N04 Linking adherence and self-care in IBD

Purpose: Depression is common among patients with inflammatory bowel disease (IBD). Less is known about depression in the elderly population with IBD. Within an elderly IBD population, we aimed to 1) assess factors associated with depression and 2) determine whether depression is associated with disease activity, quality of life, or medication adherence. Methods: We identified elderly (≥65 years) individuals within Crohn's and Colitis Foundation of America (CCFA) Partners, an online cohort of over 10,000 patients living with self-reported IBD. Individuals were asked to complete the short- geriatric depression scale (GDS), a 15 question validated tool used to assess depression in the elderly population. A score of ≥5 on this scale suggests depression. We used bivariate statistics to determine whether demographic or disease related factors, disease activity (as measured by the short Crohn's disease activity index (sCDAI) or simple clinical colitis activity index (SCCAI), quality of life (measured by the short inflammatory bowel disease questionnaire (SIBDQ) and medication adherence (measured by the Morisky medication adherence scale (MMAS)) were associated with depression. We then used logistic regression to estimate the independent effects of depression on medication adherence. Results: A total of 359 elderly individuals with IBD completed the GDS. The mean age was 70.2 years (sd 4.7), with a mean disease duration of 25.6 years (sd 17.6). The prevalence of depression was 22.6%. Neither age, disease duration, nor gender differed by depression status. Lower education levels were significantly associated with depression (p=0.001). For both Crohn's disease (CD) and ulcerative colitis (UC), those with depression had significantly increased disease activity when compared to those without (sCDAI 52.5 versus 29, p=0.005 and SCCAI 5 versus 2, p=0.003). Depressed patients also had significantly lower health related quality of life (SIBDQ 4.6 versus 5.7, p<0.001) and lower medication adherence (p=0.01). Those with depression were more likely to have reduced medication adherence, even after controlling for disease activity (OR 2.49; 95% CI 1.26-4.92). Conclusion: Depression is common in this geriatric IBD cohort. Traditional risk factors for depression in the elderly, such as female gender and advancing age, are not associated with depression in geriatric IBD. Depression is independently associated with reduced medication adherence. The short GDS is a feasible tool for depression screening in the elderly IBD population that may allow for improved recognition and outcomes.

Background: Self-Care is essential for chronic illness management. Self-Care comprises three domains: Self-Care maintenance (daily behaviors to maintain health [e.g., medication adherence]), Self-Care monitoring (surveillance for changes), and (3) Self-Care management (prompt response to symptoms). The COVID-19 pandemic challenged self-care in some populations, but little is known about how it influenced the self-care of African immigrants living in the US with chronic illnesses such as hypertension and diabetes. Methods: Using a qualitative descriptive design, we enrolled a purposeful sample of 24 sub-Saharan African immigrant adults with self-reported symptomatic hypertension or diabetes. Participants who spoke English were enrolled between March 2020 and September 2021. Individual audio-taped interviews were transcribed and analyzed. Inductive and deductive thematic analysis was guided by the Theory of Self-Care of Chronic Illness. Results: Participants were mean=59 years (range 40-72). Most were Nigerian (n=16), male (n=16), married (n=17), living with family (n=21), highly educated (n=21), and reporting enough income to meet their needs (n=21). Five major themes were identified: (1) Being especially careful in following COVID-19 precautions (e.g., use of facemasks). (2) A focus on self-care maintenance (e.g., healthy diet, staying active while at home). Fear of COVID-19 increased medication adherence. Participants were diligent in taking medications as prescribed due to fear of COVID-19. (3) Close monitoring for symptoms. (4) Trouble reaching providers to discuss symptoms. (5) Access to resources. Participants reported loss of health insurance/jobs and lack of provider access, which impacted their ability to perform self-care. Conclusions: COVID-19 increased focused attention on self-care but also created barriers for sub-Saharan African Immigrants. Most impacted was self-care maintenance. Interventions to promote self-care in this population should leverage heightened vigilance to self-care and address challenges around access to resources.

