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Open Access 01-12-2021 | Type 2 Diabetes | Research

Reliability and validity of the Chinese version of the LMC Skills, Confidence & Preparedness Index (SCPI) in patients with type 2 diabetes

Authors: Ximin Wang, Weibo Lyu, Ronnie Aronson, Aihua Li, Gendi Lu, Weijin Xu, Yang Cao, Ying Yu, Liting Wang, Huiting Lin

Published in: Health and Quality of Life Outcomes | Issue 1/2021

Abstract

Background

A variety of diabetes self-management instruments have been developed but few of them consist of the preparedness for diabetes self-management behavior. The novel psychometric evaluation tool “the LMC Skills, Confidence & Preparedness Index (SCPI)” measures three key aspects of a patient’s diabetes self-management: knowledge of the skill, confidence in being able to perform skill and preparedness to implement the skill. The objective of this study was to translate, adapt and validate the SCPI for use in Chinese adult patients with type 2 diabetes.

Methods

This study followed the guideline recommended by the American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee (AAOS) to indigenize the scale. Forward and back translation, and cross-cultural language debugging were completed according to the recommended steps. A convenience sample of Chinese patients with type 2 diabetes (n = 375) were recruited from a university-affiliated hospital in Shanghai. The validity (criterion, discriminant validity, and construct validity), reliability (internal consistency and test–retest reliability) and the interpretability of the instrument were examined. The content validity was calculated by experts’ evaluation.

Results

The Chinese version of SCPI (C-SCPI) has good internal consistency with a Cronbach’s alpha of 0.92. The ceiling effects of the preparedness subscales is 21%. The criterion validity of three dimensions of C-SCPI was established with significantly moderate correlations between the DKT, DES-SF and SDSCA (p < 0.05). The S-CVI of the whole scale was 0.83. Except for entry 21, the I-CVI values of all entries were greater than 0.78. The C-SCPI has also shown good discriminative validity with statistically significant differences between the patients with good and poor glycemic control. Confirmatory factor analysis showed that modified results indicate that the fitting degree of the model is good, χ²/df = 2.775, RMSEA = 0.069, CFI = 0.903, GFI = 0.873, TLI = 0.889, IFI = 0.904. The test–retest reliability coefficient was 0.61 (p < 0.01).

Conclusion

We established a Chinese version of SCPI through translation and cross-cultural adaptation. The C-SCPI is reliable and valid for assessment of the level of self-management in Chinese patients with type 2 diabetes.

Available only for authorised users

International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium: 2019. http://www.diabetesatlas.org.

Wang L, Gao P, Zhang M, Huang Z, Zhang D, Deng Q, et al. Prevalence and Ethnic pattern of diabetes and prediabetes in China in 2013. JAMA. 2017;317(24):2515. https://doi.org/10.1001/jama.2017.7596.CrossRefPubMedPubMedCentral

Washington G, Wang-Letzkus MF. Self-care practices, health beliefs, and attitudes of older diabetic Chinese Americans. J Health Hum Serv Adm. 2009;32(3):305–23.PubMed

Hewitt J, Smeeth L, Chaturvedi N, Bulpitt CJ, Fletcher AE. Self management and patient understanding of diabetes in the older person. Diabet Med. 2011;28(1):117–22. https://doi.org/10.1111/j.1464-5491.2010.03142.x.CrossRefPubMed

Carpenter R, DiChiacchio T, Barker K. Interventions for self-management of type 2 diabetes: an integrative review. Int J Nurs Sci. 2018;6(1):70–91. https://doi.org/10.1016/j.ijnss.2018.12.002.CrossRefPubMedPubMedCentral

Ayele K, Tesfa B, Abebe L, Tilahun T, Girma E. Self-care behavior among patients with diabetes in Harari, Eastern Ethiopia: the health belief model perspective. PLoS ONE. 2012;7(4):e35515. https://doi.org/10.1371/journal.pone.0035515.CrossRefPubMedPubMedCentral

Ji JJ, Liu L, Lou QQ, Yuan XD, Yao P, Zhang DY. Self-management behaviors and glycemic control in patients with type 2 diabetes mellitus. Chin J Nurs. 2014;49(1):617–20. https://doi.org/10.3761/j.issn.0254-1769.2014.05.026.CrossRef

Wu JL, Cheng KY, Lyu WB. The research progress on the current situation of self -blood glucose monitoring at home and abroad and its influencing factors. Nurs J Chin PLA. 2017;34(21):35–9. https://doi.org/10.3969/j.issn.1008-9993.2017.21.009.CrossRef

Qin MY, Liang YR, Gong X. Research on diabetes management and influencing factors among middle-aged and the elderly diabetes patient. Chin Prim Health Care. 2019;33(09):46–50. https://doi.org/10.3969/j.issn.1001-568X.2019.09.0017.CrossRef

10.

