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Development and validation of a self-management scale of type 1 diabetes for Chinese adults.

ABSTRACT: OBJECTIVE:Self-management is beneficial for improving health outcomes in adults with type 1 diabetes. However, there are no validated instruments to assess self-management in Chinese adults with type 1 diabetes. The aim of this study was to develop and validate the Self-Management of Type 1 Diabetes for Chinese Adults (SMOD-CA) scale. METHODS:Qualitative and quantitative methods were used to develop the SMOD-CA.We conducted a literature review and semi-structured interviews to generate an initial item pool. An expert panel examined the content validity. We conducted a cross-sectional survey to evaluate scale reliability and validity. A total of 243 participants were recruited. Exploratory factor analyses were used to test the construct validity, and internal consistency and test-retest reliability were assessed. RESULTS:The expert panel determined that the SMOD-CA content validity index was satisfactory. The final 30-item scale consisted of four factors explaining 49.50% of the total variance in the data. Cronbach's ? was 0.901 for the total scale and 0.911 for test-retest reliability. CONCLUSIONS:The SMOD-CA demonstrated good reliability and validity. The scale is a credible and effective instrument that can be used by social workers and health care professionals to assess self-management in Chinese adults with type 1 diabetes.Trial registration number NCT03610984.

SUBMITTER: Zhu S

PROVIDER: S-EPMC7469726 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Development and validation of a self-management scale of type 1 diabetes for Chinese adults.

Zhu Song S Liu Fang F Li Jina J Guan Yuzhu Y Meng Meng M Li Xia X Zhou Zhiguang Z Xu Rong R Li Lezhi L

The Journal of international medical research 20200801 8

<h4>Objective</h4>Self-management is beneficial for improving health outcomes in adults with type 1 diabetes. However, there are no validated instruments to assess self-management in Chinese adults with type 1 diabetes. The aim of this study was to develop and validate the Self-Management of Type 1 Diabetes for Chinese Adults (SMOD-CA) scale.<h4>Methods</h4>Qualitative and quantitative methods were used to develop the SMOD-CA.We conducted a literature review and semi-structured interviews to gen ...[more]

PMID: 32865059

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Project description:Being highly self-efficacious is a key factor in successful chronic disease self-management. In the context of measuring self-efficacy in type 2 diabetes management, the Diabetes Management Self-Efficacy Scale (DMSES) is the most widely used scale. The aim of this study was to adapt the English version of the scale to Italian and to evaluate the psychometric properties of the Italian version of DMSES in type 2 diabetes (IT-DMSES).We conducted a cross-sectional study of people with type 2 diabetes attending the Endocrine-Metabolic Disease Care Unit of the Internal Medicine Department of San Marino State Hospital between October 2016 and February 2017. Patients completed a socio-demographic and clinical data form, the IT-DMSES and 3 self-report questionnaires measuring diabetes distress (PAID-5), psychological well-being (WHO-5) and depression (PHQ-9). Psychometric testing included construct validity (principal component analysis), internal consistency (Cronbach's ? coefficient) and convergent/discriminant validity (Spearman's correlation coefficient). Decision tree analysis was performed to classify patients into homogeneous subgroups of self-efficacy based on their demographic and clinical characteristics.Participants were 110 males and 55 females, mean age of 65.2 years (SD?±?9), 56.9% had been diagnosed for 1-15 years, 63% had HbA1c level?>?53 mmol/mol. Two main factors underlain the construct of self-efficacy in diabetes management: 'Disease Management' and "Lifestyles Management". Disease Management had a good reliability (??=?.849) and Lifestyle Management had an excellent reliability (??=?.902) indicating that the instrument is internally consistent. A negative and weak correlation was found between Lifestyle management, PAID-5 (r?=?-?0.258, p?=?<?0.01) and PHQ-9 (r?=?-?0.274, p?=?<?0.01) and a positive one with WHO-5 (r?=?0.325, p?<?0.01) supporting convergent validity. Disease management was uncorrelated with PAID-5 (r?=?-?0.142, p?=?0.083), PHQ-9 (r?=?-?0.145, p?=?0.076) and weekly correlated with WHO-5 (r?=?0.170, p?=?0.037) confirming discriminant validity. Higher levels of self-efficacy in lifestyle management were found in patients diagnosed for at least 1 year up to 15 years and aged >?65 years and the poorest self-efficacy was found in males <?65 years.Results support the validity and reliability of IT-DMSES. The scale can be used in research and clinical practice to monitor type 2 diabetes self-management over time.

