Development and validity testing of the revised diabetes self-care inventory for children and adolescents
Development and validity testing of the revised diabetes self-care inventory for children and adolescents
复制标题
修订后的儿童和青少年糖尿病自我护理清单的开发和有效性测试
DOI：
10.1007/s13340-018-0377-8
复制
发表时间：
2018
影响因子：
2.2
通讯作者：
Aya Nakai
中科院分区：
文献类型：
--
作者：
Nobue Nakamura;Yuko Yakushijin;Tomo Kanamaru;Hiroe Tani;Keiko Ideno;Aya Nakai
最近，1型糖尿病儿童和青少年的自我护理在坚持治疗和自我管理方面都发生了变化。日本只使用了一种针对儿童和青少年的糖尿病自我护理量表，缺乏对灵活治疗方案的反思。本研究的目的是修订和检验修订后的儿童青少年糖尿病自我护理问卷(R-DSCI)的效度，并构建基于R-DSCI、HbA1c、糖尿病病程和年龄的糖尿病自我护理模型。在对青少年自我护理框架进行定性二次分析的基础上，结合对糖尿病自我护理工具的文献综述，对原DSCI中有关胰岛素注射和饮食计划的条目进行了修改，增加了与父母和他人协商的条目。参加效度测试的儿童青少年1型糖尿病患者122人，女生占50.8%，年龄在9-18岁之间，平均糖化血红蛋白为7.9%。R-DSCI的最终版本由41个条目组成。用VARIMAX方法确定了8个因素，解释了40.9%的方差；41个项目的Cronbach‘sα为0.79。糖尿病自我护理模式通过“糖尿病自我护理实践”对糖化血红蛋白产生直接负向影响(P= 0.004)，通过“糖尿病自我护理实践”对糖化血红蛋白产生间接负向影响(P= 0.002；估计效应− 为0.21)。此外，“独立自理行为”直接受年龄的影响(P<； 0.001)。R-DSCI对临床医生和研究人员评估儿童和青少年的自我管理有一定的参考价值。
Recently, self-care in children and adolescents with type 1 diabetes has changed with regard to both adherence to treatment and self-management. Only one diabetes self-care scale for children and adolescents is used in Japan which lacks reflection on flexible regimens. The aims of this study were to modify and subsequently test the validity of the revised diabetes self-care inventory (R-DSCI) for children and adolescents, and to construct the diabetes self-care model on the R-DSCI, HbA1c, duration of diabetes and age. Based on qualitative secondary analysis of the self-care framework for teenagers and a literature review of diabetes self-care instruments, the items concerning insulin injection and meal planning were modified from the original DSCI and new items concerning negotiation with parents and others were added. The participants in the validity testing were 122 children and adolescents with type 1 diabetes, 50.8% were girls, aged 9–18 years, mean HbA1c of 7.9%. The final version of the R-DSCI was composed of 41 items. Eight factors, which explained 40.9% of the variance, were identified using the varimax method; Cronbach’s alpha for the 41 items was 0.79. The diabetes self-care model showed a negative direct effect of “diabetes self-care practice” on HbA1c (P= 0.004), and the negative indirect effect of “support and perception of life with diabetes” on HbA1c through “diabetes self-care practice” (P= 0.002; estimated effect − 0.21). In addition, “independent self-care behavior” was directly affected by age (P< 0.001). The R-DSCI should be useful for clinicians and researchers to assess the self-management in children and adolescents.