This study developed two instruments, the Self-Care in Chronic Obstructive Pulmonary Disease (COPD) Inventory (SC-COPDI) and the COPD-Self-Care Self-Efficacy Scale (SCES), and tested their psychometric properties on a convenience sample of 498 patients from Northern, Central, and Southern Italy. First, the domains and the items of the SC-SCOPDI were generated based on the middle-range theory of self-care of chronic illness, comprising the dimensions of self-care maintenance, self-care monitoring, and self-care management, and the SCES-COPD was developed accordingly. Second, we assessed the content validity of each scale. Third, we conducted a multicenter cross-sectional study to test their structural validity, convergent and discriminative validity, internal consistency, and test–retest reliability. The theoretical dimensions of the two instruments were confirmed through confirmatory factor analysis. Convergent validity was demonstrated by the correlation among the three self-care scales and the Self-Efficacy Scale, and discriminative validity by higher self-care scale scores in individuals with greater COPD severity and poorer health status. The global reliability index ranged from .78 to .92 for all scales. The intraclass correlation coefficients were higher than .70. Further studies are needed to confirm the psychometric properties of the two instruments in different COPD populations and countries to extend their use in clinical practice.
AdeloyeD.ChuaS.LeeC.BasquillC.PapanaA.TheodoratouE.,…Global Health Epidemiology Reference Group. (2015). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. Journal of Global Health, 5, 1–7. doi:10.7189/jogh.05-020415
2.
AlbertoJ. (1993). The reliability and validity of the COPDSC: A tool that measures self-care behaviour of persons with chronic obstructive pulmonary disease. Perspectives in Respiratory Nursing: A Publication of the Respiratory Nursing Society, 4, 3–4.
3.
AndersonJ. C.GerbingD. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411–423.
4.
AusiliD.BarbaranelliC.RossiE.ReboraP.FabriziD.CoghiC.…RiegelB. (2017). Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: The Self-Care of Diabetes Inventory. BMC Endocrine Disorders, 17, 66. doi:10.1186/s12902-017-0218-y
5.
AyreC.ScallyA. J. (2014). Critical values for Lawshe’s content validity ratio: Revisiting the original methods of calculation. Measurement and Evaluation in Counseling and Development, 47, 79–86. doi:10.1177%2F0748175613513808
6.
BagozziR. P.YiY. (2012). Specification, evaluation, and interpretation of structural equation models. Journal of the Academy of Marketing Science, 40, 8–34.
7.
BarbaranelliC.LeeC. S.VelloneE.RiegelB. (2014). Dimensionality and reliability of the self-care of heart failure index scales: Further evidence from confirmatory factor analysis. Research in Nursing and Health, 37, 524–537. doi:10.1002/nur.21623
8.
BarbaranelliC.LeeC. S.VelloneE.RiegelB. (2015). The problem with Cronbach’s alpha: Comment on Sijtsma and van der Ark (2015). Nursing Research, 64, 140–145. doi:10.1097/NNR.0000000000000079
9.
BourbeauJ.NaultD.Dang-TanT. (2004). Self-management and behaviour modification in COPD. Patient Education and Counseling, 52, 271–277.
10.
BrowneM. W.CudekR. (1992). Alternative ways of assessing model fit. Social Methods Research, 21, 230–258. doi:10.1177/0049124192021002005
11.
ByrneB. M. (2006). Structural equation modeling with EQS: Basic concepts, applications, and programming (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates.
12.
CarusoR.ReboraP.DellafioreF.FabriziD.RiegelB.AusiliD.Di MauroS. (2018). Clinical and socio-demographic determinants of inadequate self-care in adults with type 1 diabetes mellitus: The leading role of self-care confidence. Acta Diabetologica. doi:10.1007/s00592-018-1259-z
13.
ClariM.MatareseM.AlvaroR.PireddaM.De MarinisM. G. (2016). Measurement properties of instruments evaluating self-care and related concepts in people with chronic obstructive pulmonary disease: A systematic review. Heart & Lung, 45, 441–448. doi:10.1016/j.hrtlng.2016.06.006
14.
