Reliability and validity of a self‐efficacy instrument for hepatitis C antiviral treatment regimens

Abstract

Self-efficacy or confidence in one’s ability to successfully engage in goal-directed behavior has been shown to influence medication adherence across many chronic illnesses. In the present study we investigated the psychometric properties of a self-efficacy instrument used during treatment for chronic hepatitis C viral infection (HCV). Baseline (n=394) and treatment week 24 (n=254) data from the prospective, longitudinal VIRAHEP-C study were examined. Baseline participants were randomly split into two equal sized subsamples (S1 & S2). Initial exploratory and confirmatory factor analyses (EFA/CFA) were performed on S1, while S2 was used to validate the factor structure of the S1 results using CFA. An additional CFA was performed on the treatment week 24 participants. Convergent & discriminant validity were assessed by comparing the revised instrument with other psychosocial measures: depression, social support, quality of life, and medication-taking behavior. Our findings supported a reduced 17-item global measure of HCV Treatment Self-Efficacy (HCV-TSE) with four underlying factors: patient communication self-efficacy, general physical coping self-efficacy, general psychological coping self-efficacy, and adherence self-efficacy. The global score (0.92 to 0.94) and four factors (0.85 to 0.96) demonstrated good internal consistency. Correlations of convergent and discriminant validity yielded low to moderate associations with other measures of psychosocial functioning. The revised HCV-TSE instrument provides a reliable and valid global estimate of confidence in one’s ability to engage in and adhere to HCV antiviral treatment. The four factor structure suggests different types of efficacy beliefs may function during HCV treatment and should be explored further in relation to clinical outcomes.

Self-Efficacy and Adherence to Antiviral Treatment for Chronic Hepatitis C

“…Strengths of the present study include a large sample size, rigorous prospective study design, measurement of medication adherence using objective electronic monitoring technology, and use of an psychometrically sound measure of HCV treatment self-efficacy 19 . However, a few limitations are noted.…”

“…A recent factor analysis of the instrument led to refining the measure into a 17-item scale that yielded a Global Self-Efficacy scale (GSE) and four self-efficacy subscales: (a) communication SE (i.e., confidence to communicate with healthcare provider); (b) physical coping SE (i.e., confidence to cope with physical side effects of treatment); (c) psychological coping SE (i.e., confidence to cope with emotional side effects of treatment); and (d) treatment adherence SE (i.e., confidence to take all medication as prescribed and attend doctor visits) (See Table 1) 19 . The revised HCV Treatment Self-Efficacy Survey demonstrated good reliability for the GSE and the four subscales (Cronbach’s α range = .85 to .96) and good discriminant validity with other psychosocial measures 19 . Higher scores on each scale indicate higher levels of self-efficacy.…”

“…Internal attitudes, such as self-efficacy or confidence in one’s ability to mobilize internal and/or external resources to engage in specific goal-directed behaviors, have been the focus of empirical and theoretical exploration across myriad health behaviors and medical conditions 17, 18 . However, self-efficacy’s relationship to missed doses and nonpersistence in the context of HCV treatment has yet to be explored 19 . While self-efficacy’s relationship to missed doses and nonpersistence is largely unknown in the HCV population, its role in adherence to medications for other chronic disease treatment, including the HIV population, has been explored.…”

Development of Self-Management Indicators for Chronic Hepatitis B Patients on Antiviral Therapy: Results of a Chinese Delphi Panel Survey

“…A list of 53 self-management indicators was compiled on the basis of nine articles [ 11 , 20 – 27 ]. Based on the three tasks of self-management by Corbin and Straus (medical management, role management and emotional management) [ 28 ] and the domains of the already published self-management scale for other chronic disease patients [ 20 , 27 , 29 ], four major domains were identified. Treatment management (14 indicators) refers to medication adherence, symptom monitoring and management.…”

A Persian Adaptation of Medication Adherence Self-Efficacy Scale (MASES) in Hypertensive Patients: Psychometric Properties and Factor Structure

“…Several studies have suggested the beneficial effects on health outcomes by the implementing self-efficacy to continuing treatment programs [33,34]. However, most of these studies were on life-threatening infectious diseases, such as HIV infection and chronic viral hepatitis [35][36][37][38][39]. In addition, in previous studies, self-efficacy has been correlated with practicing self-care practices for the Table 4 The MASES scores between patients with uncontrolled hypertension and those with well-controlled blood pressure U N C O R R E C T E D P R O O F generality of the results.…”