Development of Diabetes Self Care Assessment Tool (D-SCAT): Conceptualization and Assessment of Self-Care in a Real Life Setting
Background: Self-care is a critical component in the management of type-2 diabetes to prevent poor glycemic control and diabetes-related complications. In order to achieve an ideal state of characteristics of diabetic’s patients that is; reflective, knowledgeable and sufficient in self-care, a person must be motivated, and anticipating in their daily choices. Supporting the patients to reflect in a structured and targeted education may increase patient’s performance in self-care. It can be promoted through situation based discussion and regular assessment. However, there has been a lack of conceptual clarity regarding self-care in a psychosocial environment of population in this study, thus lack of adequate measurement to help them reflect and make a rationale decision for their daily self-care. Objectives: This study describe a process for conceptualizing and operationalizing the meaning of self-care in the existing environment and define the process used to develop a measure for assessing self-care and the psychometric properties of that measure. Methods: The Diabetes Self-Care Assessment Tool (D-SCAT) was developed for State Registered Nurse (SRN) to facilitate patient reflection on daily decisions of self-care behavior in the existing psychosocial settings. Such instrument helps patients to reflect on his/her personal daily choice and preference of self-care for future improvement. This study used convergence of findings from the views of multidisciplinary clinical experts and patient focus groups to define the concept and identify the domains of self-care to be included in the assessment instrument. These domains were operationalized by constructing a large item pool for each identified self-care domain. The developed items were pilot tested and initial psychometric analysis was performed using the factor analysis methods. A pilot study was used for feedback on item content and suggestions for refinement with a sample of 11 multidisciplinary healthcare professionals and 30 registered nurses from three continuous professional educational (CPD) programs. A total of 77 SRN completed a refined D-SCAT measure using face-to-face survey method. Internal consistency estimate was measured using Cronbach’s alpha (0.86).