The aim of this study was to probe the rigorousness of the factor structure of the HDSMI and to test the instrument’s construct validity.
Cross-sectional study.
The hemodialysis unit of four hospitals in Taiwan provided data from 628 patients with end-stage renal disease (ESRD), through the period of September to December in 2012. The patients were divided into a calibration sample for CFA and model modification, and a validation sample for cross-validation of the postmodification model. Goodness of fit was tested with standard fit indices.
The four latent variables (i.e. partnership, self-care, problem-solving and emotional management) were verified as dimensions of HDSMI through CFA. The construct validity of the HDSMI was improved by omitting two items, allowing one inter-item correlation and transferring the loading of one item. These modifications improved fit indices of the calibration sample. Cross-validation of the validation sample verified the construct validity of the modified HDSMI-18.

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