Development and evaluation of a scale to measure perceived self‐efficacy in people with arthritis

Abstract

There is evidence that the psychological attribute of perceived self-efficacy plays a role in mediating health outcomes for persons with chronic arthritis who take the Arthritis Self-Management Course. An instrument to measure perceived self-efficacy was developed through consultation with patients and physicians and through study of 4 groups of patients. Tests of construct and concurrent validity and of reliability showed that the instrument met appropriate standards. Health outcomes and self-efficacy scores improved during the Arthritis Self-Management Course, and the improvements were correlated.We describe the development and testing of an instrument to measure patients' perceived self-efficacy (SE) to cope with the consequences of chronic arthritis. The need for such an instrument arose in the course of studying the effects of the Arthritis SelfManagement Course (ASMC). When evaluated in randomized studies, subjects who took the ASMC were found to have less pain and to be more active than controls (1). These results persisted, albeit attenuated, for 20 months after the course, without reinforcement. However, when the data were examined for anticipated associations between changes in behavior (ex- ercise, relaxation, and walking) and changes in health status (pain, disability, and depression), the expected associations were weak or were absent (2).These unexpected findings precipitated an interview with the participants and evaluation of their experiences in the course. Fifty-four participants were asked why they found the course helpful or not helpful. For half the people interviewed, pain and/or disability had decreased; for the other half, pain and/or disability had not changed or had increased. The former group attributed their benefits to an increased sense of influence over the consequences of arthritis; the latter group believed that they could do little to improve their situation (3).The findings from these interviews indicated that a sense of one's personal ability to affect the consequences of disease was strong in some subjects and relatively weak in others, and interacted with the course to create the health outcomes. This sense of ability to effect change (akin to confidence) is similar to the psychological concept of perceived SE (43). In a preliminary study using early instruments to measure perceived SE to cope with the consequences of arthritis, we found statistically significant correlations between perceived SE and health status (ref. 6 and unpublished observations). We therefore sought to develop a reliable and valid instrument for measuring perceived SE.Perceived SE, as postulated by Bandura (4), is one's belief that one can perform a specific behavior or task in the future. It refers to personal judgments of performance capabilities in a given domain of activity.Although it is related to other psychological concepts, such as locus of control, learned helplessness, and self-esteem, it differs in that it is behavior-specific.

Physical functioning over three years in knee osteoarthritis: Role of psychosocial, local mechanical, and neuromuscular factors

“…Self-efficacy for lower extremity function was assessed using the lower extremity questions of the Arthritis Self-Efficacy Scale function subscale (self-rating of degree of certainty in one's ability to walk 100 feet on flat ground in 20 seconds, walk 10 steps downstairs in 7 seconds, and get out of an armless chair without using hands for support) (higher value ϭ better) (20). Construct and concurrent validity and test-retest reliability for the subscales have been demonstrated in patients with arthritis (20). Social support was assessed using the Medical Outcomes Study Social Support Survey (higher value ϭ better) (21).…”

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

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Maintenance of exercise in women with fibromyalgia

“…Self efficacy was measured using the Arthritis Self-Efficacy Scale (35). Two of the 3 subscales, self efficacy for pain management and self efficacy for other (FM) symptoms, were used in this study.…”