ClariM.MatareseM.IvzikuD.De MarinisM. G. (2017). Self-care of people with chronic obstructive pulmonary disease: A meta-synthesis. Patient, 10, 407–427. doi:10.1007/s40271-017-0218-z
15.
CohenJ. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
16.
ComreyA. L.LeeH. B. (1992). A first course in factor analysis. Hillsdale, NJ: Erlbaum.
17.
CrockerL.AlginaJ. (1986). Introduction to classical and modern test theory. Orlando, FL: Holt, Rinehart and Winston.
18.
DavisA. H. T.FigueredoA. J.FahyB. F.RawiworrakulT. (2007). Reliability and validity of the Exercise Self-regulatory Efficacy Scale for individuals with chronic obstructive pulmonary disease. Heart & Lung, 36, 205–216. doi:10.1016/j.hrtlng.2006.08.007
19.
De VetH. C.TerweeC. B.MokkinkL. B.KnolD. L. (2011). Measurement in medicine: A practical guide. Cambridge, England: Cambridge University Press.
20.
DicksonV. V.BuckH.RiegelB. (2011). A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions. Journal of Cardiac Failure, 17, 413–419. doi:10.1016/j.cardfail.2010.11.011
21.
FornellC.LarckerD. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18, 39–50. doi:10.2307/3151312
22.
GiacominiM.DeJeanD.SimeonovD.SmithA. (2012). Experiences of living and dying with COPD: A systematic review and synthesis of the qualitative empirical literature. Ontario Health Technology Assessment Series, 12, 1.
23.
Global Initiative for Chronic Obstructive Lung Disease. (2018). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Retrieved fromhttp://www.goldcopd.org
24.
HoyleR. H.PanterA. T. (1995). Writing about structural equation models. Structural equation modeling: Concepts, issues, and applications. Thousand Oaks, CA: Sage.
25.
HuL. T.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55. doi:10.1080/10705519909540118
26.
JollyK.MajothiS.SitchA.JHeneghanN. R.RileyR. D.MooreD. J…JordanR. E. (2016). Self-management of health care behaviors for COPD: A systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 11, 305–326. doi:10.2147/COPD.S90812
27.
JonesP. W.HardingG.BerryP.WiklundI.ChenW. H.Kline LeidyN. (2009). Development and first validation of the COPD Assessment Test. European Respiratory Journal, 34, 648–654. doi:10.1183/09031936.00102509
28.
JonesP. W.TabbererM.ChenW. H. (2011). Creating scenarios of the impact of COPD and their relationship to COPD assessment test (CAT™) scores. BMC Pulmonary Medicine, 11, 42. doi:10.1186/1471-2466-11-42
29.
KaşıkçıM. K.AlbertoJ. (2007). Family support, perceived self-efficacy and self-care behaviour of Turkish patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 16, 1468–1478. doi:10.1111/j.1365-2702.2006.01782.x
30.
KlineP. (1986). A handbook of test construction. New York, NY: Methuen.
31.
LandisJ. R.KochG. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.
32.
LawsheC. H. (1975). A quantitative approach to content validity 1. Personnel Psychology, 28, 563–575. doi:10.1111/j.1744-6570.1975.tb01393.x
33.
LenferinkA.Brusse-KeizerM.van der ValkP. D.FrithP. A.ZwerinkM.MonninkhofE. M.…EffingT. W. (2017). Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD011682.pub2
34.
MahlerD. A.WellsC. K. (1988). Evaluation of clinical methods for rating dyspnea. Chest, 93, 580–586. doi:10.1378/chest.93.3.580
35.
McDonaldR. P. (1999). Test theory. A unified treatment. Mahwah, NJ: Lawrence Erlbaum Associates.
36.
MeadeA. W.JohnsonE. C.BraddyP. W. (2008). Power and sensitivity of alternative fit indices in tests of measurement invariance. Journal of Applied Psychology, 93, 568. doi:10.1037/0021-9010.93.3.568
37.
MorinA. J.ArensA. K.MarshH. W. (2016). A bifactor exploratory structural equation modeling framework for the identification of distinct sources of construct-relevant psychometric multidimensionality. Structural Equation Modeling: A Multidisciplinary Journal, 23, 116–139. doi:10.1080/10705511.2014.961800
38.
