Diabetes mellitus is difficult to cure and has a long process. The level of self-care is crucial for determining the regression and health outcomes of patients with diabetes. A comprehensive and theory-based tool is urgently needed to assess the level of self-care of diabetes. In this way, the self-care of patients with diabetes can be kept up to date and accurate nursing care can be carried out.

To examine the psychometric properties of the Chinese version of Self-Care of Diabetes Inventory (SCODI) , and provide a scientifically validated assessment tool for the self-care of Chinese patients with diabetes.

The Brislin Translation Model was used for translation and cultural adaptation of the English version of the SCODI into Chinese. A total of 261 adult patients with diabetes were enrolled using a consecutive sampling method at the First Affiliated Hospital and the Affiliated Sir Run Run Hospital of Nanjing Medical University from December 2022 to June 2023. Data were collected using a self-developed general information questionnaire and the Chinese version of SCODI.Exploratory factor analysis was used to assess the structural validity. Cronbach's α, split-half reliability and composite reliability were used to describe the reliability. Glycosylated hemoglobin was used as a criterion to assess the criterion-related validity. Spearman's rank correlation analysis was used to examinate the correlation between the Chinese version of SCODI score and glycosylated hemoglobin.

The Chinses version of SCODI contained 4 dimensions and 40 items: self-care maintenance score (75.94±13.15) , self-care monitoring score (70.65±18.71) , self-care management score (69.16±18.24) , and self-care confidence score (85.41±13.63) . In the self-care maintenance dimension, 4 factors were identified: complication screening behaviors, exercise behaviors, hygienic care behaviors and diet-medication behaviors. The self-care monitoring dimension had 2 factors: physical monitoring and symptom identification. The self-care management dimension included 2 factors: autonomous behaviors and counseling behaviors. Two factors were extracted from the self-care confidence dimension: monitoring and managing confidence, health maintenance confidence. The Cronbach's α, split-half reliability and composite reliability values for the total scale were 0.915, 0.836 and 0.912, respectively. The Cronbach's α for the four dimensions were 0.709-0.908. A significantly negative correlation was observed between each subscale and glycosylated hemoglobin (r_s=-0.160, -0.300, -0.177, -0.192; P<0.001) , serving as a criterion.

Based on the middle-range theory of self-care of chronic illness, the Chinese version of SCODI exhibits strong psychometric properties, making it a valid and reliable instrument for evaluating self-care of Chinese patients with diabetes.