Background. A reliable and valid instrument printed in English that measures self-management for adults with vascular diseases receiving hemodialysis therapy was not found in the literature. The Vascular Disease Self-Management Instrument (VSMI) was developed to support the measurement and assessment of self-management.
Objectives. The primary objective was to assess the feasibility of the study methods to develop and explore the psychometric properties of the Vascular Disease Self-Management Instrument (VSMI) for adults receiving hemodialysis therapy. Feasibility outcomes included recruitment, consent and completion rates. The secondary objective was to begin to explore the reliability (internal consistency and test-retest), and construct validity using exploratory factor analysis and criterion-related validity.
Method. This feasibility study used seminal work (Thabane et al., 2010) and clinical expertise to determine feasibility outcomes. Examination of psychometric properties was based on Streiner & Norman (2008).
Results. Of the 267 eligible patients, a total of 136 patients were recruited into the study. The consent rate was 51% and completion rate was 32% for the test-retest analysis. Study participants were primarily male (61%), diagnosed with chronic kidney disease for 12 years and receiving hemodialysis therapy for 6 years. Half (50%) the participants were at moderate risk for psychological distress and used avoidant-oriented coping. Preliminary psychometric analysis suggested good reliability (Cronbach’s alpha = 0.945) and stability (Intraclass correlation coefficient = 0.927, p <0.0001). The results of the exploratory factor analysis indicated four main factors comprised the self-management instrument including collaborative partnerships, self-advocacy, self-monitoring and normalcy. Preliminary evidence of criterion-related validity demonstrated a significant positive relationship between task-orientated coping and self-management.
Conclusion. Feasibility outcomes were successfully met. Preliminary evidence suggests that the VSMI has the potential to become a reliable and valid instrument. A full-scale psychometric evaluation with a sample that includes adults receiving peritoneal dialysis is needed to support utilization of the VSMI in research and clinical practice. / Dissertation / Doctor of Philosophy (PhD) / Background: Adults receiving dialysis therapy must engage in self-management of their illnesses. A questionnaire on self-management activities based on the individuals’ experiences would help health care providers to identify areas where people struggle. This information could be used to develop programs that support self-management.
What Did We Learn: A total of 136 people took part in the study. The development and testing of a self-management questionnaire for adults undergoing hemodialysis is a worthwhile and reasonable goal. The questionnaire provided people with the opportunity to describe their self-management activities. Half the people that participated in the study were at risk for experiencing anxiety and depression and tried to avoid stress.
Conclusions: The questionnaire would assist health care providers to engage in future research projects and develop programs and resources that help people more independently manages their illnesses.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/19105 |
| Date | 14 June 2016 |
| Creators | Costantini, Lucia |
| Contributors | Browne, Gina, Nursing |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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