Abstract
Study design
Validation cross-sectional study.
Objectives
To develop and assess the psychometric properties of two instruments based on the middle-range theory of self-care in chronic illness: the Self-Care in Spinal Cord Injuries Inventory (SC-SCII) and the Self-Care Self-Efficacy Scale in Spinal Cord Injuries (SCSES-SCI).
Setting
Multicenter study in five spinal units across Italy and Ireland.
Methods
Instrument development was based on self-care behaviours identified in the scientific literature. Behaviours were grouped into four dimensions during a consensus conference: self-care maintenance, self-care monitoring, self-care management and self-care self-efficacy. Sixty-seven items were subsequently generated based on these dimensions. A multidisciplinary group of 40 experts evaluated content validity. Dimensionality of the final items was tested by confirmatory factor analyses (CFA) with a sample of 318 participants. Internal consistency and test–retest reliability were evaluated for each dimension. Construct validity was assessed using correlations between items and scoring differences amongst participants with more severe conditions and secondary complications.
Results
Content validity of the SC-SCII and SCSES-SCI was satisfactory for thirty-five of the previously generated items, which were further refined. CFA showed comparative fit indexes ranging from 0.94 to 0.97 and root mean square errors of approximation from 0.03 to 0.07. Internal consistency ranged from 0.71 to 0.85, and intraclass correlation coefficients were higher than 0.70. Correlations among dimensions were moderate, and the theoretical hypotheses formulated when designing the instruments were largely confirmed.
Conclusions
The SC-SCII and the SCSES-SCI represent valid and reliable theoretically-grounded instruments to assess self-care in people with spinal cord injury.
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Data availability
The datasets generated and analysed during this study are available from the corresponding author on request.
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Acknowledgements
Sincere thanks go to Prof. Barbara Riegel for her supervision during the process of constructing the instrument and the methodological support provided during the design of the study protocol. Moreover, we wish to thank the participants and the staff at the Spinal Cord Injury Units of Città della Salute e della Scienza University Hospital of Torino, Careggi Hospital of Firenze, IRRCS Fondazione Santa Lucia of Roma, Cannizzaro Hospital of Catania, and the National Rehabilitation Hospital of Dublin. Particularly, we would like to acknowledge Silvia Mozzone, Simona Frigerio, Patrizia Maitan, Eva Wallace, Sara Arese, Marco Tommasini, Vittoria Parolai, and Stefano Gatta for their contribution in the data collection and accomplishment of this project.
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AC was responsible for designing and writing the study protocol, and for submitting the study to the ethical committee. He was also responsible for writing the article, collaborating with recruiting centres, and interpreting results. EV, VD, and SC were responsible for designing and writing the study protocol and provided feedback on the article draft. GS, MN, BB, and AB were responsible for recruiting the participants and managing the data. MC was responsible for the database managing, analyzing data, and interpreting the results. MC and MN contributed to writing the article.
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Ethics approval (Resolution no. CS2/596, March 13, 2018) was granted by the Città della Salute e della Scienza di Torino, Mauriziano Hospital, ASL TO1 Research Ethics Committee, Turin, Italy. All recruitment centres gave their authorisation for participation in the study. Furthermore, all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed. Participants provided written, informed consent, and anonymity was maintained throughout the research process.
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Conti, A., Campagna, S., Nolan, M. et al. Self-care in spinal cord injuries inventory (SC-SCII) and self-care self-efficacy scale in spinal cord injuries (SCSES-SCI): development and psychometric properties. Spinal Cord 59, 1240–1246 (2021). https://doi.org/10.1038/s41393-021-00702-9
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DOI: https://doi.org/10.1038/s41393-021-00702-9