Objectives: To assess the patient medication adherence using 8 item morisky medication adherence scale (MMAS). To categorize patients based on their adherence to antidiabetic medications into low, medium, and high adherent. To provide educational interventions such as patient counseling using teach-back method, patient medication information leaflet, and audio-visual aids and thus to improve the patient medication adherence.Methods: After obtaining informed consent from the patients, data of the patients were recorded in data collection forms. Their adherence to antidiabetic medication was evaluated using 8 item MMAS and patients were categorized into low, medium, and high adherence groups based on the score. Counseling was done based on the categorization (high, medium, and low). During review, again adherence was rechecked using 8 item MMAS.Results: Medication adherence was measured using 8 item MMAS on review and adherence was found to be improved using different patient counseling methods according to their adherence category. Improvement in score within low adherence group was found to be 83.87%; improvement of the low adherence group to medium adherence group was 16.12%. Improvement within the medium adherence group was 82.14% and from medium adherence to high adherence group was 17.85%.Conclusion: Patient counseling can improve adherence in type 2 diabetes mellitus patients, which in turn help patients in achieving optimal glycemic control.

To date no adherence survey has been validated in IBD. The aim was to administer an improved medication adherence survey to IBD patients, to validate the scale in IBD, and to compare the results to perceived adherence by the gastroenterologists. IBD patients were given the Morisky Medication Adherence Scale (MMAS-8). To validate the scale, prescription claim information, calculated as continuous single-interval medication availability (CSA) and mean possession ratio (MPR), was correlated to the MMAS-8 scale. Nonpersistence or low adherence was defined as a CSA or MPR<0.8. Treating gastroenterologists, blinded to the instrument, then assessed adherence in these patients. Of 110 IBD patients in the study, MMAS-8 identified 54 patients as low adherers (LAs) to their IBD medication and 56 patients as medium or high adherers (MHAs). Eighty-five percent of LAs had nonpersistent fill rates, as per CSA, compared with 11% of MHAs. Physicians correctly classified 95% of patients who were MHAs but only 33% of LAs. Underestimation of adherence only occurred in 5% of patients, whereas overestimation occurred in 67% (P<0.0001). In a linear regression analysis, CSA was significantly correlated with disease activity score (P<0.001). LAs are a challenge to identify. This study demonstrates that the MMAS-8 scale is a valid instrument for assessing medication adherence in IBD. This is the first adherence scale to be validated in IBD.

Background Patients with heart failure (HF) experience challenges in self-care that contribute to poor quality of life and high health care utilization. The COVID-19 pandemic required HF patients, especially living in countries with strict lockdowns and quarantines, to change their lifestyle including health promoting behaviors. Purpose To assess changes in self-care maintenance in patients with HF changed during quarantine compared to before quarantine. We hypothesized that the self-care maintenance behavior physical activity was most effected during quarantine. Method This is a cross-sectional survey study. From the medical chart, patients' disease severity (NYHA-class), ejection fraction and comorbidities were collected. Self-care maintenance was assessed using subscale Self-Care of Heart Failure Index 6.2. The total score ranges from 0–100, where 70 or higher is seen as having good self-care maintenance. With all the questions in the self-care maintenance scale a question was added: Did this change due to the COVID-19 pandemic? Patients could answer yes or no. When patients answered yes, they were asked the elaborate. Patients self-reported physical activity, before and during the pandemic, using the International Physical Activity Questionnaire (short form). Descriptive analyses were used for self-care maintenance, content analysis was applied for the qualitative data. Paired sample t-test were performed to assess the change in the total physical activity. Results In total, 120 patients with HF were included in this study (mean age was 79±13, 39% female, 78% NYHA-class I/II). Patients had a mean self-care maintenance of 32 (±6). No participant had good self-care maintenance (score of 70 or higher). Patients were non-adherent to regular physical activity (77%, n=92), keeping weight down (74%, n=89) and weighing themselves (66%, n=79) during quarantine (Figure). Behaviors which changed the most included keeping medical appointments (81%) and regular exercise (82%). Significantly higher levels of physically active was noticed before quarantine (776 Mets-minutes) compared to during quarantine (106 Mets-minutes) (p&amp;lt;0.01). The change in self-care maintenance was explained by change in motivation and self-confidence. Because of the pandemic and the quarantine, patients reported not being able to rely on health care and their usual social support system. Patients tried to create new habits when trying to maintain their self-care. Conclusion Patients with HF reported experiencing low self-care maintenance during quarantine due to not being able to go to medical appointments and decrease in physical activity. Public health policies during crisis events such as a pandemic should strive to provide support in coping with these changes and offer alternative ways of maintaining their self-care maintenance, especially with physical activity. Funding Acknowledgement Type of funding sources: None.