Group of Diabetes Education and Management, Diabetes Society of Chinese Medical Association. Chinese consensus on self-administered prescriptions for type 2 diabetes. Chin J Diabetes Mellitus. 2017;2017(12):740–50. https://doi.org/10.3760/cma.j.issn.1674-5809.2017.12.004.CrossRef

11.

Lou QQ, Yang LL, Shao AX. Behavior change and diabetes mellitus. Chin J Diabetes Mellitus. 2005;40(12):935–6.

12.

Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, et al. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998;21(5):706–10. https://doi.org/10.2337/diacare.21.5.706.CrossRefPubMed

13.

Garcia AA, Villagomez ET, Brown SA, Kouzekanani K, Hanis CL. The Starr County Diabetes Education Study: development of the Spanish-language diabetes knowledge questionnaire. Diabetes Care. 2001;24(1):16–21. https://doi.org/10.2337/diacare.24.1.16.CrossRefPubMed

14.

Dunn SM, Bryson JM, Hoskins PL, Alford JB, Handelsman DJ, Turtle JR. Development of the diabetes knowledge (DKN) scales: forms DKNA, DKNB, and DKNC. Diabetes Care. 1984;7(1):36–41. https://doi.org/10.2337/diacare.7.1.36.CrossRefPubMed

15.

Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18(6):754–60. https://doi.org/10.2337/diacare.18.6.754.CrossRefPubMed

16.

Van Der Ven NC, Weinger K, Yi J, Pouwer F, Adèr H, Van Der Ploeg HM, et al. The confidence in diabetes self-care scale: psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and US patients with type 1 diabetes. Diabetes Care. 2003;26(3):713–8. https://doi.org/10.2337/diacare.26.3.713.CrossRef

17.

Anderson RM, Fitzgetald JM, Gruppen LD, Funnell MM, Oh MS. The diabetes empowerment scale-short form (DES-SF). Diabetes Care. 2003;26(5):1641–2. https://doi.org/10.2337/diacare.26.5.1641-a.CrossRefPubMed

18.

Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943–50. https://doi.org/10.2337/diacare.23.7.943.CrossRefPubMed

19.

Charron-Prochownik D, Zgibor JC, Peyrot M, Peeples M, McWilliams J, Koshinsky J. The Diabetes Self-management Assessment Report Tool (D-SMART): process evaluation and patient satisfaction. Diabetes Educ. 2007;33(5):833–8. https://doi.org/10.1177/0145721707307613.CrossRefPubMed

20.

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. https://doi.org/10.1186/1477-7525-11-138.CrossRefPubMedPubMedCentral

21.

Fitzgerald JT, Davis WK, Connell CM, Hess GE, Funnell MM, Hiss RG. Development and validation of the Diabetes Care Profile. Eval Health Prof. 1996;19(2):209–31. https://doi.org/10.1177/016327879601900205.CrossRef

22.

Wang WJ, Liu XX, Chen B, Li CF, Feng NP. Development on the diabetes self-management knowledge, attitude, and behavior assessment scale (DSKAB). Chin J Prev Med. 2016;50(1):40–9. https://doi.org/10.3760/cma.j.issn.0253-9624.2016.01.008.CrossRef

23.

Mayberry R, Willock RJ, Boone L, Lopez P, Qin H, Nicewander D. A high level of patient activation is observed but unrelated to glycemic control among adults with type 2 diabetes. Diabetes Spectr. 2010;23(3):171–6. https://doi.org/10.2337/diaspect.23.3.171.CrossRefPubMed

24.

Mbuagbaw L, Aronson R, Walker A, Brown RE, Orzech N. The LMC Skills, Confidence & Preparedness Index (SCPI): development and evaluation of a novel tool for assessing self-management in patients with diabetes. Health Qual Life Outcomes. 2017;15(1):27. https://doi.org/10.1186/s12955-017-0606-z.CrossRefPubMedPubMedCentral

25.

Aronson R, Li A, Brown RE, et al. Optimizing diabetes self-management using the novel skills, confidence, and preparedness index (SCPI). Diabetes Care. 2019;42(10):1873–8. https://doi.org/10.2337/dc19-0699.CrossRefPubMed

26.

Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2013;37 Suppl 1:S1–3. https://doi.org/10.1016/j.jcjd.2013.01.009.CrossRef

27.

Bandura A. Self-efficacy: towards a unifying theory of behavior change. Psychol Rev. 1977;84(2):191–215. https://doi.org/10.1037/0033-295X.84.2.191.CrossRefPubMed

28.

Yin B. Cross-theoretical model of health behavior change. Chin Ment Health J. 2007;21(3):194–9. https://doi.org/10.3321/j.issn:1000-6729.2007.03.015.CrossRef

29.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine J. 2000;25(24):3186–91. https://doi.org/10.1097/00007632-200012150-00014.CrossRef

30.

Chinese Diabetes Society. Guidelines for the prevention and control of type 2 diabetes in China (2017 Edition). Chin J Pract Internal Med. 2018;38(04):292–344. https://doi.org/10.19538/j.nk2018040108.CrossRef

31.

Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268–74. https://doi.org/10.1111/j.1365-2753.2010.01434.x.CrossRefPubMed

32.

Chen AL, Zhang ZL, Liao ZH, Wan LH, Deng WP, Yuan YH. Self-management and quality of life in patients with diabetes mellitus. Chin J Behav Med Sci. 2006;15(5):434.

33.

Hu BB, Lou QQ, Tian Y, Zhang QW, Zhu JY. Study on empowerment and its influencing factors among diabetes inpatients. Chin J Nurs. 2011;46(03):225–8. https://doi.org/10.3761/j.issn.0254-1769.2011.03.002.CrossRef

34.

Hua L, Zhu WP. Verification of the reliability and validity of chinese version of diabetes self-management activities questionnaire. Nurs J Chin PLA. 2014;31(16):5–8. https://doi.org/10.3969/j.issn.1008-9993.2014.16.002.CrossRef

35.

Brown TA. Confirmatory factor analysis for applied research. 2nd ed. New York: Guilford Press; 2015.

36.

Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489–97. https://doi.org/10.1002/nur.20147.CrossRefPubMed

37.

Kulthanan K, Chularojanamontri L, Tuchinda P, Rujitharanawong C, Maurer M, & Weller K. Validity, reliability and interpretability of the Thai version of the urticaria control test (UCT). Health and quality of life outcomes.2016;14:61. https://doi.org/https://doi.org/10.1186/s12955-016-0466-y.

38.

Sigurdardottir AK, Benediktsson R. Reliability and validity of the Icelandic version of the Problem Area in Diabetes (PAID) Scale. Int J Nurs Stud. 2008;45(4):526–33. https://doi.org/10.1016/j.ijnurstu.2006.10.008.CrossRefPubMed

39.

Jobe JB. Cognitive psychology and self-reports: models and methods. Qual Life Res. 2003;12(3):219–27. https://doi.org/10.1023/a:1023279029852.CrossRefPubMed

40.

Strychar I, Elisha B, Schmitz N. Type 2 diabetes self-management: role of diet self-efficacy. Can J Diabetes. 2012;36(6):337–44. https://doi.org/10.1016/j.jcjd.2012.10.005.CrossRef

41.

Zou YX, Deng AH, Zhong Y, Sun Y, Luo HC. The impact of Empowerment Ability on Self-management Behavior in Type 2 Diabetes. Chin Nurs Manag. 2013;13(01):43–6. https://doi.org/10.3969/j.issn.1672-1756.2013.01.014.CrossRef

42.

Guo HJ, Wang Q, Mao T, Zhu J, Xu XP, Wang B et al. The cognitive status and influence factors of diabetes mellitus with different populations. Chin J Health Educ. 2018; 34(08):694–698+708. https://doi.org/10.16168/j.cnki.issn.1002-9982.2018.08.005.

43.

Kwok C, Fethney J, White K. Confirmatory factor analysis of the Chinese Breast Cancer screening beliefs questionnaire. Cancer Nurs. 2012;35(6):429–37. https://doi.org/10.1097/NCC.0b013e31823fcb6a.CrossRefPubMed

44.

Lance CE, Butts MM, Michels LC. The sources of four commonly reported cutoff criteria: what did they really say? Org Res Methods. 2006;9(2):202–20. https://doi.org/10.1177/1094428105284919.CrossRef

45.

Aronson R, Brown RE, Jiandani D, Walker A, Orzech N, Mbuagbaw L. Assessment of self-management in patients with diabetes using the novel LMC Skills, Confidence and Preparedness Index (SCPI). Diabetes Res Clin Pract. 2018;137:128–36. https://doi.org/10.1016/j.diabres.2017.10.028.CrossRefPubMed

46.

Sloan JA, Symonds T, Vargas-Chanes D, Friendly B. Practical guidelines for assessing the clinical significance of health related quality of life changes within clinical trials. Ther Innov Regul Sci. 2003;37:23–31. https://doi.org/10.1177/009286150303700105.CrossRef

47.

Beaton DE, Boers M, Wells GA. Many faces of the minimal clinically important difference (MCID): a literature review and directions for future research. Curr Opin Rheumatol. 2002;14(2):109–14.CrossRefPubMed

Title: Reliability and validity of the Chinese version of the LMC Skills, Confidence & Preparedness Index (SCPI) in patients with type 2 diabetes
Authors: Ximin Wang
Weibo Lyu
Ronnie Aronson
Aihua Li
Gendi Lu
Weijin Xu
Yang Cao
Ying Yu
Liting Wang
Huiting Lin
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Type 2 Diabetes
Published in: Health and Quality of Life Outcomes / Issue 1/2021
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-020-01664-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reliability and validity of the Chinese version of the LMC Skills, Confidence & Preparedness Index (SCPI) in patients with type 2 diabetes

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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