Exercise barriers self-efficacy: development and validation of a subcale for individuals with cancer-related lymphedema

Abstract

BackgroundNo tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers.MethodsA lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale.ResultsThe final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach’s alpha = 0.93) and test-retest reliability (ICC = 0.67, p < 0.01).ConclusionsA valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.

Psychometric properties and performance of existing self-efficacy instruments in cancer populations: a systematic review

“…Nine (60.0%) instruments measured the self-efficacy of general health strategies in cancer, such as self-care [15, 16], self-management [17], and coping behaviors [18, 19]. Six (40.0%) instruments were task-specific, focusing on fatigue [20, 21], communication [22], rehabilitation [23], exercise [24], and narcotic pain killer usage [25]. Six instruments were disease-specific for breast cancer [10, 26, 27], lung cancer [23] and advanced cancer [21, 28].…”

“…The dimensions of all instruments were determined and each demonstrated one confirmed factor pattern, except for the SUPPH, which had three structured factor patterns [11, 15]. The number of items included in the instruments ranged widely from five [24] to 38 [18]. Only one instrument [22] was administered by an interviewer.…”

Relationships Between Learned Self-Regulatory Skills and Changes in Weight-Loss Behaviors: Mediation by Barriers Self-Efficacy

“…The incorporation of contrast groups could partially control for expectation and social support effects in extensions of this research. Barriers self-efficacy is markedly difficult to accurately measure because the array of lifestyle barriers presented within included items (in which the respondent’s perception of ability to overcome is evaluated) might substantially differ, by individual (Buchan et al, 2015). The ideographic nature of the construct and its measurement challenges can affect scoring accuracies, especially across respondents (Teixeira et al, 2015).…”

The evaluation of selected physiotherapeutic methods in the treatment of post-mastectomy lymphoedema

“…However, a number of physical medicine procedures are contraindicated in cancer patients due to their stimulating character [16][17][18][19][20][21]. Physiotherapy applied in these clinical cases significantly lowers the intensity of lymphoedema [22,23]. The best results in the examined group were noted in the case of patients who underwent no more than three physiotherapy procedures during a day.…”

“…Jednak wiele zabiegów z zakresu medycyny fizykalnej z powodu bodźcującego charakteru u osób z choroba nowotworową jest przeciwwskazanych [16][17][18][19][20][21]. Stosowana w tych przypadkach klinicznych fizjoterapia istotnie zmniejsza nasilenie obrzęku limfatycznego [22,23]. W badanej grupie zaobserwowano najlepsze wyniki u osób których liczba zabiegów fizjoterapeutycznych nie przekraczała trzech w ciągu dnia.…”