To evaluate the effect of mutuality on self-care in people with CHD and the contribution of their caregivers, and whether such relationships can be mediated by self-efficacy. Secondary analysis of baseline data from a multi-centre longitudinal study. Patients at the onset of coronary artery disease who underwent angioplasty, along with their caregivers, were included in the sample. Data from 136 patients and 136 caregivers were used for the analysis. Mutuality between patients and caregivers was measured using the Mutuality Scale. Self-care was measured using the Self-Care of Coronary Heart Disease Index and the Caregiver Contribution to Self-Care of Coronary Heart Disease Index. The actor-partner interdependence mediation models were used to assess the mediating role of self-efficacy for self-care between perceived mutuality and self-care behaviours. An actor indirect effect was found between patient mutuality and their self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on their contribution to self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on patient self-care maintenance and on patient self-care monitoring, through the mediation of patient self-efficacy. All models demonstrated satisfactory fit to the data. Mutuality between patients and caregivers enhances self-care behaviours in patients with coronary heart disease, and self-efficacy is a crucial mediator in this relationship. Interventions targeting both mutuality and self-efficacy within patient-caregiver dyads may improve self-care outcomes. We adhered to STROBE guidelines. Patients and members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research.

The aim of the present study was to evaluate the impact of adverse drug events (ADEs) and treatment satisfaction on antihypertensive medication adherence. A cross-sectional study was conducted in six public hospitals in Ethiopia. We included adult ambulatory patients on antihypertensive medication. Adherence was measured using the eight-point Morisky Medication Adherence Scale, which categorizes as low (0-5), medium (6-7) and high (8) adherence. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4, which included questions about ADEs. Data were analysed using generalized ordered logistic regression with 95% confidence intervals (CIs). We included 925 out of 968 patients. Overall, 42% of patients scored low, 37% medium and 21% high adherence. Satisfaction with treatment was low, with a mean (standard deviation) TSQM score for global satisfaction of 51 (14). A total of 193 (21%) patients experienced 421 ADEs - mainly dyspeptic symptoms (12%), headache (11%) and cough (11). Experiencing more ADEs reduced the odds of being adherent [low vs. medium/high: odds ratio (OR) OR1 0.77 (95% CI 0.67, 0.89), and low/medium vs. high: OR2 0.55 (05% CI 0.41, 0.73)]. Being more satisfied increased the odds of being adherent [low vs. medium/high: OR1 1.02 (95% CI 1.01, 1.03)]. Taking medication >1year [OR1=2 , 0.60 (95% CI 0.43, 0.83)] and taking calcium channel blockers [OR1=2 0.71 (95% CI 0.54, 0.92)] decreased the odds for both low vs. medium/high and low/medium vs. high adherence. Only one in five patients reported perfect (high) adherence to their antihypertensive treatment regimen. Experiencing ADEs and being dissatisfied with treatment were associated with lower adherence. In addition to addressing treatment satisfaction and drug safety in first-world countries, these should also be addressed in resource-poor settings, within patient consultations, to enhance adherence.

Patients with inflammatory bowel disease (IBD) suffer physical dysfunction and impaired quality of life (QOL), and need frequent health care. They often lack knowledge about their disease and desire more education. Educational interventions for other chronic diseases have demonstrated reduced health care use and increased knowledge, medication adherence and QOL. Sixty-nine participants were randomly assigned to formal IBD education and standard of care (pamphlets and ad hoc physician education) or standard of care alone. Assessment of IBD knowledge and QOL occurred at baseline, immediately posteducation and eight weeks posteducation. Participants documented medication adherence and health care use in diaries. Patient satisfaction was assessed at the end of the study. The education group had higher knowledge scores (P=0.000), perceived knowledge ratings (P=0.01) and patient satisfaction (P=0.001). There was a lower rate of medication nonadherence and health care use for the education group, but the differences were not significant. QOL indices did not change. Significant correlations were found for increased health care use in patients with poorer medication adherence (P=0.01) and lower perceived health (P=0.05). Formal IBD patient education improves knowledge, perceived knowledge and patient satisfaction. Further study of long-term effects may better demonstrate potential benefits for QOL, medication adherence and health care use.

