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KMID : 1022320200140040249
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Asian Nursing Research
2020 Volume.14 No. 4 p.249 ~ p.256
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A New Self-management Scale with a Hierarchical Structure for Patients with Type 2 Diabetes
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Lee Eun-Hyun
Lee Young-Whee
Chae Duck-Hee
Lee Kwan-Woo
Chung Jin-Ook
Hong Seong-Bin
Kim So-Hun
Kang Eun-Hee
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Abstract
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Purpose: The aims of this study were to develop a new instrument for measuring self-management witha hierarchical structure [the Diabetes Self-Management Scale (DSMS)] in patients with type 2 diabetes,and evaluate its psychometric properties.
Method: The DSMS instrument was developed in three phases: (1) conceptualization and item generation;(2) content validity and pilot testing; and (3) field testing of its psychometric properties. A conveniencesample of 473 participants was recruited in three university hospitals and one regional healthcenter, South Korea.
Results: Exploratory and confirmatory factor analyses yielded two second-order component modelsexplaining the common variance among six first-order factors. Principal axis factoring with a varimaxrotation accounted for 60.88% of the variance. Confirmatory factor analysis of the hierarchical structurerevealed the following fit indices: c2/df ¼ 1.373, standardized root-mean-square residual ¼ .050,goodness-of-fit index ¼ .935, incremental fit index ¼ .975, comparative fit index ¼ .974, and root-meansquareerror of approximation ¼ .039. All Cronbach' a values for internal consistency exceeded the criterionof .70. All of the intraclass correlation coefficients for testeretest reliability exceeded .70 exceptthat for the taking-medication subscale. The components of the DSMS were moderately correlated withthe comparator measures of self-efficacy and health literacy administered for convergent validity.
Conclusion: The DSMS is a new instrument for measuring the complex nature of self-management inpatients with type 2 diabetes, comprising 17 items scored on a five-point Likert scale. The DSMS exhibitssatisfactory psychometric properties for five reliability and validity metrics, and so is a suitable instrumentto apply in both research and clinical practices.
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KEYWORD
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diabetes, patient-reported outcome measures, reliability, self-management, validity
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