Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus.
OBJECTIVE
To determine the psychometric properties and theoretical grounding of instruments that evaluate self-care behaviour or barriers in people with type 2 diabetes.


BACKGROUND
There are many instruments designed to evaluate self-care behaviour or barriers in this population, but knowledge about their psychometric validation processes is lacking.


METHODS
Systematic review.


METHODS
We conducted a search for psychometric or validation studies published between January 1990-December 2012. We carried out searches in Pubmed, CINAHL, PsycINFO, ProQuolid, BibliPRO and Google SCHOLAR to identify instruments that evaluated self-care behaviours or barriers to diabetes self-care.


METHODS
We conducted a systematic review with the following inclusion criteria: Psychometric or clinimetric validation studies that included patients with type 2 diabetes (exclusively or partially) and which analysed self-care behaviour or barriers to self-care and proxies like self-efficacy or empowerment, from a multidimensional approach. Language: Spanish or English. Two authors independently assessed the quality of the studies and extracted data using Terwee's proposed criteria: psychometrics properties, dimensionality, theoretical ground and population used for validation through each included instrument.


RESULTS
Sixteen instruments achieved the inclusion criteria for the review. We detected important methodological flaws in many of the selected instruments. Only the Self-management Profile for Type 2 Diabetes and Problem Areas in Diabetes Scale met half of Terwee's quality criteria.


CONCLUSIONS
There are no instruments for identifying self-care behaviours or barriers elaborated with a strong validation process. Further research should be carried out to provide patients, clinicians and researchers with valid and reliable instruments that are methodologically solid and theoretically grounded.
District of Primary Health Care of Málaga, Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, Spain.
Jorge
J
Caro-Bautista
Francisco Javier
FJ
Martín-Santos
Jose Miguel
JM
Morales-Asencio
D003924:Diabetes Mellitus, Type 2 / Q000451:nursing*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods*; D010353:Patient Education as Topic; D011594:Psychometrics / Q000295:instrumentation* / Q000379:methods; D012648:Self Care / Q000295:instrumentation* / Q000379:methods; D020377:Self Efficacy; D054928:Validation Studies as Topic
nursing assessment; patient education; psychometrics; self-care; systematic review; type 2 diabetes