Translation, cross-cultural adaptation and psychometric evaluation of the Portuguese version of the self-care in chronic obstructive pulmonary disease inventory.

Background: Chronic obstructive pulmonary disease is a major global cause of death, marked by frequent exacerbations, high healthcare use, and reduced quality of life. Its progressive nature requires continuous self-care and symptom management. Understanding how individuals make self-care decisions is key to developing patient-centered nursing interventions. This study validates a theory-based instrument designed to assess core self-care domains in individuals living with chronic obstructive pulmonary disease, addressing gaps in existing tools that insufficiently capture behavioral aspects of disease management. Objective: To translate and adapt the Self-care in Chronic Obstructive Pulmonary Disease Inventory to the Portuguese context and to test its psychometric properties on a sample of patients with chronic obstructive pulmonary disease in Portugal. Design: A methodological study focused on the validation of an instrument. Settings: A Local Health Unit and its aggregated primary care centers from a municipality in the north region of Portugal. Participants: 196 patients met the inclusion criteria and accepted to participate in the study. Methods: Construct validity was assessed using confirmatory factor analysis and hypothesis testing, while internal consistency reliability was evaluated using Cronbach's alpha and McDonald's omega. Results: A convenience sample of 196 chronic obstructive pulmonary disease patients was recruited from September 2023 to February 2024. The instrument consists of four scales: Self-Care Maintenance, Self-Care Monitoring, Self-Care Management and Self-Care Self-Efficacy. Confirmatory factor analysis was assessed on all four dimensions of the inventory producing acceptable model fit indices. The hypotheses presumed to evaluate the convergent and discriminant validity were confirmed. Internal consistency was adequate with Cronbach's alpha values ranging from 0.673 to 0.893 across the four scales. Conclusions: The Portuguese version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory demonstrated acceptable psychometric properties. Some differences were observed compared to the original instrument. Further validation studies are needed to confirm its psychometric characteristics in the Portuguese population.