findings highlight the importance of designing and improving technology related to diabetes accounting for patients' experiences. Second, it is imperative to work towards a de-stigmatisation of diabetes. Finally, health professionals should work with people with T1DM on the psychological aspects of the disease and identity integration. PRACTICE IMPLICATIONS Diabetes-related technology should promote usability and acceptability while addressing visibility and device burden issues. Clinicians should pay particular attention during the transition from the paediatric to the adult centres and offer global assessments and treatment.
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Affiliation(s)
- Lorenzo Montali
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Edoardo Zulato
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Mattia Cornara
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy.
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, Italy.
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza, Italy.
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De Maria M, Fabrizi D, Luciani M, Caruso R, Di Mauro S, Riegel B, Barbaranelli C, Ausili D. Further Evidence of Psychometric Performance of the Self-care of Diabetes Inventory in Adults With Type 1 and Type 2 Diabetes. Ann Behav Med 2021; 56:632-644. [PMID: 34559189 DOI: 10.1093/abm/kaab088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The Self-care of Diabetes Inventory (SCODI) is a theory-based tool that measures self-care, a key strategy in the appropriate treatment of diabetes. However, despite the clinical differences between people with Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM), the psychometric properties of the SCODI were only tested in mixed samples. PURPOSE This study aims to test the psychometric performances of the SCODI in two separate groups of adults with T1DM and T2DM. METHODS This is a secondary analysis from two previous multicentre cross-sectional observational studies involving patients with T1DM (n = 181) and T2DM (n = 540). We tested dimensionality with confirmatory factor analysis and reliability with a multidimensional model-based coefficient for every scale of the SCODI: self-care maintenance, self-care monitoring, self-care management, and self-care self-efficacy. RESULTS We found that the SCODI showed the same dimensionality, with minimal variation in factor loadings for each factor and each scale among T1DM and T2DM groups. High reliability for each scale in both groups was also found (self-care maintenance: T1DM = 0.86, T2DM = 0.83; self-care monitoring: T1DM = 0.84, T2DM = 1.00; self-care management: T1DM = 0.87, T2DM = 0.86; self-care self-efficacy: T1DM = 0.88; T2DM = 0.86). CONCLUSION The SCODI can be used for measuring self-care in people with T1DM, T2DM, or mixed groups using identical scoring procedures. Considering the well-known differences between Type 1 and Type 2 diabetes diseases and patients' characteristics, our results support the generalizability of the self-care theory on which the instrument is based.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Diletta Fabrizi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Michela Luciani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Claudio Barbaranelli
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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