Development and psychometric evaluation of state self-compassion scale for Nepalese older adults with chronic diseases (SSCS-NOACD): a sequential exploratory mixed-methods study
Year: 2026
Type: article
Abstract: Self-compassion is an important psychological resource for older adults with chronic diseases, as it may support adaptive coping, reduce stress, and contribute to physical and psychological well-being. However, no instrument has been specifically developed to assess state self-compassion among older adults living with chronic diseases, either globally or in Nepal. Therefore, this study aimed to develop and evaluate the psychometric properties of the State Self-Compassion Scale for Nepalese Older Adults with Chronic Diseases (SSCS-NOACD). A sequential exploratory mixed-methods study was conducted using a two-phase, eight-step instrument development framework. Phase I involved item generation based on theory, concept analysis, previous qualitative findings, and qualitative data from older adults with chronic diseases. Phase II included content and face validation of the SSCS-NOACD, pilot testing among 42 older adults, and psychometric evaluation among 500 older adults recruited from four wards of Kathmandu Metropolitan City using quota sampling. The sample was randomly divided into two groups for exploratory factor analysis ( EFA ) and confirmatory factor analysis ( CFA ), with 250 participants in each group. Psychometric evaluation included construct validity, internal consistency, floor and ceiling effects, and social desirability bias. Known-groups validity was assessed in a separate sample of 60 older adults. Following content and face validation, pilot testing, and psychometric evaluation, the initial pool of 78 items was refined to a final 15-item scale comprising six factors. EFA identified a six-factor structure explaining 62.59% of the total variance, and CFA indicated acceptable model fit. The SSCS-NOACD-15 demonstrated acceptable internal consistency, with Cronbach’s α = 0.76 in the CFA sample and 0.81 in the contrasted-group sample, while subscale coefficients ranged from 0.19 to 0.73 in the CFA sample. The total scale score was positively correlated with each of the six subscale scores. No overall floor or ceiling effects were observed, although several individual items exhibited floor or ceiling effects. A statistically significant but weak positive correlation was observed between social desirability and SSCS-NOACD-15 scores in the CFA sample ( r = .135, p = .032). Preliminary evidence of known-groups validity was observed, with statistically significant differences according to marital status, literacy status, and parental status. The second-order CFA did not adequately support a single higher-order construct underlying the six factors. The SSCS-NOACD-15 offers a context-specific measure of state self-compassion among older adults with chronic diseases in Nepal. Preliminary evidence supports its six-factor structure, overall internal consistency, and known-groups validity. However, the low internal consistency of several subscales and the lack of support for a single higher-order construct warrant caution in interpreting subscale and summed total scores. Further psychometric evaluation in diverse populations is needed to assess convergent validity, responsiveness to change, and the appropriateness of interpreting the summed score as an overall measure of state self-compassion. Not applicable. This study employed a sequential exploratory mixed-methods design and did not involve any clinical intervention or trial procedures.
Source: BMC Geriatrics
Institution: Patan Academy of Health Sciences
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7225424737