Parental self-efficacy and the management of childhood atopic eczema: development and testing of a new clinical outcome measure

Abstract

Summary Background Effective parental management of childhood eczema requires education and support to reduce disease severity and improve the child's quality of life. Self‐efficacy is a key factor influencing effective chronic disease management, yet there are no published scales to measure parental self‐efficacy in managing childhood eczema. The Parental Self‐Efficacy with Eczema Care Index (PASECI) was designed to measure parental self‐efficacy in managing childhood eczema as a pre‐ and postintervention tool in the evaluation of a structured Eczema Education Programme (EEP). Objectives To develop and test the validity, reliability and sensitivity of a new outcome measure (PASECI) designed to assess parental self‐efficacy in managing their child's eczema to determine pre‐ vs. postintervention changes in educational intervention evaluation studies. Methods PASECI was developed from the literature, expert consultation and piloting of a 40‐item prototype. The final 29‐item scale is arranged in four subscales. Parents of children with eczema aged 0–16 years (n = 242) attending the EEP were assessed at 1 week pre‐EEP and 4 weeks postintervention. Cronbach's α and factor analyses were undertaken. Results PASECI has face, content and construct validity. It is reliable, with high item internal consistency (α > 0·87 in all domains). Factor analysis revealed four viable domains. It was sensitive to change for postintervention measures using sign tests (P < 0·001). Conclusions PASECI is a useful, valid, reliable and sensitive evaluative outcome measure of self‐efficacy in parents managing childhood eczema.

Translation and Validation of a Chinese Version of the Parental Self-Efficacy with Eczema Care Index

“…The results of confirmatory factor analysis supported the 4-factor structure of the C-PASECI, which reflects the domains of managing medication, managing eczema and symptoms, communicating with health care professionals and managing personal challenges when caring for your child with eczema. This result was consistent with the original factor structure identified in previous studies [14,25]. All of the factor loadings were > 0.70, with a χ 2 value to degree of freedom ratio (χ 2 /df) of 1.53 and a root mean square error of approximation of 0.06.…”

“…Our analysis of the C-PASECI demonstrated a high level of internal consistency, and the results were similar to previous studies. Ersser et al [14] developed and validated the original version of the PASECI on 242 parents of children aged 0-16 years diagnosed with eczema in the UK. The results indicated a high level of internal consistency among the items with Cronbach's α of the 4 domains ranging from 0.87 to 0.95 [14].…”

“…Ersser et al [14] developed and validated the original version of the PASECI on 242 parents of children aged 0-16 years diagnosed with eczema in the UK. The results indicated a high level of internal consistency among the items with Cronbach's α of the 4 domains ranging from 0.87 to 0.95 [14]. Another study which examined the psychometric properties of the Korean version of the PASECI on 125 mothers (mean age 36.8 years) consistently found high internal consistency with a Cronbach's α of 0.94 [25].…”

“…In addition to measuring the quality of life of children with eczema and their parents or caregivers, a specific measure of parental self-efficacy is a crucial determinant of the effects of interventions intended to enhance the parental management of childhood eczema [13]. The Parental Self-Efficacy with Eczema Care Index (PASECI) is a disease-specific tool designed to evaluate parental self-efficacy in the management of childhood eczema [14]. This 29-item index is arranged in 4 subscales, and each item is scored on an 11-point Likert scale with response options ranging from 0 (cannot do it at all) to 10 (highly certain I can do it).…”

“…The PASECI has a high level of internal consistency, with an overall Cronbach's α of 0.87 and respective Cronbach's α values of 0.91, 0.87, 0.92, and 0.95 for the 4 domains of "managing medication," "managing eczema and symptoms," "communicating with health care professionals" and "managing personal challenges." The findings of previous studies indicate that the PASECI is a useful, valid, reliable and sensitive evaluative outcome measure of parental self-efficacy regarding the management of childhood eczema [13,14]. However, no validated translated version of this index is currently available for the Chinese population.…”