Psychometric Testing of the Thai Version of Self-Care of Chronic Illness Inventory Version 4c in Patients With Stroke

Abstract

Background Self-Care of Chronic Illness Inventory version 4c is a non-disease-specific self-care measure used in individuals with multiple chronic conditions. This instrument may be applied to patients with specific diseases such as stroke. Objective The aim of this study was to evaluate the psychometric properties of the Thai version of the Self-Care of Chronic Illness Inventory version 4c in patients with stroke. Methods This multicenter, cross-sectional study adhered to the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) guidelines and enrolled patients with stroke from 16 primary care centers in southern Thailand. Structural validity was assessed using confirmatory factor analysis, internal consistency reliability using Cronbach α coefficient and global reliability index, and test-retest reliability using intraclass correlation coefficients. Results The final analysis included a total of 350 participants. Confirmatory factor analysis supported the 2-factor Self-Care Maintenance scale structure, although the item allocation to the dimensions differed from that of the original model. The Self-Care Monitoring scale demonstrated a 1-factor structure with permitted residual covariance. The Self-Care Management scale maintained a 2-factor structure, similar to that of the original model. Simultaneous confirmatory factor analysis of the combined items supported the general model with the 3 scales. The Self-Care Maintenance scale exhibited marginally adequate α (0.68) and ω (0.66) coefficients, and an adequate composite reliability index (0.79). The other 2 scales demonstrated adequate α (range, 0.79-0.86), ω (range, 0.75-0.86), and composite reliability (range, 0.83-0.86) indices. Intraclass correlation coefficients showed adequate test-retest reliability for all scales (range, 0.76-0.90). Conclusions The generic self-care measure, Self-Care of Chronic Illness Inventory version 4c, demonstrated strong psychometric properties in patients with stroke. This instrument may be a valuable tool for assessing stroke self-care in Thailand.