title: Development and psychometric properties of a new social support scale for self-care in middle-aged patients with type II diabetes (S4-MAD).
abstract: BACKGROUND
  Social support has proved to be one of the most effective factors on the success of diabetic self-care. This study aimed to develop a scale for evaluating social support for self-care in middle-aged patients (30-60 years old) with type II diabetes.
  
  
  METHODS
  This was a two-phase qualitative and quantitative study. The study was conducted during 2009 to 2011 in Tehran, Iran. In the qualitative part, a sample of diabetic patients participated in four focus group discussions in order to develop a preliminary item pool. Consequently, content and face validity were performed to provide a pre-final version of the questionnaire. Then, in a quantitative study, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the scale.
  
  
  RESULTS
  A 38-item questionnaire was developed through the qualitative phase. It was reduced to a 33-item after content validity. Exploratory factor analysis loaded a 30-item with a five-factor solution (nutrition, physical activity, self monitoring of blood glucose, foot care and smoking) that jointly accounted for 72.3% of observed variance. The confirmatory factor analysis indicated a good fit to the data. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.94), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (ICC=0.87).
  
  
  CONCLUSIONS
  The findings showed that the designed questionnaire was a valid and reliable instrument for measuring social support for self-care in middle-aged patients with type II diabetes. It is an easy to use questionnaire and contains the most significant diabetes related behaviors that need continuous support for self-care.
authors.affiliation: Department of Health Education, Tarbiat Modares University, Tehran, Iran.
authors.forename: Shohreh
authors.initials: S
authors.lastname: Naderimagham
authors.forename: Shamsaddin
authors.initials: S
authors.lastname: Niknami
authors.forename: Farid
authors.initials: F
authors.lastname: Abolhassani
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Hajizadeh
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D036301:Qualitative Research; D015203:Reproducibility of Results; D012648:Self Care / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires