Psychometric testing of the hemodialysis self‐management instrument (HDSMI‐18): A confirmatory factor analysis

Aim 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. Design Cross‐sectional study. Methods 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. Results 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.