Background/Introduction Educational interventions have been developed and tested in an attempt to improve health-related quality of life (HRQOL) for patients with heart failure (HF). While some have shown satisfactory results, the mechanism of the intervention effect on HRQOL remains unclear. Purpose To explore whether HF knowledge, self-care behaviours, self-care maintenance, self-care confidence, or social support mediates the effect of intervention on HRQOL of patients with HF Methods We analysed data from a randomized controlled trial testing the effect of an educational intervention for patients with HF. The intervention group (n=60) received 1-hour single session education followed by 8-week telephone follow-ups, and the control group (n=62) received care as usual. Study variables were measured at baseline and at 3 and 6 months. Using causal mediation analysis described by Valeri &amp; VanderWeele (2013), we explored the causal pathway between intervention allocation and HRQOL at 6 months with HF knowledge, self-care behaviours, self-care maintenance, self-care confidence, and social support measured at 3 months as potential mediators (Figure 1). Results Intervention allocation was significantly associated with HF knowledge, self-care behaviours, self-care maintenance, and self-care confidence at 3 months (all p&amp;lt;0.05), but not with social support at 3 months (p=0.57). In unadjusted models, none of the potential mediators had a significant indirect effect between intervention and HRQOL. When adjusting for age and gender, the indirect effect of self-care behaviours on 6-month HRQOL became significant (indirect effect −6.24, 95% CI: −12.88 to −1.18). When baseline values of the mediator and HRQOL were adjusted in addition to age and gender, the indirect effect of self-care behaviours remained significant (indirect effect −7.18, 95% CI: −13.48 to −2.35) and the indirect effect of self-care maintenance became significant (indirect effect −3.02, 95% CI: −7.94 to −0.07). Conclusion Our findings support the mediating role of self-care behaviours on the relationship between the educational intervention and HRQOL of patients with HF. In order to successfully improve HRQOL of patients with HF, educational interventions should aim to promote self-care behaviours, especially by encouraging treatment adherence and self-monitoring. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Seoul National University, College of Medicine Figure 1. Mediation model

Tuberculosis (TB) remains a major global health concern, particularly in high-burden countries such as Indonesia. Although TB is curable, prolonged therapy, potential adverse effects, and social stigma may affect medication adherence and patients’ quality of life (QoL). Evaluating the association between adherence and QoL is important to support patient-centered TB management. This study aimed to examine the association between medication adherence and quality of life among tuberculosis patients at Permata Kuningan Hospital. A cross-sectional analytic study was conducted involving 62 TB patients selected through purposive sampling. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8), and quality of life was measured using the EQ-5D-5L instrument. Data were analyzed using Spearman rank correlation. Most patients demonstrated high adherence (95.2%) and reported good quality of life (96.8%). Statistical analysis showed a significant positive correlation between medication adherence and quality of life (r = 0.384; p = 0.002), indicating that higher adherence was associated with better quality of life. These findings suggest a significant association between medication adherence and quality of life among TB patients. Strategies to support adherence, including education, counseling, and monitoring, may be considered as part of comprehensive TB care to optimize patient-centered outcomes.

