[Self-care Assessment in Type-2 Diabetes: the Italian Translation and Validation of the Summary of Diabetes Self-Care Activities]

Introduction: Self-care represents a key factor for diabetes patients to maintain quality of life and to prevent serious disease complications. Self-care standardized assessment tools are needed to evaluate and to promote self-care in diabetes patients. The Summary of Diabetes Self-Care Activities Scale (SDSCA) has been widely used in clinical and research settings and has been translated in many languages. Validity and reliability of this self-report scale were reported by several studies. However, SDSCA has not yet been translated, culturally adapted and tested in the Italian context. The aim of this methodological research was to translate and to provide a first validation study of the Italian SDSCA - 11 item Version.

Methods: A process of translation, back-translation and semantic concordance evaluation has been performed in order to translate the SDSCA into Italian language in collaboration with the original authors. A cross-sectional survey has been planned to test internal consistency and test -retest reliability on a convenience sample of 80 type 2 diabetes patients. As secondary objective, SDSCA criterion validity has been explored referring to a range of clinical outcomes as glicated emoglobin and presence of complications.

Results: A description of respondents' self-care abilities is provided for the whole sample and for sub-groups by gender, age, instruction and income levels. Cronbach's Alfa and Intraclass Correlation Coefficient showed acceptable values considering the multidimensionality of SDSCA. High values were obtained in 3 out of 5 sub-classes of items. As in previous studies, specific diet and physical exercise sub-classes showed limited internal consistency. Cohen's Kappa Concordance Correlation Coefficient and t-test demonstrated high test-retest reliability of SDSCA. Overall SDSCA score did not show significant correlations with selected clinical outcomes; however 3 SDSCA single items significantly correlated with glicated emoglobin, complications and the clinical judgment of the diabetes case manager nurse.

Conclusion: Further researches involving larger samples are needed to integrate data about Italian SDSCA performances, especially concerning construct and criterion validity. However, based on these preliminary results, SDSCA could find relevant applications in clinical settings to systematically evaluate, to compare over time and to improve specific self-care abilities of diabetes patients.