Maddalena De Maria1, Maria Matarese2, Anna Strömberg3, Davide Ausili4, Ercole Vellone5, Tiny Jaarsma6, Onome Henry Osokpo7, Marguerite Marie Daus8, Barbara Riegel9, Claudio Barbaranelli10. 1. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. Electronic address: maddalena.demaria@outlook.it. 2. School of Nursing, Campus Bio-Medico University of Rome, Italy. Electronic address: m.matarese@unicampus.it. 3. Department of Medical and Health Sciences, Linköping, Sweden; Department of Cardiology Linköping University, Linköping, Sweden. Electronic address: anna.stromberg@liu.se. 4. Department of Medicine and Surgery, University of Milan-Bicocca, Italy. Electronic address: davide.ausili@unimib.it. 5. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy. Electronic address: ercole.vellone@uniroma2.it. 6. Department of Social and Welfare Studies, Faculty of Health Science, Linköping University, Linköping, Sweden. Electronic address: tiny.jaarsma@liu.se. 7. School of Nursing, University of Pennsylvania, Philadelphia, United States. Electronic address: onome@nursing.upenn.edu. 8. School of Nursing, University of Pennsylvania, Philadelphia, United States. Electronic address: mdaus@nursing.upenn.edu. 9. School of Nursing, University of Pennsylvania, Philadelphia, United States. Electronic address: briegel@nursing.upenn.edu. 10. Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy. Electronic address: claudio.barbaranelli@uniroma1.it.
Abstract
BACKGROUND: Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. OBJECTIVE: The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. METHODS: This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. RESULTS: Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [χ2(50) = 63.495, p = 0.095; RMSEA = 0.022, p = 0.999, 90% CI = 0.000 0.038; CFI = 0.981; TLI = 0.977; SRMR = 0.036], self-care monitoring [χ2(22) = 28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI = 0.000 0.046; CFI = 0.996; TLI = 0.995; SRMR = 0.054], and self-care management [χ2(51) = 91.334, p = 0.001; RMSEA = 0.048, p = 0.576, 90% CI = 0.031 0.063; CFI = 0.949; TLI = 0.937; SRMR = 0.047] scales. CONCLUSIONS: These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries.
BACKGROUND: Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. OBJECTIVE: The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. METHODS: This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. RESULTS:Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [χ2(50) = 63.495, p = 0.095; RMSEA = 0.022, p = 0.999, 90% CI = 0.000 0.038; CFI = 0.981; TLI = 0.977; SRMR = 0.036], self-care monitoring [χ2(22) = 28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI = 0.000 0.046; CFI = 0.996; TLI = 0.995; SRMR = 0.054], and self-care management [χ2(51) = 91.334, p = 0.001; RMSEA = 0.048, p = 0.576, 90% CI = 0.031 0.063; CFI = 0.949; TLI = 0.937; SRMR = 0.047] scales. CONCLUSIONS: These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries.
Authors: Barbara Riegel; Maddalena De Maria; Claudio Barbaranelli; Maria Matarese; Davide Ausili; Anna Stromberg; Ercole Vellone; Tiny Jaarsma Journal: Front Public Health Date: 2022-05-17
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