Validation of the Self‐Efficacy for Managing Chronic Disease Scale: A Scleroderma Patient‐Centered Intervention Network Cohort Study

Abstract

Objective. Self-management programs for patients with chronic illnesses, including rheumatic diseases, seek to enhance self-efficacy for performing health management behaviors. No measure of self-efficacy has been validated for patients with systemic sclerosis (SSc; scleroderma). The objective of this study was to assess the validity and internal consistency reliability of the Self-Efficacy for Managing Chronic Disease (SEMCD) scale in SSc. Methods. English-speaking SSc patients enrolled in the Scleroderma Patient-centered Intervention Network Cohort who completed the SEMCD scale at their baseline assessment between March 2014 and June 2015 were included. Patients were enrolled from 21 sites in Canada, the US, and the UK. Confirmatory factor analysis (CFA) was used to evaluate the factor structure of the SEMCD scale. Cronbach's alpha was calculated to assess internal consistency reliability. Hypotheses on the direction and magnitude of Pearson's correlations with psychological and physical outcome measures were formulated and tested to examine convergent validity. Results. A total of 553 patients were included. CFA supported the single-factor structure of the SEMCD scale (Tucker Lewis Index 5 0.99, comparative fit index 5 0.99, root mean square error of approximation 5 0.10). Internal consistency was high (a 5 0.93), and correlations with measures of psychological and physical functioning were moderate to large (|r| 5 0.48-0.67, P < 0.001), confirming study hypotheses. Conclusion. Scores from the SEMCD scale are valid for measuring self-efficacy in patients with SSc, and results support using the scale as an outcome measure to evaluate the effectiveness of self-management programs in SSc.

Feasibility, Acceptability, and Preliminary Effectiveness of a Peer-Delivered and Technology Supported Self-Management Intervention for Older Adults with Serious Mental Illness

“…SEMCD is a six-item scale that assesses domains of self-efficacy. SEMCD has demonstrated reliability and validity in people with chronic health conditions [36, 37]. Participants respond to each item on a 1–10 point scale (1=not confident at all to 10 totally confident) and the final SEMCD score is the mean of the six items.…”

Factors associated with patient-reported likelihood of using online self-care interventions: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study

“…The score for the scale is the mean of all items, with higher scores reflecting greater self-efficacy. The SEMCD scale has been validated in patients with SSc 33…”

Unmet Needs in Systemic Sclerosis Understanding and Treatment: the Knowledge Gaps from a Scientist’s, Clinician’s, and Patient’s Perspective

“…In general, these aspects have mostly been neglected, and while several trials have used some self-reported measures as secondary endpoints to measure treatment efficacy, such as the short form (SF-36) health survey or the Euro quol questionnaire (EQ-5D), more focused and structured PROs have seldom been used in SSc. Recently, the Self-Efficacy for Managing Chronic Disease (SEMCD) scale has been validated in SSc [ 130 ] and indeed, it will be of interest to compare therapy responses by scales created by the physician’s judgment with those indexes that take into account fatigue, physical discomfort and pain, emotional distress, interference of health problems in daily life activities and independence. More specific PROs that assess specific domains (gastrointestinal, circulatory to name a few) have been validated and can be used to gauge disease progression and response to therapy from the patient’s perspective [ 9 ]; however, more specific instruments to capture the complexity of the disease or that combine clinical and patient-based endpoints are needed.…”