Translation and Evaluation of the Denyes Self-Care Agency Instrument (DSCAI-90) with Thai Adolescents

Self-care agency (SCA), the ability that enables an individual to engage in self-care to promote their health, is significantly associated with adolescents’ health outcomes. Because there is no instrument to specifically measure adolescents’ SCA in Thailand, the purpose of this study was to translate the Denyes Self-Care Agency Instrument (DSCAI-90) for use with Thai adolescents. This study consisted of three phases. In Phase 1, a descriptive qualitative method was used to explore Thai Adolescents’ understanding of SCA as it relates to their health. Four major themes emerged from the interviews: taking care of health, abilities for taking care of health, taking care of mental health, and abilities for taking care of mental health. Multiple subthemes emerged for each theme. Phase 1 demonstrated that the concept of SCA applies to Thai adolescents and supported the applicability of translating the DSCAI-90 to measure SCA in Thai adolescents. In Phase 2, the DSCAI-90 was translated into Thai using a team translation model and pretested by cognitive interview with Thai adolescents. We identified and resolved potential issues with some DSCAI-90 items using iterative translation, and derived a culturally and linguistically appropriate Thai version of the DSCAI-90. In Phase 3, a quantitative method was used to evaluate the initial psychometric properties of the DSCAI-90 (Thai version). The findings revealed that the DSCAI-90 (Thai version) had good content validity (S-CVI/Ave = 1.0). The results from the exploratory factor analysis suggested a five-factor scale DSCAI-90 (Thai version), which had appropriate construct validity in the study sample of 219 Thai adolescents. The five factors included: valuing of health, attention to health, and decision-making capability; ego strength; health knowledge; feelings; and energy. The internal consistency reliability of the total scale was relatively high (Cronbach’s Alpha = .91). Our findings contribute to the understanding of SCA for Thai adolescents and the availability of an instrument to measure SCA with Thai adolescents. These findings support the argument for future research of SCA, self-care, and other health outcomes of Thai adolescents, and contribute to the provision of health care.