THE EVALUATION OF THE VASCULAR DISEASE SELF-MANAGEMENT INSTRUMENT FOR ADULTS RECEIVING IN-CENTER/SATELLITE AND HOME HEMODIALYSIS: A FEASIBILITY STUDY

Abstract

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.