Project description:BackgroundAlthough supported self-management is a well-recognised part of chronic disease management, it has not been routinely used as part of healthcare for adults with a learning disability. We developed an intervention for adults with a mild or moderate learning disability and type 2 diabetes, building on the principles of supported self-management with reasonable adjustments made for the target population.MethodsIn five steps, we:Clarified the principles of supported self-management as reported in the published literatureIdentified the barriers to effective self-management of type 2 diabetes in adults with a learning disabilityReviewed existing materials that aim to support self-management of diabetes for people with a learning disabilitySynthesised the outputs from the first three phases and identified elements of supported self-management that were (a) most relevant to the needs of our target population and (b) most likely to be acceptable and useful to themImplemented and field tested the intervention.ResultsThe final intervention had four standardised components: (1) establishing the participant's daily routines and lifestyle, (2) identifying supporters and their roles, (3) using this information to inform setting realistic goals and providing materials to the patient and supporter to help them be achieved and (4) monitoring progress against goals.Of 41 people randomised in a feasibility RCT, thirty five (85%) completed the intervention sessions, with over three quarters of all participants (78%) attending at least three sessions.Twenty-three out of 40 (58%) participants were deemed to be very engaged with the sessions and 12/40 (30%) with the materials; 30 (73%) participants had another person present with them during at least one of their sessions; 15/41 (37%) were reported to have a very engaged main supporter, and 18/41 (44%) had a different person who was not their main supporter but who was engaged in the intervention implementation.ConclusionsThe intervention was feasible to deliver and, as judged by participation and engagement, acceptable to participants and those who supported them.Trial registrationCurrent Controlled Trials ISRCTN41897033 (registered 21/01/2013).

Project description:BackgroundSelf-regulation refers to a person's ability to manage their cognitive, emotional, and behavioral processes to achieve long-term goals. Most prior research has examined self-regulation at the individual level; however, individual-level assessments do not allow the examination of dynamic patterns of intraindividual variability in self-regulation and thus cannot aid in understanding potential malleable processes of self-regulation that may occur in response to the daily environment.ObjectiveThis study aims to develop a brief, psychometrically sound momentary self-regulation scale that can be practically administered through participants' mobile devices at a momentary level.MethodsThis study was conducted in 2 phases. In the first phase, in a sample of 522 adults collected as part of a larger self-regulation project, we examined 23 previously validated assessments of self-regulation containing 594 items in total to evaluate the underlying structure of self-regulation via exploratory and confirmatory factor analyses. We then selected 20 trait-level items to be carried forward to the second phase. In the second phase, we converted each item into a momentary question and piloted the momentary items in a sample of 53 adults over 14 days. Using the results from the momentary pilot study, we explored the psychometric properties of the items and assessed their underlying structure. We then proposed a set of subscale and total score calculations.ResultsIn the first phase, the selected individual-level items appeared to measure 4 factors of self-regulation. The factors identified were perseverance, sensation seeking, emotion regulation, and mindfulness. In the second phase of the ecological momentary assessment pilot, the selected items demonstrated strong construct validity as well as predictive validity for health risk behaviors.ConclusionsOur findings provide preliminary evidence for a 12-item momentary self-regulation scale comprising 4 subscales designed to capture self-regulatory dynamics at the momentary level.

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Development and validation of a self-management scale of type 1 diabetes for Chinese adults.

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Development and validation of a self-management scale of type 1 diabetes for Chinese adults.

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