Academic journal article Journal of Nursing Measurement

Reliability and Validity of a Shortened Version of an Instrument for Diabetes Self-Care Agency

Academic journal article Journal of Nursing Measurement

Reliability and Validity of a Shortened Version of an Instrument for Diabetes Self-Care Agency

Article excerpt

Purpose: The purpose of this study was to develop a shortened version of the Instrument of Diabetes Self-Care Agency (IDSCA). Methods: In the development of the shortened version of IDSCA, intraclass correlation coefficient 2 (ICC2) analysis was done to determine items to be deleted. However, the 7 subscales were retained. The shortened IDSCA was evaluated for internal consistency, reproducibility, concurrent validity, criterion-related validity, and goodness of fit. Results: The shortened IDSCA included 35 items addressing 7 subscales. High ICC2 (.804) and a high Cronbach's alpha (.89) indicate internal consistency and reproducibility. A high correlation (.62) between the shortened version of the IDSCA and the Self-Care Agency Questionnaire indicated concurrent validity. Conclusion: The shortened IDSCA provides a reliable and valid measure of self-care agency of individuals with diabetes.

Keywords: assessment tool; self-care agency; diabetes nursing; reliability; validity

Self-care is an important issue in chronic illnesses such as diabetes. Orem (2001) provided one of the most comprehensive and well-known definitions of self-care, describing it as "the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being" (p. 43). People with diabetes must perform self-care behaviors in multiple domains, including diet therapy, physical activity, medications, glucose monitoring, and symptom management, to maintain their health status and prevent complications (The Diabetes Control and Complications Trial Research Group, 1993; UK Prospective Diabetes Study Group, 1998). People with diabetes must gain the knowledge and skills for practicing self-care and incorporate self-care activities into their daily lives. Orem also described self-care agency, an indicator of the ability to engage in self-care, defining it as "the complex acquired ability to meet one's continuing requirements for care that regulates life processes, maintains or promotes integrity of human structure and functioning and human development, and promotes well-being" (p. 254). People with diabetes must manage their condition while maintaining and enhancing their self-care agency. Diabetes nursing is required to evaluate the self-care agency of people with diabetes and to support them in maintaining and enhancing their self-care agency. Thus, this study focuses on self-care agency, which leads to behavioral changes in patients, and advances the project on developing an assessment tool for self-care ability.


One of the central roles of diabetes nursing is to provide the educational support in terms of self-care for people with diabetes. Diabetes nursing does not lead to an immediate improvement in symptoms and clinical inspection data, so it is difficult to clearly evaluate diabetes nursing itself. This causes exhaustion in nurses.

Furthermore, interventions for people with diabetes require cooperation among health care professionals (such as doctors, nutritionists, physical therapists, and pharmacists). At this point, it is important to highlight the effect of diabetes nursing by deepening understandings of other health care professionals about nurses' role, so that they can effectively cooperate with others as the effective team approach. Thus, to show the effects of diabetes nursing clearly is an important issue.

In this study, we focus on the self-care agency of people with diabetes. When their action is improved, their resulting self-care agency is also improved. Thus, to evaluate the effectiveness of diabetes nursing that supports their initiative, it is necessary to pay attention to changes in their behavior as well as their self-care agency. Previous study evaluated self-care agency of people with diabetes (Dolovich et al., 2004). However, it did not pay attention to multidirectional perspectives, and the other previous studies focused on people with chronic diseases (including diabetes) and on people in general (Honjo, 2001; Riesch & Hauck, 1988; Sousa et al. …

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