| Objectives:1.To explore the experience of caregivers of type 2 diabetes patients during caring,which can provide reference for the development of self-efficacy scale for caregivers of type 2 diabetes.2.To develop the self-efficacy scale for the caregivers of type 2 diabetes in China and conduct a preliminary reliability and validity test of the scale.Methods:1.On the basis of reviewing the literature,a semi-structured interview outline was drawn up,and the purpose sampling method was used to select caregivers of patients with type 2 diabetes who were treated in the endocrinology department of a hospital from March 2018 to May 2018.Finally,13 caregivers underwent the semi-structured interviews.After each interview,the interview recordings were converted into words in time combined with the notes taken,and the data were analyzed using the seven-step analysis method of Colaizzi phenomenological data.2.The Delphi expert consultation method was used and 20 experts major in diabetes management,psychological nursing,and nursing education were invited to evaluate the scale items.The mean and coefficient of variation of the importance of the items were used as the main basis for the deletion.Finally,the scale was modified in combination with the expert opinion to obtain the clinical test version of the scale.3.200 caregivers of patients with type 2 diabetes who were admitted to the endocrinology department of a hospital from September 2018 to January 2019 wereenrolled in the present study by convenient sampling.The scales were analyzed by item analysis,exploratory factor analysis and reliability test to test the reliability and validity of the Self-Efficacy Scale for Caregivers of type 2 diabetes patients.Results:1.A total of 13 caregivers of type 2 diabetes were interviewed.Through repeated analysis and refinement,we obtained themes from the perspectives of the physical and mental feelings of the caregivers,the willingness and the ability to care and the expectation,including: physical fatigue,satisfaction when recognized by others,powerlessness in the self-management of diabetes patients,anxiety about the complications of diabetic patients,initiative in caring for diabetics,limitations of diabetes knowledge of caregivers,the need of emotional support from family members,the desire for community medical assistance and the need for social and economic support.2.Based on the qualitative interviews and the literature review,a pool of scale entries with 23 entries was obtained.The response rates of the two rounds consultation were 75% and 100% respectively,and the authority coefficient of experts were both greater than 0.8.In the first round,four indicators with an average below3.5 and a coefficient of variation above 25% were deleted.Combined with expert opinions,a second round of questionnaire containing 29 items was modified.In the second round,three items with overlapping meanings were deleted,and a preliminary draft of the 26-item scale was formed.After the completion of 2 rounds of correspondence,the importance of each item was from 4.1 to 5.0,and the coefficient of variation was from 0.0 to 0.2,which reflects the consistency of expert opinions.After the pre-survey of 15 caregivers,a revised scale was developed.3.In the item analysis,the items 1,9,11 and 22 did not satisfy 4 or more of the 6indicators,including critical ratio,the correlation and rectified correlation between the items and the total score,the Cronbach's ?,commonality and factor load,and were deleted.Besides,items 8,12,14,19,21,25 and 26 had individual requirements that were not met and were temporarily retained.After item analysis,22 entries remained.4.After 4 rounds of factor analysis,4 items that did not meet the factor load criterion were deleted.The remaining 18 entries were again subjected to exploratory analysis with a KMO of 0.846,and the Barlett spherical test was statistically significant.A total of 4 factors were obtained from the exploratory factor analysis,and the cumulative variance contribution rate was 59.722%.According to the previous theoretical basis and the content of the item,the four factors were named as‘Blood glucose monitoring and foot care',‘Medication management',‘Diet and exercise' and ‘Emotional management'.Eventually the self-efficacy scale for caregivers of type 2 diabetes with 4 dimensions,18 items was formed.The Cronbach's ? coefficient of the total scale was 0.853,and for each dimensions were from 0.746 to 0.824,indicating that the scale had good internal consistency.And the20 caregivers of type 2 diabetes selected in this study showed that the test-retest reliability of the total scale was 0.945 and the test-retest reliability of each dimensions were from 0.721 to 0.931,indicating that the questionnaire had good stability.Conclusions:1.Caregivers of patients with type 2 diabetes have multiple experiences.While paying attention to patients with type 2 diabetes,health care workers should not neglect the physical and mental stress of family caregivers and should provide them with professional education and psychological support in order to improve their care skills.2.The self-efficacy scale for caregivers of type 2 diabetes in this study included four dimensions: diet and exercise,medication management,blood glucose monitoring and foot care,and emotional management,totally 18 items.The preliminary reliability and validity test confirmed that the scale had sound reliability and validity and can be used as an objective tool to evaluate the self-efficacy of caregivers of type 2 diabetes patients. |
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