Appraisal Of Self-Care Agency Scale Research Articles

Development and validation of self-care requisites assessment

AbstractBackground:Assessment of patient’s needs is the first step for recognizing problems andprevention of complications. Assessment tools are needed in order assess needs, and plannursing care to prevent complications such as diabetic foot ulcer .The purpose of the presentstudy was to develop self-care requisites assessment tool for prevention of diabetic footulcer and examine its validity and reliability.Material and Methods: This methodological study consisted of two phases, phrase I wasdevelopment of the comprehensive assessment form, for which a qualitative study and aliterature review was conducted. Phase 2consisted of testing the instrument for validity andreliability. In qualitative study unstructured interviews were conducted with 8 patients withtype 2 diabetes. Validity of the instrument was measured by content validity, concurrentvalidity (criterion related validity) and construct validity. A sample of153 type two diabeticpatients were selected to conduct factor analysis of the tool. Reliability was confirmed byinternal consistency. Data were analyzed by SPSS statistical software.Findings:The initial form consisted of 103 items. Final version of self –care requisitesassessment form for preventing diabetic foot ulcer consisted of 43 items with 5 sub scales.Validity was established for content, construct and concurrent validity. Content validity wasassured by a panel of experts .Concurrent validity was measured by comparing the scoresfrom assessment tool with self-care agency and diabetic clients' quality of life scales, whichdemonstrated an acceptable correlation among the scores. Internal consistency reliability ofthe tool was demonstrated with Cronbach'sP coefficient ranged from 0.70 to 0.89 forsubscales, the overall test re test reliability was 0.97..ConclusionThe self-care requisite assessment tool for prevention of diabetic foot ulcer is areliable and valid instrument to measure self-care needs for prevention of diabetic footamong individuals with type two diabetes mellitus.Key words : Orem model, Tool development, Diabetes, self-care requistisEFERENCES-Azizi F (2008). [Started learning course "foot care nurse" promise for prevention and care of diabetic foot]. IranianJournal of Endocrinology and Metabolism. 4 (10) 297-298. (Persian).-Burns N, Grove SK (2006). Understanding Nursing Research Building an Evidence Based Practice. 4th edition. StLouis, Mosby.-Darvishpoor Kakhaki A et al (1384). [Instrument development to measure diabetic client quality of life.] IranianJournal of Endocrinology & Metabolism.7 (2) 149-155. 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Self‐care agency and perceived health among people using advanced medical technology at home

This article reports a study of self-care agency and perceived health in a group of people using advanced medical technology at home. An increasing number of people are using medical technology for self-care. Few studies describe daily life in this context at an overriding level, irrespective of the specific sort of technology. A connection between self-care, perceived health and sense of coherence has previously been implied. A descriptive, comparative, cross-sectional quantitative design was used. Data were collected from a questionnaire during the winter of 2009/2010. The questionnaire addressed perceived health and daily life with medical technology. Swedish versions of the Appraisal of Self-care Agency scale and the 13-item version of Antonovsky's sense of coherence scale were included. The questionnaire was answered by 180 adults performing self-care at home involving long-term oxygen, a ventilator, or peritoneal- or haemo-dialysis. Health-related and technology-related variables in daily life were mostly highly satisfactory. Perceived health was rated significantly lower among participants using long-term oxygen. Sufficient sense of coherence, knowledge of how to use technology, close contact with others and not feeling helpless contributed positively to self-care agency. Positive contributing factors for perceived health were being satisfied with life, having an active life and not feeling helpless, whereas age was a negative factor. Daily life is manageable for people in this context. Long-term oxygen treatment and advanced age can be regarded as risk factors for perceiving ill health.

FactOr Analysis Of the Appraisal Of Self-care Agency Scale in American Adults With Diabetes Mellitus

The purpose of this methodological secondary data analysis study is to examine the reliability, construct validity, and dimensionality of the Appraisal of Self-care Agency Scale (ASAS) in an American sample of adults with diabetes mellitus. The sample consisted of 141 insulin-requiring adults with diabetes mellitus recruited from a Diabetes Care Center in the southern United States. The ASAS, along with Hurley's Insulin Management Diabetes Self-efficacy and Insulin Management Diabetes Self-care Scales, was used in the study to determine convergent validity, thus contributing to the construct validity of the ASAS. Other data analysis consisted of internal consistency estimates of reliability, Pearson correlations, and factor analysis. The findings suggest that the ASAS consists of a single substantive dimension and has adequate construct validity and reliability. Revision of certain items and conducting further analysis of the scale, prior to its adoption in clinical practice, should be considered.

Clinical Application of Orem's Self-care Model of Nursing in a Chinese Community

ABSTRACTThis paper reports the clinical application of Orem's Self-care model of nursing in a Chinese community. Eighty-six patients from one major city of China, Tianjin, all of whom had end stage renal disease and were undergoing haemodialysis formed the sample of the study. The research instrument employed in the study was the modified version of the Appraisal of Self-care Agency Scale, developed for use with patients undergoing haemodialysis. The levels of self-care agency of the patients were identified with respect to the findings of the study. The relationships between the self-care agency and basic conditioning factors were investigated by the use of Spearman Rank Correlation Coefficients and the relationships were statistically supported by the findings of this research.

Contextualising the Appraisal of Self-care Agency Scale in Hong Kong

Published reports on the use of the Appraisal of Self-care Agency (ASA) Scale among Chinese people are scarce, the procedure of testing the ASA Scale is thus necessary before it is used clinically on Chinese population. The objective of this study was to test the validity and reliability of the ASA Scale on the Chinese population. Qualitative and quantitative approaches were adopted in testing the Scale. A panel of 4 experts was invited to examine the content of the Scale and 128 elderly people from 3 elderly centers in Hong Kong were employed to examine its construct validity. Item analysis was conducted using Cronbach’s Alpha coefficient to examine the reliability of the Scale. Content validity index of 0.88 was achieved resulting from the assessment of the 4 experts. Seven factors were extracted from the factor analysis representing approximately 70% of variance. The reliability coefficient for the entire Scale was 0.72. It was evident that the ASA Scale was a valid and reliable research instrument that can be used in the Chinese communities.