Background: Hypertension is the most common disease in India where 1 in 4 people suffering with it. In order to achieve the intended therapeutic outcomes, medication adherence is essential. Patients with hypertension must adhere to their disease by taking their prescriptions on time, following their diet, and making other lifestyle modifications. This study aims to assess medication adherence in Warangal population among hypertensive patients with comorbidities, social habits, medication use etc. Aims: The aim of the study is to assess the level of medication adherence and to investigate predictors of medication adherence and controlled hypertension in patients and to identify the factors enhancing medication adherence. The secondary aim is to describe the extent and type of medication used in patient population in Warangal. Study Design: An Observational, retrospective and cross - sectional study was employed to assess the predictors and level of medication adherence in hypertensive patients. Place and Duration of Study: Department of Cardiology, Sri Sri Cardiac Centre and Bhageerath Cardiac Care Centre, Hanamkonda, Warangal. The study was conducted from October 2022 to April 2023 for about a duration of 7 months. Methodology: This study includes 300 Hypertensive patients (Male - 169, Female 131) of age range between 20-90 years with various comorbidities like diabetes mellitus, coronary artery disease, hypothyroidism, dyslipidemia, COPD. We also included various sociodemographic factors like Gender, Age, Literacy, Income status, Alcohol consumption, Smoking status, Marital status, Controlled and Uncontrolled hypertension, usage of various drugs and Duration of hypertension. We observed Medication Adherence by using MMAS 8 scale. Results: Low levels of medication adherence among female patients (41%), educated patients (58%) compared to other groups because of awareness about their condition. Low adherence is noted in patients with low-income status ( 9.6% ), High adherence in nonsmokers (73.3%) and non-alcoholic (60.6%) compared to smokers (10.6%) and alcoholics (12.6%) and high adherence is reported in married (85%) category as compared to unmarried (2.6%), Patients with low comorbidities reported high adherence compared to patients with low comorbidities. High medication adherence is reported in uncontrolled blood pressure (50.3%) and in patients with \(\le\) year (24.6%) and 2-6 years (28%) of duration of hypertension. High adherence is noted with 2 combination therapy (23.6%), most of the participants are adherent to Telmisartan+ Metoprolol (25.2%) followed by Telmisartan+ hydrochlorothiazide (19.3%). According to MMAS-8 scale most of the patients reported (Q1) and (Q6), 91.3% of our study population were adherent to their medication, 7% were moderately adherent and 1.6% were low adherent to their medication. Conclusion: 91.3% of Medication adherence is noted in hypertensive patients in Warangal population. 8.6% of Medication Non-Adherence is noted and various factors for nonadherence were reported by patients. However various methods and apps should be developed to overcome the Medication Non-Adherence.

Background Dyslipidemia affects approximately one-third of Saudi Arabia's adult population. Dyslipidemia, hypertension, diabetes mellitus (DM), smoking, and a familial predisposition to cardiovascular disease (CVD) are significant risk factors for CVD. It can be prevented effectively through lifestyle changes and lifelong statin therapy; however, poor adherence limits its effectiveness. This study is designed to assess the level of adherence to statin prescription in patients with DM in diabetic centers in the Qassim region and to assess the factors associated with neglecting to take medication. Methodology A cross-sectional study was conducted among 226 diabetic patients who were prescribed statins. Medication adherence was assessed using the eight-item Morisky Medication Adherence Scale (MMAS-8). Demographic and clinical data were collected, and multivariate logistic regression analysis was used to identify factors associated with medication adherence. Results Of the 226 patients, 29.7% had high adherence, 32.7% had medium adherence, and 37.6% had low adherence to statin medication. Patients diagnosed with diabetes for less than five years had the highest proportion of low adherence (41.2%). No significant associations were found between medication adherence and gender, nationality, or educational level. Conclusion The study found that medication adherence to statins in diabetic patients in the Al Qassim region of Saudi Arabia is suboptimal, with a significant proportion of patients having low adherence. Patients diagnosed with diabetes for less than five years had the highest proportion of low adherence, suggesting that patients with a shorter disease duration may require additional support or interventions to improve their medication adherence. Healthcare providers should emphasize the importance of medication adherence and work with patients to develop personalized treatment plans that include medication and lifestyle modifications to optimize lipid control and improve overall health outcomes in diabetic patients.

BackgroundDiabetes is a chronic medical condition and adherence to medication in adults with diabetes is important. Identifying predictors to medication adherence in adults with diabetes would help identify vulnerable patients who are likely to benefit by improving their adherence levels.MethodsWe conducted a cross-sectional study at the Dubai Police Health Centre between February 2015 and November 2015. Questionnaires were used to collect socio-demographic, clinical and disease related variables and the primary measure of outcome was adherence levels as measured by the Morisky Medication Adherence Scale (MMAS-8©). Multivariate logistic regression was carried out to identify predictors to adherence.ResultsFour hundred and forty six patients were interviewed. Mean age 61 year +/− 11. 48.4 % were male. The mean time since diagnosis of diabetes was 3.2 years (Range 1–15 years). Two hundred and eighty eight (64.6 %) patients were considered non-adherent (MMAS-8© adherence score < 6) while 118 (26.5 %) had moderate adherence (MMAS-8© adherence score 6 = <8) and 40 (9.0 %) high adherence (MMAS-8© adherence scores <8) to their medication respectively. The strongest predictor for adherence as predicted by the multi-logistic regression model was the patient’s level of education. A technical diploma certificate as compared to a primary school level of education was the strongest predictor of adherence (OR = 66.1 CI: 6.93 to 630.43); p < 0.001). The patient’s age was also a predictor of adherence with older patients reporting higher levels of adherence (OR = 1.113 (CI: 1.045 to 1.185; p = 0.001 for every year increase in age). The duration of diabetes was also a predictor of adherence (OR = 1.830 (CI: 1.270 to 2.636; p = 0.001 for every year increase in the duration of diabetes). Other predictors to medication adherence include Insulin use, ethnicity and certain cultural behaviours.ConclusionA number of important predictors to medication adherence in diabetics were identified in this study. Such predictors could help develop policies for improving adherence in diabetics.

