Development Of Self-management Ability Questionnaire For Gestational Diabetes Mellitus Patients And Its Reliability And Validity Test

Objectives 1.To interview gestational diabetes mellitus patients,to understand the status of self-management ability of GDM patients and related factors to self-management ability;2.Based on the information-motivation-behavioral skills model,Self-management ability questionnair for patients with gestational diabetes mellitus(short for SMQGDM)was prepared and its reliability and validity were tested.To provide an assessment tool for evaluating the self-management ability of GDM patients.Methods 1.A qualitative study was conducted in the first phase(From October 2016 to December 2016).We recruited 16 patients with GDM to take part in our semi-structured interviews to the related factors that affect their self-management ability.2.Development of self-management ability questionnaire for gestational diabetes patients and its reliability and validity test in the second phase(From January 2017 to December 2017).Based on the information-motivation-behavioral skills model,combined with the results of literature review and qualitative interview,and referring to the characteristics of GDM patients and the existing assessment tools for self management of diabetes,and the questionnaire dimensions and items were written.After assessing through the three rounds of Delphi expert consultation,making further selection,supplement and adjustment of the item pool,removing the unimportant or unrelated items,making appropriate merger of the similar items,form a pretest questionnaire.Inviting 20 patients with GDM to read and screen the draft,to test the feasibility,forming the initial questionnaire of self-management ability for patients with GDM.According to the inclusion and exclusion criteria,464 patients with GDM were enrolled to complete the initial questionnaire.Results The first phase:The self-management ability content includes: GDM related knowledge,attitude and beliefs,social support,management methods and behaviors.The status of self management ability of GDM patients is as follows:(1)GDM patients have different levels of understanding of GDM related information;(2)GDM patients attitude towards GDM management is more positive,and GDM patients have different levels of self-efficacy;(3)Production examination can not meet the needs of GDM patients to get GDM related information,and the family members' participation capacity is limited;(4)GDM patients have differences in mastering GDM management skills and implementing management practices.The second phase:The compilation of the questionnaire and the reliability and validity test.1.We formed a 52 optional item pool.The questionnaire was a Likert5-level scoring method,the higher the score,the higher level of self-management ability for patients with GDM.2.With the method of pilot study and expert consultatio,we acquired the Initial questionnaire of SMQGDM with 31-item.3.With the item screening,exploratory factor analysis(EFA),confirm factor analysis(CFA),we got the formal scale with 4-domain(GDM related information,attitudes and beliefs,social support,skills and behaviors),26-item.4.The Scale-Content Validity Index(S-CVI)0.98,the Item-Content Validity Index(I-CVI)ranged from 0.75~1.00.The GDM related information domain was 0.614~0.736;attitudes and beliefs domain was 0.783~0.929;social support domain was 0.793~0.918;skills and behaviors domain was 0.584~0.812.5.In the general module,the reliability results showed that the total scale's Cronbach's ? coefficient was 0.937,the Cronbach's ? for six dimensions ranged from 0.893 to 0.920;the total scale's Guttman Spilt-Half coefficient was 0.914,and the Guttman Spilt-Half coefficient varied from 0.826~0.909;the test-retest reliability was 0.947 for the whole scale,and 0.824~0.888 for the four dimensions.Conclusions The "Self-management ability questionnair for patients with gestational diabetes mellitus" has good stability and reliability,and can be used to assess the self-management abilities of GDM patients.