The aim of this study was to validate a Chinese version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C). In 2012, a cross-sectional study was conducted in a community clinic, in Beijing, China. A total of 262 hypertension patients participated in this study. Concurrent validity was validated by Pearson’s correlations between the SES6C and Hospital Anxiety and Depression Scale (HADS). Intraclass correlation coefficients (ICC) were performed to evaluate test-retest reliability of the scale. Related factors of self-efficacy were explored in linear regression models. The results of our study display acceptable psychometric properties: the scale was two-dimensional, reproducible (ICC = 0.78; 95% CI, 0.70–0.84), and the reliability was good (Cronbach’s alpha = 0.88). Significant ( ; ) correlation was found between the level of self-efficacy and the level of psychological distress. In multivariable analysis, the factors significantly associated with self-efficacy were regular exercise ( , ), HADS total score ( , ) and health status ( , ). The study provides evidence that the SES6C is acceptable, valid and repeatable for hypertension patients. 1. Introduction Hypertension management requires the individual to perform varying forms of self-care behaviors, according to the recommendations of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) [1]. Self-efficacy, a widely used psychological concept, has been recognized as an essential prerequisite of effective self-care of chronic disease [2–4]. Several studies have underlined the association between self-efficacy and chronic disease self-care among hypertension, diabetes, and arthritis [5–7]. In a study by Warren-Findlow and colleagues [8], hypertension self-efficacy is strongly associated with adherence to five of the six JNC7 recommended self-care behaviors. In China, the prevalence of hypertension in adults may reach to 25% in recent years according to reports from various provinces [9–11]. However, low prevalence rate of self-care engagement among hypertension patients was reported in China [12]. Measuring the self-efficacy for self-care behaviors in hypertension patients is an important step towards improving hypertension control in individual or population level. The information gained from measurement of self-efficacy can help physicians or public health professionals to identify low self-efficacy patients and implement suitable interventions. Thus, there is a need for a measure which could be used as a screening method both
References
[1]
A. V. Chobanian, G. L. Bakris, H. R. Black et al., “The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report,” The Journal of the American Medical Association, vol. 289, no. 19, pp. 2560–2572, 2003.
[2]
T. Bodenheimer, K. Lorig, H. Holman, and K. Grumbach, “Patient self-management of chronic disease in primary care,” The Journal of the American Medical Association, vol. 288, no. 19, pp. 2469–2475, 2002.
[3]
S. Du and C. Yuan, “Evaluation of patient self-management outcomes in health care: a systematic review,” International Nursing Review, vol. 57, no. 2, pp. 159–167, 2010.
[4]
H. Leventhal, J. Weinman, E. A. Leventhal, and L. A. Phillips, “Health psychology: the search for pathways between behavior and health,” Annual Review of Psychology, vol. 59, pp. 477–505, 2008.
[5]
R. Marks, J. P. Allegrante, and K. Lorig, “A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II),” Health Promotion Practice, vol. 6, no. 2, pp. 148–156, 2005.
[6]
K. Farrell, M. N. Wicks, and J. C. Martin, “Chronic disease self-management improved with enhanced self-efficacy,” Clinical Nursing Research, vol. 13, no. 4, pp. 289–308, 2004.
[7]
H. B. Bosworth and E. Z. Oddone, “A model of psychosocial and cultural antecedents of blood pressure control,” Journal of the National Medical Association, vol. 94, no. 4, pp. 236–248, 2002.
[8]
J. Warren-Findlow, R. B. Seymour, and L. R. Brunner Huber, “The association between self-efficacy and hypertension self-care activities among African American adults,” The Journal of Community Health, vol. 37, no. 1, pp. 15–24, 2012.
[9]
S. S. Hu, L. Z. Kong, R. L. Gao, et al., “Outline of the report on cardiovascular disease in China, 2010,” Biomedical and Environmental Sciences, vol. 25, no. 3, pp. 251–256, 2012.
[10]
W. J. Ma, J. L. Tang, Y. H. Zhang, et al., “Hypertension prevalence, awareness, treatment, control, and associated factors in adults in Southern China,” American Journal of Hypertension, vol. 25, no. 5, pp. 590–596, 2012.
[11]
Y. F. Wu, R. Huxley, L. M. Li et al., “Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002,” Circulation, vol. 118, no. 25, pp. 2679–2686, 2008.
[12]
Z. Q. Sun, L. Q. Zheng, R. Detrano et al., “Incidence and predictors of hypertension among rural Chinese adults: results from Liaoning Province,” The Annals of Family Medicine, vol. 8, no. 1, pp. 19–24, 2010.
[13]
K. R. Lorig, R. L. Chastain, E. Ung, S. Shoor, and H. R. Holman, “Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis,” Arthritis & Rheumatism, vol. 32, no. 1, pp. 37–44, 1989.
