Measuring Diabetes Self-Care

Measuring Diabetes Self-Care A psychometric analysis of the Self-Care Inventory-revised with adults Katie Weinger , EDD, RN 1 2 , Heather A. Butler , PHD, RN 1 , Garry W. Welch , PHD 3 and Annette M. La Greca , PHD 4 1 Behavioral and Mental Health Research, Joslin Diabetes Center, Boston, Massachusetts 2 Harvard Medical School, Boston, Massachusetts 3 Behavioral Medicine Research, Bay State Medical Center, Springfield, Massachusetts 4 Department of Psychology, University of Miami, Coral Gables, Florida Address correspondence and reprint requests to Katie Weinger, EdD, RN, Section on Behavior and Mental Health Research, Joslin Diabetes Center, 1 Joslin Place, Boston, MA 02115. E-mail: katie.weinger{at}joslin.harvard.edu Abstract OBJECTIVE —To examine psychometric properties of the Self-Care Inventory-revised (SCI-R), a self-report measure of perceived adherence to diabetes self-care recommendations, among adults with diabetes. RESEARCH DESIGN AND METHODS —We used three data sets of adult type 1 and type 2 diabetic patients to examine psychometric properties of the SCI-R. Principal component and factor analyses examined whether a general factor or common factors were present. Associations with measures of theoretically related concepts were examined to assess SCI-R concurrent and convergent validity. Internal reliability coefficients were calculated. Responsiveness was assessed using paired t tests, effect size, and Guyatt’s statistic for type 1 patients who completed psychoeducation. RESULTS —Principal component and factor analyses identified a general factor but no consistent common factors. Internal consistency of the SCI-R was α = 0.87. Correlation with a measure of frequency of diabetes self-care behaviors was r = 0.63, providing evidence for SCI-R concurrent validity. The SCI-R correlated with diabetes-related distress ( r = −0.36), self-esteem ( r = 0.25), self-efficacy ( r = 0.47), depression ( r = −0.22), anxiety ( r = −0.24), and HbA 1c ( r = −0.37), supporting construct validity. Responsiveness analyses showed SCI-R scores improved with diabetes psychoeducation with a medium effect size of 0.62 and a Guyatt’s statistic of 0.85. CONCLUSIONS —The SCI-R is a brief, psychometrically sound measure of perceptions of adherence to recommended diabetes self-care behaviors of adults with type 1 or type 2 diabetes. CIDS, Confidence in Diabetes Scale PAID, Problem Areas In Diabetes scale RSE, Rosenberg Self-Esteem SCI, Self-Care Inventory SCI-R, SCI-revised S