Sousa Valmi D, Hartman Susan W, Miller Edith H, Carroll Michael A
The University of Kansas, School of Nursing, Rainbow Boulevard, Kansas City, KS 66160, USA.
J Clin Nurs. 2009 May;18(9):1305-12. doi: 10.1111/j.1365-2702.2008.02729.x.
To develop and refine three new scales that measure diabetes self-care agency, diabetes self-efficacy and diabetes self-management to reflect the American Diabetes Association current standards of diabetes care and the American Association of Diabetes Educators self-care behaviours. And, to establish the clarity, consistency and content validity of the scales.
There is a need to have valid and reliable instruments or scales to assess an individual's diabetes self-care agency, self-efficacy and self-management to plan appropriate interventions that can be effective in improving glycaemic control and delaying or preventing diabetes-related complications.
A methodological design was used to conduct this study.
Ten clinicians and 10 insulin-treated individuals with type 2 diabetes (T2DM) from a diabetes care center in the southern USA participated in this study. Analysis consisted of inter-rater agreement to determine clarity and consistency with standards of diabetes care and content validity of individual items on the scales (I-CVI) and the overall scales (S-CVI/Ave) to determine relevance for current diabetes care practice.
All I-CVI and S-CVI/Ave of the DSES exceeded the minimum acceptable criteria. All I-CVI and the S-CVI of the DSMS also exceeded the minimum accepted criteria, except for one item that had I-CVI = 0.70. Evaluation of the items and the directions of the scales by the sample of insulin-treated individuals with T2DM exceeded the minimum criteria of 80% inter-rater agreement. RELEVANCE TO RESEARCH AND CLINICAL PRACTICE: Further psychometric testing of the scales with samples of insulin-treated individuals with diabetes is warranted and will lay the groundwork for further research and clinical practice to enhance the capability, confidence and actual performance of diabetes self-management activities among insulin-treated individuals with T2DM.
The scales can be used by diabetes care providers to assess and follow-up individuals with diabetes who need intense case management. They also can be the measures of choice to conduct future research to test the effects of interventions among insulin-treated individuals with T2DM.
开发并完善三个新量表,用于测量糖尿病自我管理能力、糖尿病自我效能感和糖尿病自我管理情况,以反映美国糖尿病协会当前的糖尿病护理标准以及美国糖尿病教育者协会的自我护理行为。此外,还要确立这些量表的清晰度、一致性和内容效度。
需要有有效且可靠的工具或量表来评估个体的糖尿病自我管理能力、自我效能感和自我管理情况,以便规划适当的干预措施,从而有效改善血糖控制,延缓或预防糖尿病相关并发症。
采用方法学设计开展本研究。
来自美国南部一家糖尿病护理中心的10名临床医生和10名接受胰岛素治疗的2型糖尿病(T2DM)患者参与了本研究。分析包括评定者间一致性,以确定与糖尿病护理标准的清晰度和一致性,以及量表单个条目(I-CVI)和整个量表(S-CVI/Ave)的内容效度,以确定与当前糖尿病护理实践的相关性。
糖尿病自我管理能力量表(DSES)的所有I-CVI和S-CVI/Ave均超过了可接受的最低标准。糖尿病自我管理量表(DSMS)的所有I-CVI和S-CVI也超过了可接受的最低标准,但有一个条目的I-CVI为0.70除外。接受胰岛素治疗的T2DM患者样本对量表条目和指导说明的评估超过了评定者间一致性80%的最低标准。与研究和临床实践的相关性:有必要对这些量表在接受胰岛素治疗的糖尿病患者样本中进行进一步的心理测量测试,这将为进一步研究和临床实践奠定基础,以提高接受胰岛素治疗的T2DM患者糖尿病自我管理活动的能力、信心和实际表现。
糖尿病护理提供者可以使用这些量表来评估和随访需要强化病例管理的糖尿病患者。它们也可以成为未来研究的首选测量工具,以测试干预措施对接受胰岛素治疗的T2DM患者的效果。