BackgroundTuberculosis (TB) remains a major public health challenge, especially in developing countries like India. A successful TB treatment relies heavily on good medication adherence, which helps to prevent complications such as drug resistance and poor treatment outcomes. Multiple factors influence medication adherence, including socioeconomic, patient-related, and therapy-related aspects.ObjectivesThis study aims to assess the level of medication adherence and factors affecting medication adherence in TB patients during treatment.MethodologyA cross-sectional observational study was conducted among 223 TB patients (≥18 years) who had received more than two months of anti-TB treatment in a tertiary care hospital. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8). Data were analysed based on demographic and clinical variables using IBM SPSS Statistics for Windows, V. 30.0 (IBM Corp., Armonk, NY, USA).ResultsAmong 223 patients, 126 (56.5%) were male and 97 (43.5%) were female with a mean age of 35.08 ± 13.28 years. Using MMAS-8 to analyse medication adherence levels, 150 (67%) patients showed high medication adherence, 41 (18%) medium, and 32 (15%) low. High medication adherence was more prevalent among 70 (72.16%) females as compared to 80 (63.49%) males. Medication adherence was similar between 92 drug-sensitive TB (67.6% high medication adherence) and 58 drug-resistant TB (66.7% high medication adherence) cases. The most common factors affecting medication adherence were difficulty in procurement of medicines, lack of family support, and misunderstanding of treatment schedules. The most frequently reported adverse drug reaction was gastrointestinal upset (60, 46.9%), followed by neuropathy (22, 17.2%) and arthralgia (15, 11.7%).ConclusionThe study showed good medication adherence among TB patients, supported by programmatic measures. Maintaining and enhancing medication adherence still requires addressing financial obstacles, enhancing medication availability, and monitoring and managing adverse reactions.

PurposeAs the guidelines indicate, education and self-care in diabetic patients are essential elements in the treatment process. The efficient evaluation of the level of self-care will enable the patient’s needs to be identified and education and care to be optimised. The Self-Care of Diabetes Inventory (SCODI) is a valid and reliable tool which can measure self-care behaviours among patients with diabetes. The purpose of this study was to assess the reliability of the Polish version of the SCODI.MethodsThe World Health Organization (WHO) translation protocol was used for the translation and cultural adaptation of the English version of the SCODI into Polish. The study included 276 Polish patients with type 2 diabetes (mean age 61.28±12.02 years). There were 145 men and 131 women in the study. The internal consistency of the SCODI was evaluated using Cronbach’s Alpha.ResultsThe original four actor tool structure was confirmed. The mean overall levels of self-care in the four SCODI scales in the study group were self-care maintenance (67.66 pts; SD=18.55), self-care monitoring (61.81 pts; SD=24.94), self-care management (54.65 pts; SD=22.98) and self-care confidence (62.86 pts; SD=20.87). The item-total correlations were positive, so there is no need to change the scales of any of the questions. The overall consistencies for individual scales were assessed using Cronbach’s Alpha: self-care maintenance (0.759), self-care monitoring (0.741), self-care management (0.695) and self-care confidence (0.932). Exploratory factor analysis and item factor loadings of the individual items ranged from 0.137 to 0.886 and, with two exceptions (questions number 23 and 32), were statistically significant (p<0.05).ConclusionThe SCODI questionnaire has acceptable internal consistency and reliability in assessing self-care among diabetic patients in the Polish population. This reliable research tool can be managed in planned studies of Polish patients with diabetes.