Development and preliminary validation of the chronic hepatitis B self-management scale

Backgrounds: Chronic hepatitis B (CHB) patients may face many problems resulted from their conditions. To delay the progress of CHB, patients should be responsible for the management of their conditions. There is no dedicated scale for assessing self-management behaviors of CHB patients.
Objectives: This study aimed to develop and validate a self-report measure designed to assess the self-management behaviors for CHB patients (CHBSMS).
Design: A cross-sectional descriptive study design.
Setting: Participants were recruited from the infectious disease department of two hospitals in China.
Participants: A sample of 248 and 346 CHB patients for item analysis and test for validity and reliability, respectively.
Methods: An initial 45-item scale developed based on item generation and a two-round Delphi survey was assessed by CHB patients for item analysis to develop a final scale. Construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Chronic Disease Self-Management Behavior Scale (CDSMBS) was used to test the criterion validity. Internal consistency and test-retest reliability were assessed by Cronbach’s α coefficient and intraclass correlation coefficient (ICC), respectively.
Results: A 25-item scale was developed. EFA indicated a four-factor structure (symptom management, lifestyle management, psychosocial coping and disease information management), which accounted for 58.149% of the total variance. CFA indicated appropriate fit of the four-factor model. The total scores of CHBSMS was correlated with that of CDSMBS (r = 0.634, P < 0.01). The Cronbach’s α coefficient (α = 0.887) and the test-retest correlation coefficient (ICC = 0.871) showed good internal consistency and stability of the scale.
Conclusions: The 25-item CHBSMS is a reliable and valid measure that can be used to assess the self-management behaviors of CHB patients for improving patient education and health-related outcomes.