Design and Validation of a Self-care Evaluation Instrument to Prevent Diabetic Foot
DOI:
https://doi.org/10.17533/udea.iee.v40n2e06Keywords:
psychometry, nursing theory, self-care, primary prevention, diabetic footAbstract
Objective. This work sought to design and validate a self-care instrument to prevent diabetic foot in Colombian adults with diabetes.
Methods. Psychometric study in which an instrument was designed to measure self-care to prevent diabetic foot according to the Medium Range Theory of Self-care in chronic diseases. With a sample of 230 people with type-2 diabetes, construct validity was determined through exploratory and confirmatory factor analysis. Internal consistency was calculated with Cronbach's alpha coefficient.
Results. Favorable evidence of construct validity was obtained with a model consisting of three scales: self-care maintenance with a three-factor structure (accumulated variance 43%), α = 0.7, with good fit (????2= 64.698, p = 0.001; RMSEA = 0.066; RMSSR = 0.071; CFI = 0.936, NNFI = 0.910). Monitoring of self-care with presence of symptoms a two-factor structure was found, α = 0.950, with good fit (????2 = 266.837, p = 0.000; RMSEA = 0.321; RMSSR = 0.057; CFI = 0.848; NNFI = 0.789); and without symptoms, a single-factor structure (cumulative variance 84%), α = 0.9, acceptable fit (????2= 377.327, p < 0.001; RMSEA = 0.355; RMSSR = 0.073; CFI = 0.832; NNFI = 0.764). And self-care management with two-factor structure (cumulative variance 53.7%) α = 0.7, with good fit (????2 = 14.317, p = 0.014; RMSEA = 0.144; RMSSR = 0.063; CFI = 0.905; NNFI = 0.809).
Conclusions. The resulting instrument has adequate psychometric properties, consistent with the theoretical model of self-care in chronic diseases. Its use is recommended to evaluate self-care to prevent diabetic foot in populations similar to the study population.
Downloads
References
1. Ministerio de Salud y Protección Social. Tres de cada 100 colombianos tienen diabetes. Boletín de Prensa No 493 de 2020. [Cited 15 Sept. 2020]. Available from: https://www.minsalud.gov.co/Paginas/Tres-de-cada-100-colombianos-tienen-diabetes.aspx
2. Grupo Colombiano de pie diabético-COLPEDIS. Federación diabetológica de Colombia. Guías colombianas para la prevención, diagnóstico y tratamiento del pie diabético. Manejo integral. Tercera edición 2019. ISBN: 978-98447-1-7. Available from: https://fusande.com/wp-content/uploads/2019/02/GUIA-COLOMBIANA-PIE-DIABETICO-2019.pdf
3. American Diabetes Association from Healogics, Inc., and Organogenesis, Inc. Diagnosis and Management of Diabetic Foot Complications. 2018. [Cited 15 Sept. 2020] Available from: https://professional.diabetes.org/sites/professional.diabetes.org/files/media/foot_complications_monograph.pdf
4. Guías ALAD sobre el Diagnóstico, Control y Tratamiento de la Diabetes Mellitus Tipo 2 con Medicina Basada en Evidencia. Guías ALAD 2019. ISSN: 2248-6518. Available from: https://revistaalad.com/guias/5600AX191_guias_alad_2019.pdf
5. Riegel B, Jaarsma T, Lee C, Stromberg A. Integrating Symptoms into the Middle-Range Theory of Self-Care of Chronic Illness. Adv Nurs Science. 2019; 42 (3):206-15.
6. Riegel B, Barbaranelli C, Sethares KA, Daus M, Moser DK, Miller JL, et al. Development and initial testing of the self-care of chronic illness inventory. J. Adv. Nurs. 2018; 74(10):2465-76.
7. Koirala B, Budhathoki C, Dennison-Himmelfarb CR, Bhattarai P, Davidson PM. The Self-Care of Heart Failure Index: A psychometric study. J. Clin. Nurs. 2020; 29(3-4):645-52.
8. Dickson V, Lee CS, Yehle KS, Mola A, Faulkner KM, Riegel B. Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). Res. Nurs. Health. 2017; 40(1):15-22.
9. Matarese M, Clari M, De Marinis MG, Barbaranelli C, Ivziku D, Piredda M, Riegel B. The Self-Care in Chronic Obstructive Pulmonary Disease Inventory: Development and Psychometric Evaluation. Eval. Health Prof. 2020; 43(1):50-62.
10. Dickson VV, Lee C. Yehle KS, Abel WM; Riegel B. Psychometric testing of the self-care of hypertension inventory. J. Cardiovasc. Nurs. 2017; 32(5):431-8. http://doi.org/10.1097/JCN.0000000000000364
11. Herrera E, Robles J, Bautista L. Validez y confiabilidad del Self-Care of Hypertension Inventory versión español colombiano. Av. Enferm. 2021; 39(2):2154. http://doi.org/10.15446/av.enferm.v39n2.93312
12. Ausili D, Barbaranelli C, Rossi E, Rebora P, Fabrizi D, Coghi C, et al. Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory. BMC Endocr. Disord. 2017; 17(1):66.