MurphyL. A.HarringtonP.TaylorS. J.TeljeurC.SmithS. M.PinnockH.RyanM. (2017). Clinical-effectiveness of self-management interventions in chronic obstructive pulmonary disease: An overview of reviews. Chronic Respiratory Disease, 14, 276–288. doi:10.1177%2F1479972316687208
39.
MuthénL. K.MuthénB. O. (1998–2017). Mplus user’s guide (8th ed.). Los Angeles, CA: Author.
40.
NunnallyJ.BernsteinI. H. (1994). Psychometric theory. New York, NY: McGraw Hill.
41.
PinnockH.SteedL.JordanR. (2016). Supported self-management for COPD: Making progress, but there are still challenges. European Respiratory Journal, 48, 6–9. doi:10.1183/13993003.00576-2016
42.
RaykovT. (2013). Scale construction and development using structural equation modeling. New York, NY: Guilford Press.
43.
RiegelB.BarbaranelliC.SetharesK. A.DausM.MoserD. K.MillerJ. L.…JaarsmaT. (2018). Development and initial testing of the self-care of chronic illness inventory. Journal of Advanced Nursing, 74, 2465–2476. doi:10.1111/jan.13775
44.
RiegelB.JaarsmaT.LeeC. S.StrömbergA. (2018). Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science, 19. doi:10.1097/ANS.0000000000000237
45.
RiegelB.JaarsmaT.StrömbergA. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35, 194–204.
46.
StoilkovaA.JanssenD. J.WoutersE. F. (2013). Educational programmes in COPD management interventions: A systematic review. Respiratory Medicine, 107, 1637–1650. doi:10.1016/j.rmed.2013.08.006
47.
TabachnickB. G.FidellL. S. (2007). Using multivariate statistics. Boston, MA: Pearson Education.
48.
TerweeC. B.PrinsenC. A.ChiarottoA.de VetH. C.BouterL.M.AlonsoJ.…MokkinkL. B. (2018). COSMIN methodology for assessing the content validity of PROMs—User manual. Retrieved fromhttp://www.cosmin.nl
49.
VandenbergR. J.LanceC. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–70. doi:10.1177/109442810031002
50.
VelloneE.D’AgostinoF.BuckH.G.FidaR.SpatolaC. F.PetruzzoA.…RiegelB. (2015). The key role of caregiver confidence in the caregiver’s contribution to self-care in adults with heart failure. European Journal of Cardiovascular Nursing, 14, 372–381. doi:10.1177/1474515114547649
51.
VelloneE.PancaniL.GrecoA.StecaP.RiegelB. (2016). Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model. International Journal of Nursing Studies, 60, 191–199. doi:10.1016/j.ijnurstu.2016.04.016
52.
VellosoM.JardimJ. R. (2006). Functionality of patients with chronic obstructive pulmonary disease: Energy conservation techniques. Jornal Brasileiro de Pneumologia, 32, 580–586.
53.
WickmanU. L.Yngman-UhlinP.HjortswangH.WenemarkM.StjernmanH.RiegelB.FrismanG. H. (2019). Development of a self-care questionnaire for clinical assessment of self-care in patients with inflammatory bowel disease: A psychometric evaluation. International Journal of Nursing Studies, 89, 1–7. doi:10.1016/j.ijnurstu.2018.08.016
XiaolianJ.ChaiwanS.PanuthaiS.YijuanC.LeiY.JipingL. (2002). Family support and self-care behavior of Chinese chronic obstructive pulmonary disease patients. Nursing & Health Sciences, 4, 41–49.
57.
YohannesA. M.AlexopoulosG. S. (2014). Depression and anxiety in patients with COPD. European Respiratory Review, 23, 345–349. doi:10.1183/09059180.00007813
58.
ZhangC.WangW.LiJ.CaiX.ZhangH.WangH.WangX. (2013). Development and validation of a COPD self-management scale. Respiratory Care, 58, 1931–1936. doi:10.4187/respcare.02269
59.
ZwerinkM.Brusse-KeizerM.van der ValkP. D.ZielhuisG. A.MonninkhofE. M.van der PalenJ…EffingT. (2014). Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Systematic Review, 19. doi:10.1002/14651858.CD002990.pub3
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