The purpose of this study was to develop and evaluate self-management behavior scale for diabetic chronic kidney disease patients on hemodialysis. In this study, a scale was developed through two steps: the development of the items and a test of the scale.
The first step which is the development of the items consist of three sub-steps: developing preliminary items, content validity, and face validity. The developing preliminary items were developed by literature review, guideline review and interviews of 17 experts and ten patients and were constructed using the self-management behavior theory of Blok as the theoretical framework. The content validity of the developed preliminary items was performed by ten experts and face validity by ten diabetic chronic kidney disease patients on hemodialysis.
The second step was a test of the scale that performs construct validity (item analysis, exploratory factor analysis), known-group validity, concurrent validity, and reliability. A total of 290 diabetic chronic kidney disease patients on hemodialysis were recruited in this step.
The result of the study consisted of 58 preliminary items. After revising and deleting a part of the items through content validity and face validity step, a total 40 items remained during the first step. In the second step, 17 items were deleted: 11 items below score 0.3 for total correlation of correlated items and five items below 0.4 both for communality and factor loadings and one item which lowers the reliability. Therefore, self-management behavior scale for diabetic chronic kidney disease patients on hemodialysis included 23 items and had six factors. These factors were a diet management, a stress management, daily monitoring, a medication adherence and a hemodialysis access with the explanatory variable of 55.6%. The self-management was significantly different according to a kidney transplantation waiting list. The concurrent validity shows that self-management was significantly correlated with self-efficacy and hope. The reliability of the scale was Cronbach’s alpha=.83.
The findings revealed that the self-management behavior scale for diabetic chronic kidney disease patients on hemodialysis was a valid and reliable instrument. Consequently, the scale developed through this study can measure a self-management behavior for diabetic chronic kidney disease patients on hemodialysis and use a nursing research and practice in the hospital to promote self-management.