Psychometric Evaluation of the Indonesia Version of Connor-Davidson Resilience Scale-25 among Diabetic Foot Ulcer Patients: A Confirmatory Factor Analysis

Introduction: The burden of diabetic foot ulcers (DFU) patients is quite high, such as a more frequent visits to health care services compared with diabetic patients without foot ulcers. Resilience is needed to increase their adaptability. Assessing resilience of DFU patients requires a valid instrument. However, there have been no studies on specific psychometrics test, especially to conduct validity using CFA among DFU Patients. The aim of this study was to evaluate the psychometrics, especially reliability and factor structure of the Indonesia version of the Connor-Davidson Resilience Scale-25 (CD-RISC-25) among DFU patients. Methods: A cross-sectional study design was undertaken from April to June 2021 in four hospitals located in South Kalimantan, Indonesia, namely Ulin Hospital in Banjarmasin city, Idaman Hospital in Banjarbaru city, Boeyasin Hospital in Pelaihari city, and Damanhuri Hospital in Barabai city. The inclusion criteria were patients who had a history of DFU of more than 2 years. The total sample in this study was 184 patients. The respondents were selected using purposive sampling. Permission to use the CD-RISC-25 was permitted by the original author. Cronbach s alpha was used to evaluate internal reliability. Confirmatory factor analysis (CFA) was used to evaluate the structural model fit of CD-RISC-25. Results: The Cronbach s alpha for CD-RISC-25 Indonesia version was adequate (Cronbach s alpha >0.89). Confirmatory factor analysis showed good fit with goodness-of-fit index (GFI)=0.93, and adjusted goodness-of-fit index (AGFI)=0.91, Root-Mean-Square Error of Approximation (RMSEA) = 0.08. Conclusion: Indonesia version of CD-RISC-25 had adequate reliability and validity.