13. Riegel B, Jaarsma T, Strömberg A. A Middle-Range Theory of Self-Care of Chronic Illness. Adv. Nurs. Sci. 2012; 3 (35):194-204. http://dx.doi.org/10.1097/ANS.0b013e318261b1ba
14. LoBiondo-Wood G; Habers J. Nursing research methods and critical appraisal for evidence-based practice. 8th ed. St. Louis: Elsevier; 2014.
15. LoBiondo – Wood G, Habers, J. Nursing Research Methods, Critical, Appraisal, and Utilization. Mosby; 1998. pp. 206-7.
16. Muñiz J, Fonseca-Pedrero E. Diez pasos para la construcción de un test [Ten steps for test development]. Psicothema. 2019; 31(1):7-16.
17. Fleiss JL. Measuring nominal scale agreement among many raters. Psychol. Bull. 1971; 76(5):378-82.
18. Tristán López A. Modificación al modelo de Lawshe para el dictamen cuantitativo de la validez de contenido de un instrumento objetivo. Av. Medición. 2008; 6(1):37- 48. https://bit.ly/3xm9OJG
19. Gorsuch RL. Factor Analysis: Classic Edition 2nd ed. 2014. Routledge.
20. Ministerio de Salud y Protección Social Departamento Administrativo de Ciencia, Tecnología e Innovación – Colciencias. Guía de práctica clínica para el diagnóstico, tratamiento y seguimiento de la diabetes mellitus tipo 2 en la población mayor de 18 años Guía No. GPC-2015-51. ISBN: 978-958-8903-82-8 Bogotá, Colombia March 2016. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/gpc-completa-diabetes-mellitus-tipo2-poblacion-mayor-18-anos.pdf
21. Çapık C. Gecerlik ve guvenirlik calismalarinda dogrulayici faktor analizinin kullanimi [Use of confirmatory factor analysis in validity and reliability studies]. 2014; 17(3):196–205.
22. Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol. Methods Res. 1992; 21(2):230-58.
23. Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int. J. Med. Educ. 2011; 2:53-5.
24. República de Colombia. Ministerio de salud. Resolución 8430 de 1993. Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá: El Ministerio; 1993.
25. República de Colombia. Congreso de Colombia. Ley 911 de 2004. Por la cual se dictan disposiciones en materia de responsabilidad deontológica para el ejercicio de la Profesión de Enfermería en Colombia. Bogotá; 2004.
26. Self-Care Measures. Self-Care scoring algorithm. 2021. [Cited 10 Sept. 2021] Available from: https://self-care-measures.com/self-care-scoring-algorithm/
27. Barbaranelli C, Lee C, Vellone E, Riegel B. Dimensionality and reliability of the Self-care of Heart Failure Index scales: Further Evidence from confirmatory factor analysis. Res Nurs Health. 2014; 37(6): 524-37. doi:10.1002/nur.21623
28. Yuan C, Lai CW, Chan LW, Chow M, Law HK, Ying M. The effect of diabetes self-management education on body weight, glycemic control, and other metabolic markers in patients with type 2 diabetes mellitus. J. Diabetes Res. 2014; 2014:789761.
29. Adepoju OE, Bolin JN, Phillips CD, Zhao H, Ohsfeldt RL, McMaughan DK, et al. Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: a survival analysis model. Patient. Educ. Couns. 2014; 95(1):111–7.
30. Shreck E, Gonzalez JS, Cohen HW, Walker EA. Risk perception and self-management in urban, diverse adults with type 2 diabetes: the improving diabetes outcomes study. Int. J. Behav. Med. 2014; 21(1):88–98.
31. Kargar Jahromi M, Ramezanli S, Taheri L. Effectiveness of diabetes self-management education on quality of life in diabetic elderly females. Glob. J. Health Sci. 2015; 7(1):10–5
Downloads
Published
Versions
- 2022-07-14 (2)
- 2022-06-27 (1)
How to Cite
Issue
Section
License
Copyright (c) 2022 Investigación y Educación en Enfermería
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Derechos de propiedad / Direitos de Propriedade
English: If the article is accepted for publication, all copyright will be of exclusive property of Investigación y Educación en Enfermería. The text and the graphics included in the publication are exclusive responsibility of the authors and not necessarily reflect the thought of the Editorial Committee.
Español: Si el artículo es aprobado para publicación, todos los derechos son de propiedad de Investigación y Educación en Enfermería. El texto y las gráficas incluidas en la publicación son de exclusiva responsabilidad de los autores y no necesariamente refleja el pensamiento del Comité Editorial.
Português: Se o artigo for aceito para publicação, todos os direitos autorais serão de propriedade exclusiva de Investigación y Educación en Enfermería. O texto e os gráficos incluídos na publicação são de responsabilidade exclusiva dos autores e não refletem necessariamente o pensamento do Comitê Editorial.
