Other Titles
Developing the Self-Care Guilt Scale (SCGS): A Three-Phase Approach to Measuring a Novel Barrier to Paternal Health [Poster Title]
Abstract
Purpose: A qualitative study (Fahey, 2023) using Story Theory identified "self-care guilt"—moral distress when engaging in health activities—as a barrier to wellbeing among fathers of children with ASD. This proposed study will develop and validate the first instrument measuring this construct.
Background: Fathers of children with ASD experience depression 3x general population rates (Hoyle et al., 2021) yet show lowest self-care engagement among caregivers (Martinez et al., 2021). Our preliminary work revealed guilt transforms self-care from stress-reducer to stressor, making traditional interventions paradoxically harmful. No existing measure captures guilt as self-care barrier.
Theoretical Framework: Story Theory (Smith & Liehr, 2018) guides this scale development by positioning health challenges as disruptions in life narratives. The theory conceptualizes self-care guilt as a "complicating health challenge" blocking narrative progression toward wellbeing. The SCGS bridges Story Theory’s qualitative insights with quantitative measurement.
Methods: Sequential mixed-methods design following DeVellis framework. Phase 1: Directed content analysis of existing father narratives generates items. Phase 2: Expert panel (n=10) establishes content validity (I-CVI>0.78, S-CVI/Ave>0.90); cognitive interviews (n=15) ensure comprehension. Phase 3: Psychometric validation with 100 fathers via online survey using exploratory factor analysis, reliability testing, validity assessment.
Expected Outcomes: 15-20 item scale. Anticipated psychometrics: three-factor structure (>60% variance); α>0.80 total scale; convergent validity with caregiver burden (r=0.40-0.60); discriminant validity from social desirability (r<0.30); negative correlation with self-care behaviors (r=-0.50-0.70).
Nursing Implications: The SCGS will enable nurses to screen for modifiable barriers, evaluate father-focused interventions, and advance family-centered care. The SCGS will be the first scale measuring self-care guilt.
Current Status: Foundational qualitative research complete, partnerships developing, IRB submission pending.
Notes
References:
Devillis, R.F & Thorpe, C.T. (2021). Scale Development: Theory and application (5th ed.). Sage Publications.
Fahey, M.L. (2023). The experience of fathering a child with autism spectrum disorder and the challenge of self-care. (Unpublished doctoral dissertation). Endicott College.
Hoyle, Laditka, J. N., & Laditka, S. B. (2021). Mental health risks of parents of children with developmental disabilities: A nationally representative study in the United States. Disability and Health Journal, 14(2), 101020–101020. https://doi.org/10.1016/j.dhjo.2020.101020
Keister, K. J.; Farra, S. L.; Smith, S.l J.; Bottomley, M. Development of a Scale to Measure Synergy: A Tool to Evaluate Team-Based Learning in Nursing. Nursing Education Perspectives 42(2):p 87-92, 3/4 2021. | DOI: 10.1097/01.NEP.0000000000000783
Liehr, P., & Smith, M. J. (2011). Refining story inquiry as a method for research. Archives of psychiatric nursing, 25(1), 74-75.
Liehr, P, & Smith, M.J. (2020). Claiming the narrative wave with Story Theory. Advances in Nursing Science, 43(1), 15-27.
Martinez, N., Connelly, C.D., Perez, A., & Calero, P. (2021). Self-care: A concept analysis. International Journal of Nursing Sciences, 8(4), 418-425. https://doi.org/10.1016/j.ijnss.2021.08.007.
Smith M.J., & Liehr, P. (1999). Attentively Embracing Story: A middle-range theory with practice and research implications. Research and Theory for Nursing Practice, 13(3), 187
Smith, M.J., Liehr, P.R. (2018). Middle range theory in nursing (4th ed.). Springer Publishing Company.
Sigma Membership
Chi Epsilon
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Qualitative Research
Keywords:
Parimay Care, Instrument and Tool Development, Shame, Guilt (Psychology), Fathers, Autism Spectrum Disorder, ASD, Self-Care Guilt, Paternal Health, Family-Centered Care
Recommended Citation
Fahey, Mary Lynn, "Developing the Self-Care Guilt Scale" (2026). International Nursing Research Congress (INRC). 124.
https://www.sigmarepository.org/inrc/2026/posters_2026/124
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-26
Developing the Self-Care Guilt Scale
Toronto, Ontario, Canada
Purpose: A qualitative study (Fahey, 2023) using Story Theory identified "self-care guilt"—moral distress when engaging in health activities—as a barrier to wellbeing among fathers of children with ASD. This proposed study will develop and validate the first instrument measuring this construct.
Background: Fathers of children with ASD experience depression 3x general population rates (Hoyle et al., 2021) yet show lowest self-care engagement among caregivers (Martinez et al., 2021). Our preliminary work revealed guilt transforms self-care from stress-reducer to stressor, making traditional interventions paradoxically harmful. No existing measure captures guilt as self-care barrier.
Theoretical Framework: Story Theory (Smith & Liehr, 2018) guides this scale development by positioning health challenges as disruptions in life narratives. The theory conceptualizes self-care guilt as a "complicating health challenge" blocking narrative progression toward wellbeing. The SCGS bridges Story Theory’s qualitative insights with quantitative measurement.
Methods: Sequential mixed-methods design following DeVellis framework. Phase 1: Directed content analysis of existing father narratives generates items. Phase 2: Expert panel (n=10) establishes content validity (I-CVI>0.78, S-CVI/Ave>0.90); cognitive interviews (n=15) ensure comprehension. Phase 3: Psychometric validation with 100 fathers via online survey using exploratory factor analysis, reliability testing, validity assessment.
Expected Outcomes: 15-20 item scale. Anticipated psychometrics: three-factor structure (>60% variance); α>0.80 total scale; convergent validity with caregiver burden (r=0.40-0.60); discriminant validity from social desirability (r<0.30); negative correlation with self-care behaviors (r=-0.50-0.70).
Nursing Implications: The SCGS will enable nurses to screen for modifiable barriers, evaluate father-focused interventions, and advance family-centered care. The SCGS will be the first scale measuring self-care guilt.
Current Status: Foundational qualitative research complete, partnerships developing, IRB submission pending.
Description
Story Theory will guide the development of the first scale measuring self-care guilt among fathers of children with autism spectrum disorder (ASD), transforming fathers' narrative expressions into validated assessment items. The Self-Care Guilt Scale (SCGS) will offer a practical tool for father-inclusive practice and understanding why traditional self-care advice paradoxically harms this population. This session details developing the first instrument to measure this phenomenon.