title: Self-Neglect: Development and Evaluation of a Self-Neglect (SN-37) Measurement Instrument.
abstract: Self-neglect (SN) is a global phenomenon, largely hidden, poorly defined, and a serious public health issue. It can be intentional or unintentional and depends on the individual's capacity. Creating a safe living environment for self-neglecting adults can present complex ethical challenges. The purpose of this research was to develop and evaluate the psychometric properties of an instrument to measure professional's perceptions of self-neglect. A descriptive cross-sectional design was used in this two-stage study. Stage 1 involved the generation of an item pool (90 items), face and content validity; and pilot testing of the instrument. In stage 2, the questionnaire was posted to a national sample of community health and social care professionals (n=566) across Ireland, with a 60% response (n=339). Exploratory factor analysis (EFA) was conducted using scale development guidelines to identify scales and subscales of the instrument. Construct validity was established using EFA. The result was a 37-item SN instrument, composed of five factors: environment, social networks, emotional and behavioural liability, health avoidance, and self-determinism which explained 55.6% of the total variance. Factor loadings were ≥0.40 for all items on each of the five subscales. Cronbach's alpha (α) for four subscales ranged from 0.83 to 0.89 and one subscale was 0.69. The SN-37 can be used not only to measure SN, but also to develop interventions in practice. Further testing of the SN-37 in primary care settings with diverse populations is recommended.
authors.affiliation: Public Health Nurse Consultant, Careystown, Whitegate, Co. Cork, Ireland.
authors.forename: Mary Rose
authors.initials: MR
authors.lastname: Day
authors.affiliation: Emeritus Professor, School of Nursing & Midwifery, University College Cork, Ireland; Chair, South West Hospital Group, Ireland.
authors.forename: Geraldine
authors.initials: G
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012648:Self Care / Q000592:standards*; D011795:Surveys and Questionnaires / Q000592:standards*