Exploratory and confirmatory factor analysis of an urdu-version of the summary of diabetes self-care activities measure (U-SDSCA)

Purpose: The English version of the Summary of Diabetes Self-Care Activities (SDSCA) measure is the most widely used self-reporting tool assessing the diabetes self-management. This study is aimed at conducting the exploratory and confirmatory factor analysis of an Urdu version of the summary of diabetes self-management activities measure. Method: The Urdu version of SDSCA which was obtained following forward and backward translation of English version of SDSCA, was used for the purpose of exploratory and confirmatory analysis. The exploratory and confirmatory factor analysis were carried out on the large sample (n=200) of type 2 diabetic patients to explore the factors associated with the differences in diabetes self-management approach in the middle-aged population of rural area of Pakistan. Results: The exploratory factor analysis showed statistically significant interrelationship (95% level of significance, α = 0.05, p-value ˂ 0.001) between the variables of the Urdu version of the summary of diabetes self-care activities measure (U-SDSCA). The confirmatory factor analysis resulted in a good fit of the model with chi-squared = 48.9, CFI=0.94, TLI=0.95, RMSEA = 0.065, SPMR = 0.068. Once the items related to special diet with low factor loadings of 0.03 and 0.18 were removed from the analysis, the model was improved in terms of the chi-squared value (30.895) and the relevant model fit indices (CFI= 0.98, TLI=0.989, RMSEA = 0.045, SPMR =0.048). Conclusion: This study provided evidence for reliability and validity of Urdu Summary of Diabetes Self-Care Activities (U-SDSCA) instrument which can be administered to type 2 diabetic patients of rural area of Pakistan to assess their diabetes self-management activities. The exploratory factor analysis provided excellent results and confirmatory factor analysis resulted in a good fit of the model.