Two new tools for self-care in ostomy patients and their informal caregivers: Psychosocial, clinical, and operative aspects

Stoma patients and their caregivers need to be autonomous in stoma care, but there are few instruments for measuring the level of self-care. This study aims to develop and test the psychometric properties of the Ostomy Self-Care Index (OSCI) and the Caregiver Contribution to Self-Care in Ostomy Patient Index (CC-OSCI), from a clinical, operative and psychosocial perspective. A multicentre validation study was conducted on a convenience sample of 468 ostomy patients and 227 caregivers. The signed informed consent forms were obtained before data collection. Tool validation was performed by testing content validity, construct validity, criterion and internal consistency. Two indexes were developed, building on the self-care theory of chronic illness. For the OSCI, 32 items were developed and grouped into four 5-point Likert scales: maintenance, monitoring, management and confidence. For the CC-OSCI, 22 items were developed and grouped into three 5-point Likert scales: maintenance, monitoring and management. The content validity indexes for the OSCI and CC-OSCI were 95% and 93%, respectively. Exploratory factor analysis showed appropriate factor loadings (OSCI: min 0.395 to max 0.852; CC-OSCI: min 0.442 to max 0.841). Criterion validity was established through significant correlation between levels of quality of life, complications, readmissions and self-care in patients and caregivers. Strong internal consistency was found for the overall index, and within the scales (OSCI: alpha =0.975; CC-OSCI: alpha =0.972). The OSCI and CC-OSCI are valid and reliable indexes. Further studies specifically aimed at predicting the level of self-care are especially recommended.