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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2017

Open Access 01-01-2017 | Research

The LMC Skills, Confidence & Preparedness Index (SCPI): development and evaluation of a novel tool for assessing self-management in patients with diabetes

Authors: Lawrence Mbuagbaw, Ronnie Aronson, Ashleigh Walker, Ruth E. Brown, Naomi Orzech

Published in: Health and Quality of Life Outcomes | Issue 1/2017

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Abstract

Background

Optimal diabetes care requires a specific set of self-management behaviours. The purpose of this study was to present the development and initial psychometric evaluation of a new tool to measure three key aspects of a patient’s diabetes self-management: knowledge of the skill, confidence in being able to perform the skill and preparedness to implement the skill.

Methods

A sequential exploratory mixed-methods design was used. A panel of educators, researchers and clinicians established a scale with items that would adequately capture skills, confidence and preparedness in seven core health behaviours central to diabetes care. The psychometric properties of the items were pilot tested on 120 participants with diabetes from a tertiary referral centre, and repeated 6 months later on 70 participants. Item selection was informed by factor analysis, item-total statistics and the need for brevity.

Results

Twenty five items from a pool of 36 were retained, with an excellent overall intraclass correlation (ICC) of 0.94 (95% CI 0.92–0.99; p < 0.001). Internal consistency for the subscales (skills-9 items, confidence - 8 items, preparedness – 8 items) was very good (intraclass correlation between 0.83 and 0.88), and retest reliability after 6 months was also good (r = 0.48; p < 0.01). The scale was positively correlated to established scales that assess skill (Michigan Diabetes Knowledge Test) (r = 0.21;p = 0.01), and assess skill and confidence (Diabetes Empowerment Scale) (r = 0.28;p < 0.01).

