A new self-report measure of self-management of type 1 diabetes for adolescents.
BACKGROUND
The development of instruments to measure self-management in youth with type 1 diabetes has not kept up with current understanding of the concept.


OBJECTIVE
This study aimed to report the development and the testing of a new self-report measure to assess the Self-Management of Type 1 Diabetes in Adolescents (SMOD-A).


METHODS
Following a qualitative study, items were identified and reviewed by experts for content validity. A total of 515 adolescents, 13 to 21 years old, participated in a field study by completing the SMOD-A (either once or twice) and additional measures of diabetes-related self-efficacy (Self-Efficacy for Diabetes Scale), quality of life (Diabetes Quality of Life for Youth Questionnaire), self-management (Diabetes Self-Management Profile), and adherence (Self-Care Inventory). Data were collected also on metabolic control (glycosylated hemoglobin [HbA1c]).


RESULTS
The content validity index was .93. Exploratory alpha factor analyses revealed five subscales: Collaboration With Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals (alpha = .71 to .85). The stability of the SMOD-A ranged from .60 to .88 at 2 weeks (test-retest) to .59 to .85 at 3 months. Correlations of SMOD-A subscales with Self-Efficacy for Diabetes Scale-Diabetes; Diabetes Quality of Life for Youth Questionnaire satisfaction, impact, and worry; Diabetes Self-Management Profile; and Self-Care Inventory were generally significant and in the expected direction. Collaboration with parents and HbA1c values were related significantly and positively (r = .11); all other SMOD-A subscales were related significantly and negatively to HbA1c (r = -.10 to -.26), demonstrating that better self-management is associated somewhat with better metabolic control and supporting construct validity of the new measure.


CONCLUSIONS
The SMOD-A has been found to be a reliable, stable, and valid measure of SMOD-A.
Schilling
Lynne S
LS
Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA 01655, USA. Lynne.Schilling@umassmed.edu
Dixon
Jane K
JK
Knafl
Kathleen A
KA
Lynn
Mary R
MR
Murphy
Kathryn
K
Dumser
Susan
S
Grey
Margaret
M
D000293:Adolescent; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D009730:Nursing Assessment / Q000379:methods*; D010349:Patient Compliance; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012648:Self Care; D020377:Self Efficacy; D014481:United States