Character Strengths Use in Diabetes Self-management Scale: Development and psychometric testing.

Aims: To develop and psychometrically test Character Strengths Use in Diabetes Self-management Scale in people with type 2 diabetes.

Design: Cross-sectional design.

Methods: Based on literature reviews and examination by experts, a 20-item scale was developed and administered to 350 participants with type 2 diabetes who were enrolled from two endocrine clinics by convenience sampling in Taiwan. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), concurrent and predictive validity as well as reliability were used to examine the psychometric characteristics of the scale. Data were collected from November 2021 to March 2022.

Results: EFA and CFA supported a 12-item scale with three factors, namely learning proactively, taking on challenges and thinking positively, fit the data well. The total score of the 12-item scale significantly and positively correlated with diabetes-specific quality of life, and significantly and negatively correlated with baseline and 9-month haemoglobin A1c levels. Cronbach's α for overall scale and subscales ranged between .78 and .91.

Conclusion: The 12-item Character Strengths Use in Diabetes Self-management Scale demonstrated satisfactory validity and reliability in people with type 2 diabetes.

Impact: Nurses could apply this new scale to identify the degree of using character strengths in self-management in people with type 2 diabetes; accordingly, character strength-based interventions could be provided to improve self-management in such patients with diabetes. Furthermore, the 12-item Character Strengths Use in Diabetes Self-management Scale has the potential to be used to measure the effectiveness of strength-based interventions in people with Type 2 diabetes.

Patient Or Public Contribution: Five patients with type 2 diabetes were invited to take the original 20-item scale to evaluate the clarity, readability and comprehensiveness of the 20 items.