Conclusions

The Skills, Confidence & Preparedness Index is a brief and easy to administer new scale that is more comprehensive than existing tools. It should be used to assess self-management in patients with diabetes, optimize the resources applied to each patient, and determine educational needs and direct clinical management. The scale should be further evaluated in a broader population of patients with diabetes.
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Literature
1.
World Health Organization. Global status report on noncommunicable diseases 2014. World Health Organization; 2014.
2.
Haas L, Maryniuk M, Beck J, Cox CE, Duker P, Edwards L, et al. National standards for diabetes self-management education and support. Diabetes Care. 2014;37:S144–53.CrossRefPubMed
3.
Anderson R, Funnell M, Fitzgerald J, Marrero D. The Diabetes Empowerment Scale: a measure of psychosocial self-efficacy. Diabetes Care. 2000;23:739–43.CrossRefPubMed
4.
Bott U, Muhlhauser I, Overmann H, Berger M. Validation of a diabetes-specific quality-of-life scale for patients with type 1 diabetes. Diabetes Care. 1998;21:757–69.CrossRefPubMed
5.
Boyer JG, Earp JAL. The development of an instrument for assessing the quality of life of people with diabetes. Med Care. 1997;35:440–53.CrossRefPubMed
6.
Bradley C. The Diabetes Treatment Satisfaction Questionnaire: DTSQ. In: Bradley CE, editor. Handb. Psychol. Diabetes a Guid. to Psychol. Meas. diabetes Res. Pract. Chur. Switzerland: Harwood Academic; 1994. p. 111–32.
7.
Bradley C, Todd C, Gorton T, Symonds E, Martin A, Plowright A. The development of an individualized questionnaire measure of perceived impact of diabetes on quality of life: the ADDQoL. Qual Life Res. 1999;8:79–91.CrossRefPubMed
8.
Carey M, Jorgensen R, Weinstock R, Sprafkin R, Lantinga L, Carnrike C, et al. Reliability and validity of the apprasial of diabetes scale. J Behav Med. 1991;14:43–51.CrossRefPubMed
9.
Fitzgerald J, Funnell M, Heiss G, Barr P, Anderson R, Hiss R, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21:706–10.CrossRefPubMed
10.
Fitzgerald J, Davis W, Connell C, Hess G, Funnell M, Hiss R. Development and validation of the Diabetes Care Profile. Eval Health Prof. 1996;19:208–30.CrossRefPubMed
11.
Garcia A, Villagomez E, Brown S, Kouzekanani K, Hanis C. The Starr County Diabetes Education Study: development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care. 2001;24:16–21.CrossRefPubMed
12.
Grinslade S, Paper B, Jing H, Quinn L. Development and psychometric evaluation of the Diabetes Self-Efficacy Scale. J Nurs Meas. 2015;23:40–57.CrossRefPubMed
13.
The DCCT Research Group. Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). The DCCT Research Group. Diabetes Care. 1988;11:725–32.CrossRef
14.
Hammond G, Aoki T. Measurement of health status in diabetes patients. Diabetes impact measurement scales. Diabetes Care. 1992;15:469–77.CrossRefPubMed
15.
Herschbach P, Duran G, Waadt S, Zettler A, Amm C, Marten-Mittag B. Psychometric properties of the Questionnaire on Stress in Patients with Diabetes-Revised (QSD-R). Heal Psychol. 1997;16:171–4.CrossRef
16.
Mannucci E, Ricca V, Bardini G, Rotella C. Well-being enquiry for diabetics: a new measure of diabetes-related quality of life. Diab Nutr Metab. 1996;9:89–102.
17.
Meadows K, Steen N, Mccall E, Eccles M, Shiels C, Hewison J, et al. The Diabetes Health Profile (DHP): A new instrument for assessing the psychosocial profile of insulin requiring patients-development and psychometric evaluation. Qual Life Res. 1996;5:242–54.CrossRefPubMed
18.
Polonsky W, Anderson B, Lohrer P, Welch G, Jacobson A, Aponte J, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18:754–60.CrossRefPubMed
19.
Schmitt A, Gahr A, Hermanns N, Kulzer B, Huber J, Haak T. The Diabetes Self-Management Questionnaire (DSMQ): development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health Qual Life Outcomes. 2013;11:138.CrossRefPubMedPubMedCentral
20.
Shen W, Kotsanos JG, Huster WJ, Mathias SD, Andrejasich C, Patrick D. Development and validation of the Diabetes Quality of Life Clinical Trial Questionnaire. Med Care. 1999;37:AS45–66.CrossRefPubMed
21.
Toobert D, Hampson S, Glasgow R. The Summary of Diabetes Self-Care Activities Measure: resuls from 7 studies and a revised scale. Diabetes Care. 2000;23:943–50.CrossRefPubMed
22.
van der Ven N, Weinger K, Yi J, Pouwer F, Ader H, van der Ploeg H, et al. The Confidence in Diabetes Self-Care: psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and U.S. patient swith type 1 diabetes. Diabetes Care. 2003;26:713–8.CrossRefPubMedCentral
23.
Aronson R, Orzech N, Ye C, Brown RE, Goldenberg R, Brown V. Specialist-led diabetes registries and prevalence of poor glycemic control in type 2 diabetes: The Diabetes Registry Outcomes Project for A1C reduction (DROP A1C). Diabetes Care. 2016;39:1711–7.CrossRefPubMed
24.
Creswell J, Plano CV. Designing and conducting mixed methods research. 2nd ed. Thousand Oaks: Sage; 2011.
25.
Aronson R, Orzech N, Ye C, Goldenberg R, Brown V. Specialist-led diabetes registries and predictors of poor glycemic control in type 2 diabetes : Insights into the functionally refractory patient from the LMC Diabetes Registry database. J Diabetes. 2016;8:76–85.CrossRefPubMed
26.
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2013;37:S1–S212.
27.
28.
Bandura A. Self-efficacy : toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.CrossRefPubMed
29.
Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diab Complicat. 2012;26:10–6.CrossRef
30.
Prochaska J, Velicer W. The Transtheoretical Model of Health Behavior Change. Am J Health Promot. 1997;12:38–48.CrossRefPubMed
31.
Crocker L, Algina J. Classical and modern test theory. New York: Holt, Rinehart & Winston; 1986.
32.
Streiner D. Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry. 1994;39:135–40.PubMed
33.
Streiner D, Norman G. Health Measurement Scales: a practical guide to their development and use. OUP Oxford; 2008.
34.
Kline P. A handbook of test construction: introduction to psychometric design. London: Methuen & Co. Ltd; 1986.
35.
Flesch R. A new readability yardstick. J App Psych. 1948;32:221-33.
36.
Eigenmann CA, Colagiuri R, Skinner TC, Trevena L. Are current psychometric tools suitable for measuring outcomes of diabetes education? Diab Med. 2009;26:425–36.CrossRef
37.
Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004;39:1005–26.CrossRefPubMedPubMedCentral
38.
Hibbard JH, Mahoney ER, Stockard J, Tusler M. Development and testing of a short form of the Patient Activation Measure. Health Res Educ Trust. 2005;40:1918–30.
39.
Nunnally J, Bernstein I. Psychometric Theory. 3rd ed. New York: McGraw-Hill; 1994.
40.
Terwee CB, Bot SDM, de Boer MR, Van Der Windt AWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42.CrossRefPubMed
Metadata
Title
The LMC Skills, Confidence & Preparedness Index (SCPI): development and evaluation of a novel tool for assessing self-management in patients with diabetes
Authors
Lawrence Mbuagbaw
Ronnie Aronson
Ashleigh Walker
Ruth E. Brown
Naomi Orzech
Publication date
01-01-2017
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-017-0606-z

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