Testing reliability and validity of Lorensen's Self-care Capability Scale (LSCS) among older home-living, care-dependent individuals in Norway

Tools for measuring individual self-care capability: a scoping review

BACKGROUND

Our ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific self-care measurement tools for adults as such a review was lacking.

OBJECTIVE

The aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, structure and psychometric properties.

DESIGN

Scoping review with content assessment.

METHODS

The search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool.

RESULTS

We screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to prevention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care.

CONCLUSIONS

Various tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of self-care. There is a need to develop a comprehensive, validated tool and easily accessible tool to measure individual self-care capability including the assessment of a wide range of self-care practices. Such a tool could be used to inform targeted health and social care interventions.

Self-Care Dependency Evaluation Form: Psychometric properties of the revised version with 27 items

INTRODUCTION

The Self-Care Dependency Evaluation Form assesses dependency in performing self-care activities, but its original version is extensive and provides redundant information. The present study aims to scrutinise the items of the scale with the purpose of creating a revised version and to evaluate its psychometric properties.

METHODS

The study was conducted in two phases. In the first phase, an exploratory and correctional analysis of the items of the original form was performed from a database with 282 participants, followed by a review by a panel of experts who analysed the discriminatory ability and the contribution and relevance of each item, which resulted in the revised version. In the second phase, a new study with a sample comprising 150 participants was conducted to test the psychometric properties of the revised version. All ethical aspects and matters of confidentiality and privacy were assured.

RESULTS

The scale with 27 items shows good internal consistency, ranging from 0.67 (taking medication) to 0.96 (walking). It was moderately correlated with the Barthel Index and the Lawton and Brody Scale, proven to be a discriminatory measurement instrument.

DISCUSSION/CONCLUSION

This measure will enable health professionals to better evaluate self-care activities and provide more efficient, simple and effective prescriptions.

Validity and reliability of the Self-Care Activities Screening Scale (SASS-14) during COVID-19 lockdown

BACKGROUND

In a context where there is no treatment for the current COVID-19 virus, the combination of self-care behaviours together with confinement, are strategies to decrease the risk of contagion and remain healthy. However, there are no self-care measures to screen self-care activities in general population and which, could be briefly in a lockdown situation. This research aims to build and validate a psychometric tool to screen self-care activities in general population.

METHODS

Firstly, an exploratory factor analysis was performed in a sample of 226 participants to discover the underlying factorial structure and to reduce the number of items in the original tool into a significant pool of items related to self-care. Later a confirmatory factor analyses were performed in a new sample of 261 participants to test for the fit and goodness of factor solutions. Internal validity, reliability, and convergent validity between its score with perceived stress and psychological well-being measures were examined on this sample.

RESULTS

The exploratory analyses suggested a four-factor solution, corresponding to health consciousness, nutrition and physical activity, sleep, and intra-personal and inter-personal coping skills (14 items). Then, the four-factor structure was confirmed as the best model fit for self-care activities. The tool demonstrated good reliability, predictive validity of individuals' perception of coping with COVID-19 lockdown, and convergent validity with well-being and perceived stress.

CONCLUSIONS

This screening tool could be helpful to address future evaluations and interventions to promote healthy behaviours. Likewise, this tool can be targeted to specific population self-care's needs during a scalable situation.

Systematic review of measurement properties of self-reported instruments for evaluating self-care in adults

AIMS

The aims of this study were as follows: to identify instruments developed to assess self-care in healthy adults; to determine the theory on which they were based; their validity and reliability properties and to synthesize the evidence on their measurement properties.

BACKGROUND

Many instruments have been developed to assess self-care in many different populations and conditions. Clinicians and researchers should select the most appropriate self-care instrument based on the knowledge of their measurement properties.

DESIGN

Systematic review of measurement instruments according to the protocol recommended by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel.

DATA SOURCES

PubMed, Embase, PsycINFO, Scopus and CINAHL databases were searched from inception to December 2015.

REVIEW METHODS

Studies testing measurement properties of self-report instruments assessing self-care in healthy adults, published in the English language and in peer review journals were selected. Two reviewers independently appraised the methodological quality of the studies with the COSMIN checklist and the quality of results using specific quality criteria.

RESULTS

Twenty-six articles were included in the review testing the measurement properties of nine instruments. Seven instruments were based on Orem's Self-care theory. Not all the measurement properties were evaluated for the identified instruments. No self-care instrument showed strong evidence supporting the evaluated measurement properties.

CONCLUSION

Despite the development of several instruments to assess self-care in the adult population, no instrument can be fully recommended to clinical nurses and researchers. Further studies of high methodological quality are needed to confirm the measurement properties of these instruments.

The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity Among Older Chinese People

The study aimed to test the reliability and validity of the Chinese version of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R-CHI). A cross-sectional design was used to conduct this study, and the sample consisted of 1,219 older people, collected by a demographic questionnaire, ASAS-R-CHI and the Exercise of Self-Care Agency (ESCA) scale. The Cronbach's alpha (α) of ASAS-R-CHI was .79, the test-retest correlation was 0.95, and the item-to-total correlations ranged from r = .41 to r = .74. Exploratory factor analysis (EFA) resulted in three factors that explained 65.31% of the total variance; all 15 items had strong factor loadings ranging from 0.54 to 0.91. Confirmatory factor analysis (CFA) indicated the three-factor solution of ASAS-R-CHI had a good fit (x2,chi-square/degree of freedom [CMIN/DF] = 2.61, goodness of fitness index [GFI] = 0.93, adjusted goodness of fit index [AGFI] = 0.92,, comparative fit index [CFI = 0.92], Tucker Lewis index [TLI] = 0.91, root mean square error of approximation [RMSEA] = 0.04, root mean residual [RMR] = 0.02, P-value for test of close fit [PCLOSE] = 0.68). ASAS-R-CHI is a short, reliable, and valid instrument for measuring self-care agency among Chinese older adults.