title: Measuring HIV self-management in women living with HIV/AIDS: a psychometric evaluation study of the HIV Self-management Scale.
abstract: OBJECTIVE
  To develop and validate the HIV Self-management Scale for women, a new measure of HIV self-management, defined as the day-to-day decisions that individuals make to manage their illness.
  
  
  METHODS
  The development and validation of the scale was undertaken in 3 phases: focus groups, expert review, and psychometric evaluation. Focus groups identified items describing the process and context of self-management in women living with HIV/AIDS (WLHA). Items were refined using expert review and were then administered to WLHA in 2 sites in the United States (n = 260). Validity of the scale was assessed through factor analyses, model fit statistics, reliability testing, and convergent and discriminate validity.
  
  
  RESULTS
  The final scale consists of 3 domains with 20 items describing the construct of HIV self-management. Daily self-management health practices, social support and HIV self-management, and chronicity of HIV self-management comprise the 3 domains. These domains explained 48.6% of the total variance in the scale. The item mean scores ranged from 1.7 to 2.8, and each domain demonstrated acceptable reliability (0.72-0.86) and stability (0.61-0.85).
  
  
  CONCLUSIONS
  Self-management is critical for WLHA, who constitute over 50% of people living with HIV/AIDS (PLWHA) and have poorer health outcomes than their male counterparts. Methods to assess the self-management behavior of WLHA are needed to enhance their health and wellbeing. Presently, no scales exist to measure HIV self-management. Our new 20-item HIV Self-management Scale is a valid and reliable measure of HIV self-management in this population. Differences in aspects of self-management may be related to social roles and community resources, and interventions targeting these factors may decrease morbidity in WLHA.
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106-4904, USA. allison.webel@case.edu
authors.forename: Allison R
authors.initials: AR
authors.lastname: Webel
authors.forename: Alice
authors.initials: A
authors.lastname: Asher
authors.forename: Yvette
authors.initials: Y
authors.lastname: Cuca
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Okonsky
authors.forename: Alphoncina
authors.initials: A
authors.lastname: Kaihura
authors.forename: Carol
authors.initials: C
authors.lastname: Dawson Rose
authors.forename: Jan E
authors.initials: JE
authors.lastname: Hanson
authors.forename: Robert A
authors.initials: RA
authors.lastname: Salata
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Burant
mesh_terms: D000328:Adult; D015897:Comorbidity; D005104:Expert Testimony; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods; D012648:Self Care / Q000706:statistics & numerical data; D012737:Sex Factors; D012944:Social Support; D014481:United States / Q000453:epidemiology