Lifestyle modification is a cornerstone of dry eye syndrome management, yet clinicians lack standardized tools to objectively assess patient adherence. This methodological study reports the development and psychometric evaluation of a Lifestyle Adherence Assessment Scale for patients with dry eye syndrome, using a rigorous multi-stage design grounded in classical test theory.
Following systematic item generation, expert Delphi consultations, and large-scale validation in 422 participants, the final 18-item scale encompassed five key dimensions, including ophthalmic care practices, ocular strain regulation, support-seeking behaviors, tobacco and alcohol use, and daily conduct guidelines. The scale demonstrated excellent content validity, strong construct validity with a well-fitting five-factor model, high internal consistency (Cronbach’s α = 0.894), and robust test–retest reliability…