Self-care agency and quality of life among adults diagnosed with inflammatory bowel disease.

Individuals with inflammatory bowel disease (IBD) often exhibit anxiety and depression, pain and reduced energy but may not adequately develop self-care agency (SCA) to manage IBD. The purpose of this study was to examine whether SCA is related to quality of life in adults diagnosed with IBD. The sample of 34 individuals for this descriptive, correlational study completed three questionnaires including the Appraisal of self-care agency scale (A.S.A.-A Scale), the Inflammatory bowel disease questionnaire and a Demographic data questionnaire. Results indicated SCA was unrelated to indicators of quality of life among IBD individuals. This finding may be attributed to the high level of functioning of the sample. However, IBD quality of life (emotional functioning, social functioning, and bowel and systemic symptoms) was negatively correlated with the number of medications individuals took and positively correlated with the number of diagnosed chronic illnesses.

Self-care and quality of life in patients with advanced heart failure: The effect of a supportive educational intervention

Objective: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure. Design: The study design was an experimental, random assignment. Setting: The study was located at the University Hospital in Maastricht, The Netherlands. Patients: The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure. Outcome Measures: Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril’s ladder of life). Intervention: The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care. Results: Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up. Conclusion: A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life. (Heart Lung® 2000;29:319-30.)

The Effect of Item Observability, Clarity and Wording on Patient/Nurse Ratings when using the ASA Scale

Many studies show discrepancies between patients' and professionals' ratings on the same questionnaire regarding the patient's health. A relevant question is whether the differences in ratings reflect real differences between patients and professionals or whether they are caused by characteristics of the instrument. In this study, we address the latter option by examining the effects of 3 item characteristics (item wording, observability and clarity) on the degree of patient/nurse discrepancies in ratings of the items of the Appraisal of Self-care Agency (ASA) scale. Secondary analysis on 252 patient/nurse ratings showed that item wording (positively and negatively formulated items), and the observability of the items have a significant effect on the mean absolute difference score. No effect was found for clarity. These results were generally confirmed by subgroup analyses.

A Swedish version of the appraisal of Self-Care Agency (ASA) scale.

The "Appraisal of Self-care Agency" scale (the ASA scale) is designed to measure self-care agency in accordance with Orem's self-care deficit theory of nursing. The aim of this study was to obtain a reliable Swedish version of the ASA scale by measuring the internal consistency. ASA-A for self-appraisal and ASA-B for appraisal of another were tested with a convenience sample of 52 elderly in-patients and 53 caregivers in six geriatric care units. Cronbach's alpha reliability coefficient was 0.59 for the ASA-A scores, 0.77 for ASA-B scores obtained by caregivers comprising different professions, and 0.87 for scores obtained by registered nurses. Further testing of both validity and reliability is needed if this version of the scale is to be used in nursing research and practice.

Validity of Two Self-care Instruments for the Elderly.

The aim of this study was to address concurrent and construct validity of two instruments, the Self-care Ability Scale for the Elderly (SASE) and the self-report form of the Appraisal of Self-care Agency Scale (ASA-A), by testing them with home-dwelling, elderly Swedish patients. The two self-report instruments, including some additional new questions, were mailed to an age-stratified random sample of 420 elderly subjects and were finally completed by 125 of them. Bivariate and multivariate statistical methods were used in the analyses. An analysis of the non-respondents revealed no significant differences between them and the respondents. Standardized regression coefficients for reported abilities/activities on the scores were 0.71 for SASE (p < 0.0001) and for ASA-A 0.51 (p < 0.0001). SASE and ASA-A were found to measure related but not identical concepts (r = 0.69). Sensitivity and specificity ratings for managing without any help from official and unofficial caregivers were 68% and 72% respectively for SASE, and 50% and 64% for ASA-A. Individuals of 80+ years of age had lower scores than younger respondents on the SASE (p < 0.001) and ASA-A (p < 0.05) scales. Respondents living independently had higher scores on both scales than those living in institutions (p < 0.001). Lower scores on both scales were found for respondents who were not in good health compared with those who were in good health (p < 0.001). A five-factor solution for SASE explained 70.2% of the variances, and an eight-factor solution explained 67.9% of the variances for ASA-A. The results of this study confirm that the SASE and ASA-A assessments substantially measured what they were intended to measure in the studied group of lucid, elderly subjects.

The congruence of elderly client and nurse perceptions of the clients’ self‐care agency

Congruence of client and nurse perceptions is vital to mutual goal-setting as a means of achieving self-care in the elderly. The purpose of this descriptive, correlational study was to explore the relationship between nurse and elderly client perceptions of the clients' self-care agency. A sample of 40 elderly client subjects and registered nurses' selected from two community health agencies, completed a questionnaire consisting of three instruments: (a) a demographic sheet; (b) the appraisal of Self-Care Agency Scale; and (c) the Perceived Health Status. Pearson product moment correlation coefficients were significant for the relationships between: (a) client and nurse perceptions of clients' self-care agency (r = 0.42, P less than 0.01); (b) client and nurse perceptions of clients' health status (r = 0.38, P less than 0.01; and (c) nurse perceptions of clients' self-care agency and nurse perceptions of clients' health status (r = 0.44, P less than 0.01). With increasing emphasis on health promotion of the elderly in the community, identified relationships may have potential implications for gerontological and community nursing practice.