Development, reliability, and validity of the scale for assessing home management confidence among caregivers of preschool children with asthma

This study aimed to develop a targeted assessment tool for evaluating home‑management self‑efficacy among caregivers of 3‑ to 6‑year‑old children with asthma, and to systematically validate its psychometric properties. It sought to address the shortage of context‑specific domestic instruments and provide objective evidence to support clinical screening and individualized intervention development for this caregiver group. The initial item pool and draft scale were generated from literature reviews, semi‑structured interviews, and two‑round Delphi expert consultations with 15 specialists. Two independent convenience‑sampled caregiver groups were enrolled. The first sample of 275 caregivers completed the preliminary questionnaire for item screening and exploratory factor analysis. The second sample of 360 caregivers responded to the formal scale for confirmatory factor analysis. A comprehensive set of psychometric indices was computed, including Cronbach’s α coefficient, split‑half reliability, test‑retest reliability, content validity index, average variance extracted, and composite reliability. The final 25‑item scale comprised six dimensions: confidence in medication and nebulization management, confidence in symptom monitoring and identification, confidence in daily care and environmental management, confidence in emergency management of acute attacks, confidence in psychological care and emotional management, and confidence in doctor‑patient communication and follow‑up. Six extracted common factors accounted for 62.02% of the total cumulative variance, with standardized factor loadings ranging from 0.645 to 0.844. Confirmatory factor analysis revealed favorable model fit (χ² = 826.34, df = 260, χ²/df = 1.265, RMSEA = 0.027, CFI = 0.976). The overall Cronbach’s α was 0.861, and dimensional α coefficients ranged from 0.781 to 0.830. Split‑half reliability stood at 0.641, falling below the conventional threshold of 0.7, whereas the total test‑retest reliability was 0.876 among 60 paired participants. One dimension yielded an average variance extracted of 0.467, meeting the lenient acceptability criterion (> 0.4). The scale‑level content validity index was 0.93, and item‑level values varied between 0.80 and 1.00. This culturally‑adapted Chinese scale demonstrates satisfactory overall reliability and validity for assessing home‑management self‑efficacy among caregivers of preschool children with asthma. Despite marginal split‑half reliability and sub‑optimal average variance extracted for one dimension, it can serve as a standardized instrument for relevant clinical evaluation and research.