Development and Validation of a Diabetes Foot Self-Care Behavior Scale

Abstract

Foot self-care practice is one of the most important self-management behaviors to prevent the occurrence of diabetic foot ulcers. A tool that measures all aspects of daily foot care routines and demonstrates good reliability and validity is essential to pinpointing specific foot ulcer problems and evaluating intervention outcomes. There is currently no such tool available. This study developed a diabetes foot self-care behavior scale (DFSBS) and tested its psychometric properties. The researchers reviewed the literature to generate the initial item pool. After expert confirmation of final draft scale content validity, we used convenience sampling to recruit 295 patients with diabetes and peripheral neuropathy who completed the scale. We analyzed results to determine the scale''s psychometric properties, including construct validity, internal consistency, and test-retest reliability. The final scale consisted of a one-factor structure with seven items. The analysis of the scale indicated the DFSBS score as significantly correlated with the foot care subscale score of the Chinese version of the summary of diabetes self-care activity questionnaire (rho = .87, p < .001) and the Chinese version of the diabetes self-care scale (γ = .45, p < .001). Importantly, the DFSBS was found to differentiate between participants with and without a history of foot ulcers (Mann-Whitney Z = -3.09, p < .01). Internal consistency was acceptable (Cronbach''s alpha = .73), and intraclass correlation coefficient for test-retest reliability over a 2-week period was .92. This study provides evidence of the DFSBS validity and reliability. Clinicians may use the DFSBS to screen patients'' foot self-care behavior, and researchers can use it to elucidate foot self-care issues.