Development and Psychometric Testing of the Inventory of Self‐Care Decision‐Making Styles of Older Adults

TL;DR

This paper introduces a new tool to measure how older adults make self-care decisions, showing it is valid and reliable.

Contribution

The study developed and validated a new instrument, the DECIDE Inventory, for assessing self-care decision-making styles in older adults.

Findings

The DECIDE Inventory measures four decision-making styles: independent, responsible, self-neglected, and guided.

Confirmatory factor analyses supported the structural validity of the four-scale model.

Reliability indicators showed adequate to optimal results across all scales.

Abstract

Understanding how older adults make decisions about their self‐care is essential for designing tailored interventions that promote autonomy and well‐being. However, no instrument currently exists to specifically measure self‐care decision‐making styles in this population. The study aimed to develop and test the psychometric properties of the Self‐Care Decision‐Making Styles of Older Adult (DECIDE) Inventory, a new instrument designed to assess styles of self‐care decision‐making among older adults. A three‐phase process was undertaken: (i) instrument development based on theory and previous studies; (ii) content validity evaluation with 10 experts and cognitive interviews with 10 older adults; and (iii) psychometric testing, including assessment of structural and construct validity, internal consistency, and test‐retest reliability. A convenience sample of 350 older adults from various Italian regions participated in the validation phase. The study followed the COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) reporting guidelines. Following content validation, an instrument was finalized, assessing four decision‐making styles—independent, responsible, self‐neglected, and guided—, with five items per scale. Confirmatory factor analyses supported the structural validity of the four‐scale model. Construct validity was confirmed through hypothesis testing. Reliability indicators, including Omega coefficients, factor score determinacy, item‐total correlations, and intraclass correlation coefficients, ranged from adequate to optimal across all scales. The Self‐Care Decision‐Making Styles of Older Adult Inventory demonstrated good validity and adequate reliability for assessing self‐care decision‐making styles in older adults. Further refinement and cross‐cultural validation are recommended before its use in clinical practice.