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New measures of diabetes self-care agency, diabetes self-efficacy, and diabetes self-management for insulin-treated individuals with type 2 diabetes.

AIMS AND OBJECTIVES
To develop and refine three new scales that measure diabetes self-care agency, diabetes self-efficacy and diabetes self-management to reflect the American Diabetes Association current standards of diabetes care and the American Association of Diabetes Educators self-care behaviours. And, to establish the clarity, consistency and content validity of the scales.


BACKGROUND
There is a need to have valid and reliable instruments or scales to assess an individual's diabetes self-care agency, self-efficacy and self-management to plan appropriate interventions that can be effective in improving glycaemic control and delaying or preventing diabetes-related complications.


DESIGN
A methodological design was used to conduct this study.


METHODS
Ten clinicians and 10 insulin-treated individuals with type 2 diabetes (T2DM) from a diabetes care center in the southern USA participated in this study. Analysis consisted of inter-rater agreement to determine clarity and consistency with standards of diabetes care and content validity of individual items on the scales (I-CVI) and the overall scales (S-CVI/Ave) to determine relevance for current diabetes care practice.


RESULTS
All I-CVI and S-CVI/Ave of the DSES exceeded the minimum acceptable criteria. All I-CVI and the S-CVI of the DSMS also exceeded the minimum accepted criteria, except for one item that had I-CVI = 0.70. Evaluation of the items and the directions of the scales by the sample of insulin-treated individuals with T2DM exceeded the minimum criteria of 80% inter-rater agreement. RELEVANCE TO RESEARCH AND CLINICAL PRACTICE: Further psychometric testing of the scales with samples of insulin-treated individuals with diabetes is warranted and will lay the groundwork for further research and clinical practice to enhance the capability, confidence and actual performance of diabetes self-management activities among insulin-treated individuals with T2DM.


CONCLUSIONS
The scales can be used by diabetes care providers to assess and follow-up individuals with diabetes who need intense case management. They also can be the measures of choice to conduct future research to test the effects of interventions among insulin-treated individuals with T2DM.