Psychometric Properties of Self-Management Instruments for Catheter-Related Bloodstream Infection (CRBSI) Prevention among Haemodialysis Patients: A Systematic Review of Validation Studies

Abstract

Catheter-related bloodstream infection (CRBSI) remains a major cause of morbidity and mortality among haemodialysis patients, particularly those dependent on central venous catheters. Effective patient self-management is essential for infection prevention; however, the availability of validated instruments assessing CRBSI-specific self-management behaviours remains unclear. This systematic review aimed to evaluate the psychometric properties of self-management questionnaires used among adult haemodialysis patients and to determine their relevance to CRBSI prevention. A systematic review of validation studies was conducted using semantic searches of literature indexed in Semantic Scholar and OpenAlex. Studies examining the psychometric properties of self-management instruments among adult haemodialysis patients were included. Data extraction focused on instrument characteristics, assessed domains, reliability, validity, and relevance to infection prevention. Thirteen validation studies from Asia, Europe, Africa, and South America met the inclusion criteria. Most instruments demonstrated acceptable to excellent psychometric properties. Cronbach’s alpha values ranged from 0.57 to 0.972, and test–retest reliability coefficients generally exceeded 0.80. Factor analysis explained between 50.85% and 69.41% of the total variance. Despite strong measurement properties, only one instrument addressed infection prevention behaviour, limited to hand hygiene. No validated questionnaire specifically assessed CRBSI-related self-management behaviours such as catheter exit-site care or early recognition of infection signs. Development and validation of a patient-centred CRBSI prevention questionnaire is urgently needed.