Psychometric Validation of the Greek Version of the Self-Care of Diabetes Inventory in Children and Adolescents with Type 1 Diabetes

Introduction: Reliable assessment of diabetes self-care is essential for individualized education and clinical follow-up in paediatric type 1 diabetes (T1D). This study evaluated the construct validity, convergent validity and internal consistency of the 40-item Greek Self-Care of Diabetes Inventory (SCODI).

 Methods: A cross-sectional validation study included 251 children and adolescents with T1D aged 8-18 years (mean 13.6 +/- 2.9; 50.2% girls), recruited during routine follow-up from Karamandaneio General Children's Hospital of Patras, Panagiotis and Aglaia Kyriakou General Children's Hospital, and University General Hospital of Patras 'Panagia Voitheia'. Participants completed the SCODI and Pediatric Quality of Life Inventory (PedsQL). Confirmatory factor analysis (CFA) tested the original four-factor structure; convergent validity was examined using Pearson correlations with PedsQL domains, and internal consistency using Cronbach's alpha. Ethical and institutional approvals were obtained from the Ethics Committee of the Department of Nursing, University of Patras (24557/01-01-2021), participating hospitals and the 6th Health Region; written parental consent and age-appropriate child assent were secured.

Results: CFA supported the 40-item, four-factor model comprising self-care maintenance, monitoring, management and confidence: chi-square/df = 1.518, RMSEA = 0.046, GFI = 0.907, AGFI = 0.902, TLI = 0.901, IFI = 0.913, NFI = 0.901 and CFI = 0.910. All SCODI factors correlated positively with physical, emotional, social and school PedsQL domains (r = 0.14-0.34; p = 0.03 to <0.001), supporting convergent validity. Internal consistency was acceptable to good: alpha = 0.745 for maintenance, 0.701 for monitoring, 0.762 for management and 0.886 for confidence.

 Conclusions: The Greek SCODI demonstrated satisfactory construct validity, consistent convergent associations and acceptable-to-good internal consistency in children and adolescents with T1D. It offers a multidimensional measure for clinical assessment and individualized diabetes education. Further studies should assess test–retest reliability, responsiveness and associations with objective glycaemic indicators.