The provision of self-management support to patients with type 2 diabetes mellitus in routine primary care: the development, validity and reliability of a screening instrument
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Title: The provision of self-management support to patients with type 2 diabetes mellitus (DM2) in routine primary care: the development, validity and reliability of a screening instrument (SI). Background: Practice nurses (PNs) differently integrate self-management support into their consultations. As a result, there is a lack of insight into the provision of self-management support to patients with DM2 in routine primary care. Although it is recommended to collect and record this information, there is no SI which can be used for this purpose. Aim: To develop and assess the validity and reliability of a disease-transcending (chronic obstructive pulmonary disease (COPD), asthma and DM2) SI. This paper exclusively reports on the results obtained for patients with DM2. Method: This study was conducted in three phases. In the first phase a literature review was performed. In the second phase the face validity was assessed by nursing researchers. The content validity was assessed by two focus groups (one with patients with COPD, asthma and DM2 and one with PNs) and one expert panel, using the Content Validity Index (CVI). The inter-rater reliability was assessed in the third phase. Results: The final SI consists of 10 themes and 15 items. The face validity was rated with an 8.7 (themes) and 7.7 (items). The focus groups added valuable information about the relevance of the themes and items from the participants’ perspectives. The scale-level CVI was 0.99. A percent agreement and kappa of 83.7 and 0.72 were found for the themes and of 88.1 and 0.75 for the items. Conclusion: The SI has excellent validity and good of reliability. Recommendations: The SI can be used in practice and future research to obtain insight into the provision of self-management support to patients with DM2 in routine primary care.