Advancing Nursing Education and Practice for Future Global Health
Vol. 13 No. 4 (2025): Advancing Nursing Education and Practice for Future Global Health
https://doi.org/10.4081/hls.2025.14004

Self-consciousness of health status for type 2 diabetes mellitus with chronic complications: instrument development and psychometric test

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 18 May 2025
Published: 24 December 2025
240
Views
139
Downloads
14
HTML

Authors

Self-consciousness regarding health status is crucial for individuals with Type 2 Diabetes Mellitus (T2DM) to engage actively in lifelong diabetes self-management. However, existing instruments have not fully incorporated aspects of nurse partnership, dialogue, and pattern recognition related to diabetes knowledge, self-management skills, and self-care abilities. This study aimed to develop and validate the Self-Consciousness of Health Status (SCHS) instrument for patients with T2DM and chronic complications. Instrument development occurred in three phases: Phase One involved a literature review and a three-round e-Delphi to generate the item pool. Phase Two tested content validity with five experts, and construct validity with confirmatory factor analysis (CFA) among 602 participants. Internal consistency and test-retest reliability were also assessed. Phase Three finalized the scale and score interpretation. CFA confirmed the SCHS structure, consisting of 77 items across four dimensions. The scale demonstrated strong model fit (Chi Square p > 0.05, RMSEA p > 0.05) and standardized factor loadings between 0.516–0.908 (p < 0.05). SCHS is a valid and reliable tool to measure health self-consciousness in patients with T2DM and chronic complications.

Downloads

Download data is not yet available.

1. Mikkonen K, Tomietto M WR. Instrument development and psychometric testing in nursing education research. Nurse Educ Today 2022;119:105603.

2. Corriere M, Rooparinesingh N KR. Epidemiology of diabetes and diabetes complications in the elderly: An emerging public health burden. Curr Diab Rep 2013;13:805-13.

3. Zheng Y, Ley SH HF. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol 2018;14:88-98.

4. Kariasa IM, Nurachmah E, Setyowati KR. Analysis of participants’ characteristics and risk factors for stroke recurrence. Enferm Clin 2019;29:286-90.

5. Pouwer F, Nefs G NA. Adverse effects of depression on glycemic control and health outcomes in people with diabetes a review. Endocrinol Metab Clin North Am 2013;42:529-44.

6. Sina Jasim MD, Sandhu R, Tutaryebwa L SS. Assement of functional status in diabetic and hypertensive patients: experience from rural south west Uganda. Endocr Pr 2016;22.

7. Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Educ Couns 2016;99:926-943.

8. Killackey T, Peter E, Maciver J MS. Advance care planning with chronically ill patients: A relational autonomy approach. Nurs Ethics 2020;27:360-71.

9. Lee EH, Lee YW, Lee KW, Nam M KS. A new comprehensive diabetes health literacy scale: Development and psychometric evaluation. Int J Nurs Stud 2018;88:1-8.

10. Kong SY CM. Validity and reliability of the Korean version of the self-care of diabetes inventory (SCODI-K). Int J Env Res Public Heal 2021;18:1-15.

11. Caro-Bautista J, Espinar-Toledo M, Villa-Estrada F, et al. Development and psychometric validation of an instrument to identify barriers to self-care among Spanish patients with type 2 diabetes on the basis of Theory of Planned Behavior. Value Heal 2019;22:1033-41.

12. Ausili D, Barbaranelli C, Rossi E, et al. Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: The Self-Care of Diabetes Inventory. BMC Endocr Disord 2017;17:66.

13. Kyngäs H. Theory development from the results of content analysis. In: The application of content analysis in nursing science research. Cham Springer Int Publ. Published online 2019:73-84.

14. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007;30:459-67.

15. Chen X, Zou D, Cheng G XH. Detecting latent topics and trends in educational technologies over four decades using structural topic modeling: A retrospective of all volumes of computers & education. Comput Educ 2020;151:1-21.

16. Verma I, Gopaldasani V, Jain V, et al. The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self- management outcomes: A systematic review and meta-analysis. Prim Care Diabetes 2022;16:719-35.

17. Martínez N, Connelly CD, Pérez A, Calero P. Self-care: A concept analysis. Int J Nurs Sci 2021;8:418-25.

18. Iovino P, Lyons KS, De Maria M, et al. Patient and caregiver contributions to self-care in multiple chronic conditions: A multilevel modelling analysis. Int J Nurs Stud 2021;116:1-8.

19. Lee AA, Piette JD, Heisler M, et al. Diabetes self-management and glycemic control: The role of autonomy support from informal health supporters. Heal Psychol 2019;38:122-132.

20. Sonobe Y, Yamagata T, Yang H, et al. Supramodal representation of the sense of body ownership in the human parieto-premotor and extrastriate cortices. eNeuro 2023;10:1-16.

21. Habibi Soola A, Davari M, Rezakhani Moghaddam H. Determining the predictors of self- management behaviors in patients with type 2 diabetes: an application of socio-ecological approach. Front Public Heal 2022;10:1-12.

22. Arditi C, Zanchi A, Peytremann-Bridevaux I. Health status and quality of life in patients with diabetes in Switzerland. Prim Care Diabetes 2019;13:233-41.

23. Pamungkas RA, Chamroonsawasdi K, Charupoonphol P, Vatanasomboon P. A health- based coaching program for diabetes self-management (DSM) practice: A sequential exploratory mixed-method approach. Endocrinol Diabetes y Nutr 2021;68:489-500.

24. Ampudia-Blasco FJ, Artime E, Diaz S, et al. Conversations and reactions around severe hypoglycaemia (CRASH): Spanish results of a global survey of people with type 1 diabetes or insulin-treated type 2 diabetes and caregivers. Endocrinol Diabetes y Nutr 2021;68:557-66.

25. Dao‐Tran TH, Anderson DJ, Chang AM, et al. Vietnamese version of diabetes self‐management instrument: Development and psychometric testing. Res Nurs Heal 2017;40:177-84.

26. Navarro-Flores E, Morales-Asencio JM, Cervera-Marín JA, et al. Development, validation and psychometric analysis of the diabetic foot self-care questionnaire of the University of Malaga, Spain (DFSQ-UMA). J Tissue Viability 2015;24:24-34.

27. Janssen EM, Bridges JFP. Art and science of instrument development for stated-preference methods. Patient 2017;10:377-9.

28. Tawfik DS, Sexton JB, Kan P, et al. Burnout in the neonatal intensive care unit and its relation to healthcare-associated infections. J Perinatol 2017;37:315-20.

29. Wildeboer AT, Stallinga HA, Roodbol PF. Validation of the international classification of functioning, disability and health (ICF) core set for diabetes mellitus from nurses’ perspective using the delphi method. Disabil Rehabil 2022;44:210-8.

30. Silva JA Da, Souza ECF De, Echazú Böschemeier AG, et al. Diagnosis of diabetes mellitus and living with a chronic condition: Participatory study. BMC Public Health 2018;18:1-8.

How to Cite



Self-consciousness of health status for type 2 diabetes mellitus with chronic complications: instrument development and psychometric test. (2025). Healthcare in Low-Resource Settings, 13(4). https://doi.org/10.4081/hls.2025.14004