Psychometric properties of self-report instruments for assessing self-care in patients with oncological diseases: a systematic review based on COSMIN guidelines

OBJECTIVE: To identify self-report self-care scales for patients with cancer and critically evaluate their measurement properties. DESIGN: Systematic literature review based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. DATA SOURCES: A comprehensive search was conducted from database inception to March 2025 through PubMed, CINAHL, Embase, Scopus, Web of Science and APA PsycINFO. Potentially eligible articles were also identified by consulting the reference lists of the included studies. ELIGIBILITY CRITERIA: Studies were eligible if they reported on the development or validation of self-report instruments measuring self-care in adult patients with cancer and provided data on at least one measurement property as defined by the COSMIN framework. DATA EXTRACTION AND SYNTHESIS: This review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Risk of bias and methodological quality were assessed according to COSMIN criteria. A modified Grading of Recommendations Assessment, Development and Evaluation approach was applied to determine the level of evidence for each psychometric property and to formulate recommendations for instrument use. RESULTS: 30 studies involving 26 instruments were included. Three instruments, the self-management instrument for patients with breast cancer undergoing adjuvant therapy, the Self-Care of Oral Anticancer Agents Index and the Leuven questionnaire for Patient Self-care during Chemotherapy, were strongly recommended (Grade A) based on adequate content validity and internal consistency. In contrast, the Self-Care Agency Scale and the Breast Cancer-Related Lymphoedema Self-Care Scale were not recommended (Grade C) due to high-quality evidence for insufficient structural validity and internal consistency, respectively. Most instruments received a Grade B, indicating potential for use but requiring further validation. CONCLUSIONS: This review highlights several gaps in psychometric evaluations, emphasising the need for future research to conduct more rigorous assessments of the measurement properties of current instruments and to develop tools that measure self-care in a broader population of oncology patients