Systematic review of measurement properties of self-care instruments in people with COPD
Background: Self-care is considered important in the management of COPD as it enables people to deal with symptoms and treatment regimes, and to adapt to illness-related lifestyle modifications. Several self-reported instruments have been developed and used to assess self-care and related concepts in people with COPD. However, clinicians and researchers are often not aware of the measurement properties of these instruments. Aims: To identify the instruments developed to assess self-care and related concepts in people with COPD, to evaluate their measurement properties. Methods: A systematic review was conducted on PubMed, CINAHL, PsycINFO, ISI Web of Knowledge, and EMBASE databases, including articles that describe the process of development and validation of SC instruments. The methodological quality and evidence synthesis was assessed. Results: 1,438 records were retrieved and 10 studies were ultimately included in the review. Five instruments were identified: two instruments evaluating self-care behaviors; one instrument assessing self-management and two scales considering self-efficacy. The COPD Self-Efficacy Scale (Wigal JK et al. Chest. 1991; 99(5):1193-1196) was the most validated, despite this its measurement properties were of poor methodological quality. The COPD Self-Management Scale was tested in one study only, showing more promise evidence (Zhang C et al. Respir Care. 2013; 58(11):1931-1936). Conclusions: Due to limited or unknown evidence about measurement properties, no instrument can be recommended for use in clinical practice. Further research is needed to develop valid and reliable instruments evaluating self-care and related concepts.