Development and psychometric properties of a self-care behaviors scale (SCBS) among patients with rheumatoid arthritis

Abstract

Background The role of self-care behaviors in promoting physical function, pain management, health status and quality of life among patients with Rheumatoid Arthritis (RA) is well documented. However, there is no valid and reliable instrument in the literature to assess such behaviors among the patients. In the present study, we aimed to develop and assess the psychometric properties of a Self-care Behaviors Scale (SCBS) among patients with RA. Methods In 2017, applying a cross-sectional design, we recruited a convenient sample of 436 RA patients in Hamadan, Iran, to participate in the study. We developed the initial scale, including 30 items, after literature review, and having recommendations from an expert panel. Face, content, construct and convergent validity, as well as reliability of the scale were investigated. Results In Exploratory Factor Analysis, the optimal solution comprising 25 items and 7 factors was emerged, which explained 62.5% of all variances between the items. In Confirmatory Factor Analysis, the measurement model fit the data well, and all subscales were significant within an acceptable range (χ2 [233] = 428.654, p < 0.0001, comparative fit index = 0.942, normed fit index =0.907, Tucker-Lewis index =0.916, and root mean square error of approximation = 0.043[(0.037–0.05]). Conclusion The Self-care Behaviors Scale was found with appropriate validity, reliability, functionality and simplicity. To our knowledge, this scale is the only valid and reliable RA specific self-care behavior scale in the literature. Healthcare providers and health practitioners may apply the English version of this suitable instrument to find more valid and reliable data on RA self-care behaviors during primary assessments of the behaviors in educational interventions for the patients. Electronic supplementary material The online version of this article (10.1186/s41927-019-0069-4) contains supplementary material, which is available to authorized users.

Development and psychometric evaluation of a self-management behaviours scale in rheumatoid arthritis patients (RA-SMBS)

“…It included the dimension of medication (three items), but while two items are inverse to each other, the three items do not reflect well on the ability of patients to manage medications. The items of joint protection were not grouped into the same dimension but were assigned to ‘nutrition/joints protection’ and ‘stress management/others’, respectively [ 21 ]. There is a lack of reasonable explanations for such a distribution of dimensions, and that is considered a weakness of their study.…”

“…Self-management behaviour takes time to develop. Many previous studies selected RA patients with 6 months after diagnosis [ 21 , 31 , 32 ]. In the current study, we selected patients diagnosed with RA for six months or more.…”

“…Although these scales have good psychometric properties, the contents of these instruments are not specific for RA patients. Nadrian et al developed Self-Care Behaviours Scale (SCBS) among patients with RA in 2019 [ 21 ]. This is the only specific scale used for RA patients, but Cronbach's alpha coefficients for the SCBS subscale is lower than 0.3, indicating poor internal consistency [ 21 ].…”

“…Nadrian et al developed Self-Care Behaviours Scale (SCBS) among patients with RA in 2019 [ 21 ]. This is the only specific scale used for RA patients, but Cronbach's alpha coefficients for the SCBS subscale is lower than 0.3, indicating poor internal consistency [ 21 ]. The scale also lacks a theoretical basis for self-management [ 21 ].…”

“…This is the only specific scale used for RA patients, but Cronbach's alpha coefficients for the SCBS subscale is lower than 0.3, indicating poor internal consistency [ 21 ]. The scale also lacks a theoretical basis for self-management [ 21 ]. Scale development through a rigorous approach should help to improve its psychometric properties and its suitability for use in target groups [ 22 ].…”