Development and validation of a self-management scale for pregnant women at risk of gestational diabetes mellitus: A cross-sectional study

Thaithae, Suparp; Thanaboonpuang, Parinyaporn

doi:10.48307/nms.2025.507468.1571

Development and validation of a self-management scale for pregnant women at risk of gestational diabetes mellitus: A cross-sectional study

Document Type : Original Article

Authors

Suparp Thaithae ¹

Parinyaporn Thanaboonpuang ²

¹ Kuakarun Faculty of Nursing, Navamindradhiraj University 131/5 Khao Road, Wachira Sub-district, Dusit District, Bangkok, Thailand

² Boromarajonani College of Nursing, Ratchaburi, Faculty of Nursing, Praboromarajchanok Institute, 84/21 Kathathorn road Na Muang sub-district Muang district Ratchaburi, Thailand

10.48307/nms.2025.507468.1571

Abstract

Background: Effective self-management is crucial for pregnant women at risk of gestational diabetes mellitus (GDM). The Self-Management Behavior Scale, designed to evaluate health behaviors in chronic conditions, is a key tool for this assessment.
Objectives: This study aimed to develop and validate a self-management behavior scale tailored for pregnant women at risk of GDM.
Methods: A cross-sectional study was conducted among 225 pregnant women identified as at-risk and receiving antenatal care at Vajira Hospital and Bangkok Metropolitan Administration hospitals. Participants were selected using a stratified sampling strategy. Participants were classified as "at-risk" based on GDM criteria and underwent the Glucose Challenge Test between 24–28 weeks of gestation (from the Maternal and Child Health Record Book, 2023). Self-management behaviors were assessed using an 18-item questionnaire. Inclusion criteria comprised at-risk pregnant women who provided informed consent, whereas those with severe cognitive impairments were excluded. Structural validity was evaluated via confirmatory factor analysis using Mplus software. Reliability was assessed using Cronbach’s alpha, and construct reliability was examined through CR and H coefficients.
Results: Participants had a mean age of 29.68±6.59years, mean gestational age of 25.5 weeks, and mean first-pregnancy blood glucose level of 136.95 mg/dL. The scale demonstrated excellent internal consistency (Cronbach’s alpha=0.95). Second-order factor analysis supported construct validity. The model exhibited good fit indices: χ²/df=1.83 (P<0.001), CFI=0.959, TLI=0.950, SRMR=0.045, and RMSEA=0.061. Individual items showed factor loadings ranging from 0.37 to 0.94 (P<0.01), and second-order components had standardized loadings between 0.83 and 0.96, with "Setting Goals for Self-Management" exhibiting the highest loading (β=0.964). The construct accounted for 81.7% of the variance and demonstrated a reliability coefficient of 0.957.
Conclusion: The developed 18-item scale encompassing five dimensions is valid, reliable, and appropriate for assessing self-management behaviors among pregnant women at risk of GDM.

Keywords

Self-management

Gestational diabetes

Pregnancy

Reliability

Validity

Subjects

Midwifery

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