Development and initial validation of the nonalcoholic fatty liver disease self-management questionnaire

Oh Young Kwon, Yeonsoo Jang, Ji Yea Lee, Seung Up Kim, Sang Hoon Ahn

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1 Citation (Scopus)


The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, and self-management is essential to improve health outcomes in this population. Despite the importance of self-management, there is no instrument to assess it in patients with NAFLD. The purpose of this study was to develop and validate an initial version of a self-management questionnaire for patients with NAFLD. This was a methodological and psychometric study conducted between April and November 2019. The NAFLD self-management questionnaire was developed after a theoretical and literature review and focus group interviews in three phases: (1) item generation, (2) item evaluation, and (3) psychometric evaluation. Participants (N = 155) were recruited from a hospital in Seoul, South Korea. Items were generated based on clinical NAFLD guidelines and the individual and family self-management theory. Construct validity was assessed using exploratory factor analysis. Six-factors were extracted from 22 items: lifestyle management, medical treatment compliance, management of medication and dietary supplements, alcohol consumption management, sleep management, and family support. These factors accounted for 67.4% of the total variance; each factor had an eigenvalue greater than 1, and Cronbach's alpha for the scale was 0.87. The NAFLD self-management questionnaire showed acceptable initial validity and reliability. The instrument can prove useful in the formulation of tailored interventions based on individual patients' care needs. Furthermore, it may be used as an indicator of health outcomes in this population.

Original languageEnglish
Pages (from-to)844-853
Number of pages10
JournalResearch in Nursing and Health
Issue number5
Publication statusPublished - 2021 Oct

Bibliographical note

Funding Information:
This study was supported by the Brain Korea 21 FOUR project funded by National Research Foundation (NRF) of Korea, Yonsei University College of Nursing and Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (Grant no. 2017R1D1A1B04032264).

Publisher Copyright:
© 2021 Wiley Periodicals LLC

All Science Journal Classification (ASJC) codes

  • Nursing(all)


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