Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
J Viral Hepat. 2012 May;19(5):316-26. doi: 10.1111/j.1365-2893.2011.01550.x. Epub 2011 Nov 24.
Self-efficacy or confidence in one's ability to successfully engage in goal-directed behaviour 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 Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study were examined. Baseline participants were randomly split into two equal-sized subsamples (S(1) and S(2) ). Initial exploratory and confirmatory factor analyses (EFA/CFA) were performed on S(1), while S(2) was used to validate the factor structure of the S(1) results using CFA. An additional CFA was performed on the treatment week 24 participants. Convergent and discriminant validity were assessed by comparing the revised instrument with other psychosocial measures: depression, social support, quality of life and medication-taking behaviour. 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 (0.92-0.94) and four factors (0.85-0.96) 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.
自我效能感或对成功参与目标导向行为的能力的信心已被证明会影响许多慢性疾病的药物依从性。在本研究中，我们调查了用于慢性丙型肝炎病毒感染（HCV）治疗的自我效能工具的心理测量学特性。前瞻性纵向慢性丙型肝炎抗病毒治疗病毒耐药性研究的基线（n=394）和治疗 24 周（n=254）数据进行了检查。基线参与者被随机分为两个相等大小的样本（S(1)和 S(2)）。在 S(1)上进行了初始探索性和验证性因子分析（EFA/CFA），而 S(2)用于使用 CFA验证 S(1)结果的因子结构。对治疗 24 周的参与者进行了额外的 CFA。通过将修订后的工具与其他社会心理测量进行比较，评估了聚合和判别有效性：抑郁、社会支持、生活质量和服药行为。我们的研究结果支持了一种简化的 17 项丙型肝炎治疗自我效能感（HCV-TSE）综合评估，具有四个潜在因素：患者沟通自我效能感、一般身体应对自我效能感、一般心理应对自我效能感和依从性自我效能感。全球评分（0.92-0.94）和四个因素（0.85-0.96）表现出良好的内部一致性。聚合和判别有效性的相关性与其他社会心理功能测量结果呈低度到中度相关。修订后的 HCV-TSE 工具可提供对参与和坚持 HCV 抗病毒治疗能力的信心的可靠和有效的综合评估。四因素结构表明，在 HCV 治疗期间可能存在不同类型的效能信念，并且应该进一步探索与临床结果的关系。
