Table 3.
Exploratory Factor Analysis and Item Factor Loadings for the Self-Care Maintenance, Self-Care Monitoring, Self-Care Management, and Self-Care Confidence Scales
| Self-Care Maintenance | Factor 1 Loadings | Factor 2 Loadings | Factor 3 Loadings | Factor 4 Loadings |
|---|---|---|---|---|
| 1-Maintaining an active lifestyle (e.g. walking, going outside, doing physical activities). | 0.853 | −0.009 | −0.115 | −0.033 |
| 2- Exercising 2.5 hrs a week (e.g. swimming, going to the gym, cycling, and walking). | 0.751 | −0.138 | −0.196 | 0.221 |
| 3- Eating a balanced diet of carbohydrates (pasta, rice, sugar, and bread), proteins (meat, fish, and beans), and fruits and vegetables. | 0.665 | 0.087 | 0.139 | 0.020 |
| 4- Avoiding salt and fat (e.g. cheese, pure meat, sweets, and red meat). | 0.563 | 0.228 | 0.177 | −0.099 |
| 12- Many people have difficulty taking all the medications prescribed for them. Do you take all the medication prescribed by your doctor? (If you take insulin, please consider it too). | −0.008 | 0.652 | 0.075 | 0.075 |
| 6- Trying to avoid illness (e.g. washing hands regularly, receiving the recommended vaccines). | 0.094 | 0.572 | −0.067 | −0.073 |
| 10- Visiting your doctor regularly. | −0.075 | 0.553 | −0.006 | 0.282 |
| 8- Taking care of your feet (washing and drying your feet regularly, keeping your feet wet, wearing proper socks). | −0.004 | 0.535 | −0.068 | −0.146 |
| 5- Limiting your use of non-alcoholic drinks containing high sugar levels or alcoholic drinks (less than one glass for women and two glasses for men). | 0.086 | −0.131 | 0.995 | −0.023 |
| 7- Avoiding smoking cigarettes and hookah. | −0.203 | 0.055 | 0.598 | 0.120 |
| 11- Regular health checkup (e.g. blood test, urine test, sonography, and eye examination). | 0.024 | −0.017 | 0.025 | 0.826 |
| 9- Taking care of your teeth and mouth (e.g. brushing your teeth at least twice a day, use of mouthwash, use of dental floss). | 0.098 | −0.082 | 0.101 | 0.560 |
| Self-Care Monitoring | Factor 1 Loadings | Factor 2 Loadings | Factor 3 Loadings | |
| 19-How fast did you notice the symptoms of high blood sugar (thirst, frequent urination) or low blood sugar (weakness, sweating, and anxiety)? | 0.989 | 0.022 | −0.019 | |
| 20- How fast did you notice that your symptoms were caused by diabetes? | 0.871 | −0.109 | 0.024 | |
| 13- Monitor your blood sugar? | 0.101 | 0.836 | −0.007 | |
| 14- Monitor your weight? | 0.002 | 0.663 | −0.028 | |
| 15- Monitor your blood pressure? | −0.134 | 0.449 | 0.013 | |
| 16- Write down your blood sugar levels? | 0.007 | −0.256 | 0.713 | |
| 17- Monitor your feet for injuries, red spots, or blisters on a daily basis? | 0.011 | 0.173 | 0.650 | |
| 18- Notice the symptoms of high blood sugar (thirst, frequent urination) and low blood sugar (weakness, sweating, and anxiety)? | −0.010 | 0.212 | 0.512 | |
| Self-Care Management | Factor 1 Loadings | Factor 2 Loadings | ||
| 26- If you notice that your blood sugar is too high, do you engage in physical activity to control it? | 0.737 | 0.011 | ||
| 25- When you experience the symptoms of diabetes and notice that your blood sugar is too high, do you balance your diet to control it? | 0.731 | −0.165 | ||
| 24- When you experience symptoms and notice that your blood sugar is too low, do you eat a food or drink a beverage high in sugar to solve this problem? | 0.686 | −0.152 | ||
| 21- Checking your blood sugar when experiencing such symptoms as thirst, frequent urination, weakness, sweating, and anxiety. | 0.563 | 0.126 | ||
| 27- After using some strategies to adjust your abnormal blood sugar levels, do you examine it again to see if the things you have done were effective? | 0.514 | 0.253 | ||
| 22- When your blood sugar is not in the normal range, do you take note of the things or behaviors causing it? | 0.103 | 0.776 | ||
| 28- If you notice that your blood sugar is too high or low, do you consult your doctor about it? | −0.139 | 0.392 | ||
| 23-When your blood sugar is not in the normal range, do you consult with your family members or friends? | 0.191 | 0.208 | ||
| Self-Care Confidence | Factor 1 Loadings | Factor 2 Loadings | ||
| 36- Detecting the symptoms of low blood sugar. | 0.787 | −0.208 | ||
| 30- Preventing blood sugar levels from going too high or low and related symptoms. | 0.731 | −0.029 | ||
| 34- Monitoring your blood sugar levels according to your doctor’s order. | 0.693 | 0.019 | ||
| 32- Taking your medications correctly (including insulin, if prescribed for you). | 0.660 | 0.123 | ||
| 31- Adhering to recommendations about diet and psychical activity. | 0.641 | 0.026 | ||
| 38- Engaging in activities that adjust your blood sugar levels and improve your symptoms. | 0.619 | 0.088 | ||
| 39- Examining whether your strategies to adjust blood sugar levels and improve your symptoms have been effective. | −0.212 | 0.833 | ||
| 37- Insisting on monitoring your diabetes, despite the possible difficulties. | 0.023 | 0.807 | ||
| 35- Realizing whether your blood sugar level is in the normal range. | −0.50 | 0.655 | ||
| 33- Insisting on adhering to the treatment regimen, despite the possible difficulties. | 0.258 | 0.629 | ||
| 40- Insisting on doing things that improve your blood sugar, no matter how difficult they are. | 0.258 | 0.523 |
Notes: Item 29 asking “If you notice that your blood sugar is too high or low, do you adjust your insulin doses according to what your doctor has prescribed?” was excluded by this analysis to maintain an adequate sample size because only patients taking insulin answer the question. However, it was included in the scoring of the scale when applicable to estimate internal consistency and construct validity. Thus, we recommend including this item when scoring Factor 2 labeled as “Consultative self-care management behaviors” and especially when scoring the whole Self-care management scale in people taking insulin.