Roy Adaptation Model-based adjustment scale in patients with type 2 diabetes: a scale development study

Abstract

Background. In order to prevent complications in diabetes mellitus, it is expected that the individual should regulate his diet and physical activity according to diabetes, apply medication correctly and monitor himself. Living with a chronic disease requires paying attention to bodily stimuli, carefully planning daily living activities, and developing new strategies. The purpose of this study is to develop a measurement tool based on the Roy Adaptation Model that measures the level of adherence to treatment in patients with type 2 diabetes. Materials and methods. The methodologically planned study was conducted in 298 patients who applied to the Endocrinology Clinic of a university hospital between June 2018 and May 2019. Patient information form and draft scale were used to collect data. In the study, first of all, an item pool was created and sent to 10 experts for evaluation. The study, which was applied as a pilot to 30 participants, was then applied to the original sample. Confirmatory and explanatory factor analysis was used to determine the construct validity, and the suitability of the data set for analysis was evaluated with KMO and Bartlett tests. Cronbach’s α coefficient and item-total correlations were used to determine the internal validity of the scale. Evaluation of the data was done with SPSS 17 and LISREL 8.8 package programs. Results. The KGI score of the item pool sent to 10 experts was determined as 0.90. As a result of expert opinion and pilot implementation, the number of items decreased to 52. KMO value of the scale was determined as 0.874, Bartlett value as x2 = 9040.243, p = 0.000. It was found that the factor loads of all items of the scale were above 0.30, the total explained variance was 53.33 %, and it consisted of four sub-dimensions. In confirmatory factor analysis, it was determined as x2/SD 3.54, GFI 0.89, AGFI 0.87, CFI 1.00, RMSEA 0.079 and SRMR 0.080, and the number of items decreased to 39. The Cronbach’s α coefficient of the scale with four sub-dimensions and 39 items is 0.899, and all item-total score correlations were positive. Conclusions. Roy Adaptation Model-based adjustment scale is a valid and reliable measurement tool that can be used to evaluate adherence to treatment in type 2 diabetes patients.