The psychometric testing of the diabetes health promotion self-care scale.

BACKGROUND Health-promoting behavior is an important strategy to maintain and enhance health of patients with Type 2 diabetes. Few instruments have been developed to measure health promotion self-care behavior of patients with Type 2 diabetes. PURPOSE Developing and psychometric testing of the Chinese version of the Diabetes Health Promotion Self-Care Scale (DHPSC) for patients with Type 2 diabetes. METHODS Four hundred and eighty-nine patients with Type 2 diabetes were recruited from endocrine clinics in four hospitals in Kaohsiung City in southern Taiwan. Exploratory and confirmatory factor analyses were used to assess the construct validity of the scale. Correlations between the DHPSC and the satisfaction subscale of Diabetes Quality of Life, Diabetes Empowerment Scale, and HbA1c were calculated to evaluate concurrent validity. Internal consistency and test-retest reliability were used to assess the reliability of the scale. The study was conducted in 2007 and 2008. RESULTS A proposed second-order factor model with seven subscales and 26 items fit the data well. The seven subscales were interpersonal relationships, diet, blood glucose self-monitoring, personal health responsibility, exercise, adherence to the recommended regimens, and foot care. The DHPSC statistically significantly correlated with the satisfaction subscale of Diabetes Quality of Life and the Diabetes Empowerment Scale. HbA1c only statistically significantly correlated with the subscale of health responsibility. Reliability was supported by acceptable Cronbach's alpha (range, .78-.94) and test-retest reliability (range, .76-.95). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The DHPSC has satisfactory reliability and validity. Healthcare providers can use the DHPSC to comprehensively assess the health promotion self-care behaviors of patients with Type 2 diabetes.