[14]
J. V. Bijl, A. V. Poelgeest-Eeltink, and L. Shortridge-Baggett, “The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus,” Journal of Advanced Nursing, vol. 30, no. 2, pp. 352–359, 1999.
[15]
A. R. Webel and J. Okonsky, “Psychometric properties of a symptom management self-efficacy scale for women living with HIV/AIDS,” Journal of Pain and Symptom Management, vol. 41, no. 3, pp. 549–557, 2011.
[16]
K. C. Farmer, “Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice,” Clinical Therapeutics, vol. 21, no. 6, pp. 1074–1090, 1999.
[17]
Stanford Patient Education Research Center, Self-Efficacy for Managing Chronic Disease 6-item Scale, 2012, http://patienteducation.stanford.edu/research/secd6.html.
[18]
T. Freund, J. Gensichen, K. Goetz, et al., “Evaluating self-efficacy for managing chronic disease: psychometric properties of the six-item self-efficacy scale in Germany,” Journal of Evaluation in Clinical Practice, vol. 19, no. 1, pp. 39–43, 2013.
[19]
R. W. Brislin, “Back-translation for cross-cultural research,” Journal of Cross-Cultural Psychology, vol. 1, no. 3, pp. 185–216, 1970.
[20]
K. R. Lorig, D. S. Sobel, P. L. Ritter, D. Laurent, and M. Hobbs, “Effect of a self-management program on patients with chronic disease,” Effective Clinical Practice, vol. 4, no. 6, pp. 256–262, 2001.
[21]
Y. Chang, P. C. Wang, H. H. Li, and Y. C. Liu, “Relations among depression, self-efficacy and optimism in a sample of nurses in Taiwan,” Journal of Nursing Management, vol. 19, no. 6, pp. 769–776, 2011.
[22]
P. K. Maciejewski, H. G. Prigerson, and C. M. Mazure, “Self-efficacy as a mediator between stressful life events and depressive symptoms. Differences based on history of prior depression,” British Journal of Psychiatry, vol. 176, pp. 373–378, 2000.
[23]
P. Muris, “Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample,” Personality and Individual Differences, vol. 32, no. 2, pp. 337–348, 2002.
[24]
K. Tahmassian and N. J. Moghadam, “Relationship between self-efficacy and symptoms of anxiety, depression, worry and social avoidance in a normal sample of students,” Iranian Journal of Psychiatry and Behavioral Sciences, vol. 5, no. 2, pp. 91–98, 2011.
[25]
W. Wang, S. Y. Chair, D. R. Thompson, and S. F. Twinn, “A psychometric evaluation of the Chinese version of the hospital anxiety and depression scale in patients with coronary heart disease,” Journal of Clinical Nursing, vol. 18, no. 17, pp. 2436–2443, 2009.
[26]
C. M. Leung, Y. K. Wing, P. K. Kwong, A. Lo, and K. Shum, “Validation of the Chinese-Cantonese version of the hospital anxiety and depression scale and comparison with the Hamilton rating scale of depression,” Acta Psychiatrica Scandinavica, vol. 100, no. 6, pp. 456–461, 1999.
[27]
I. Bjelland, A. A. Dahl, T. T. Haug, and D. Neckelmann, “The validity of the hospital anxiety and depression scale. An updated literature review,” Journal of Psychosomatic Research, vol. 52, no. 2, pp. 69–77, 2002.
[28]
J. M. Bland and D. G. Altman, “Cronbach's alpha,” British Medical Journal, vol. 314, no. 7080, p. 572, 1997.
[29]
K. A. Wilson, A. J. Dowling, M. Abdolell, and I. F. Tannock, “Perception of quality of life by patients, partners and treating physicians,” Quality of Life Research, vol. 9, no. 9, pp. 1041–1052, 2000.
[30]
W. Wang, D. R. Thompson, S. Y. Chair, and D. L. Hare, “A psychometric evaluation of a Chinese version of the Cardiac depression scale,” Journal of Psychosomatic Research, vol. 65, no. 2, pp. 123–129, 2008.
[31]
N. M. Clark and J. A. Dodge, “Exploring self-efficacy as a predictor of disease management,” Health Education & Behavior, vol. 26, no. 1, pp. 72–89, 1999.
[32]
M. J. Cross, L. M. March, H. M. Lapsley, E. Byrne, and P. M. Brooks, “Patient self-efficacy and health locus of control: relationships with health status and arthritis-related expenditure,” Rheumatology, vol. 45, no. 1, pp. 92–96, 2006.
[33]
D. L. Gill, B. C. Kelley, K. Williams, and J. J. Martin, “The relationship of self-efficacy and perceived well-being to physical activity and stair climbing in older adults,” Research Quarterly for Exercise and Sport, vol. 65, no. 4, pp. 367–371, 1994.
[34]
D. Grembowski, D. Patrick, P. Diehr et al., “Self-efficacy and health behavior among older adults,” Journal of Health and Social Behavior, vol. 34, no. 2, pp. 89–104, 1993.
