title: Design and development of a scale of perceived barriers to self-care in patients with type 2 diabetes mellitus: an exploratory factor analysis.
abstract: BACKGROUND
  Despite the importance of perceived barriers against self-care in diabetic patients, the role of this factor is rarely addressed in the improvement of self-care behaviors of Iranian patients. The lack of appropriate instruments that fit demographic properties of Iranian society is one reason. The aim of this study was to develop and validate the scale of perceived barriers to self-care in patients with type 2 diabetes mellitus.
  
  
  METHODS
  This cross-sectional study conducted on 400 patients with type 2 diabetes who were covered by the health centers in Isfahan (Iran) in 2015. A 22-item, researcher-made instrument was designed; the face and content validities of the instrument were examined through obtaining the opinions of an expert panel before administering the instrument in the study. Also, the exploratory factor analysis was used to investigate the instrument's validity. Cronbach's alpha was employed to measure its internal consistency (reliability). To examine the validity of the final scale, the mean scores of perceived barriers in patients with appropriate and inappropriate self-care behaviors were compared.
  
  
  RESULTS
  The research sample was comprised of 240 women (60%) and 160 men (40%). The mean value of the content validity index was 0.84. The results of factor analysis confirmed the validity of the 11 items and 3 factors of the developed scale. The factor loading ranged from 0.46 to 0.78. These three factors together explained 40.28% of the total variance. The overall reliability coefficient of the instrument was 0.79, ranging from 0.82 to 0.93 for three factors.
  
  
  CONCLUSIONS
  According to the results, the developed scale was a valid and reliable instrument for examining the barriers perceived by the patients. The findings of this research can help health policy makers in planning to facilitate the self-care behaviors as the most vital factor in diabetes control.
authors.affiliation: Ph.D., Professor, Department of Public Health, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ramezankhani
authors.affiliation: Ph.D., Professor, Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Soori
authors.affiliation: Ph.D., Associate Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Alhani
authors.affiliation: Ph.D. Candidate, Department of Public Health, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Moazemi
authors.initials: AM
authors.lastname: Goudarzi
keywords: diabetes mellitus; perceived barriers; reliability; self-care; validity