Riehm Kira E, Kwakkenbos Linda, Carrier Marie-Eve, Bartlett Susan J, Malcarne Vanessa L, Mouthon Luc, Nielson Warren R, Poiraudeau Serge, Nielsen Karen, Baron Murray, Frech Tracy, Hudson Marie, Pope Janet, Sauve Maureen, Suarez-Almazor Maria E, Wigley Fredrick M, Thombs Brett D
Jewish General Hospital, Montreal, Canada.
Jewish General Hospital and McGill University, Montreal, Canada, and Radboud University, Nijmegen, The Netherlands.
Arthritis Care Res (Hoboken). 2016 Aug;68(8):1195-200. doi: 10.1002/acr.22807.
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.
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.
A total of 553 patients were included. CFA supported the single-factor structure of the SEMCD scale (Tucker Lewis Index = 0.99, comparative fit index = 0.99, root mean square error of approximation = 0.10). Internal consistency was high (α = 0.93), and correlations with measures of psychological and physical functioning were moderate to large (|r| = 0.48-0.67, P < 0.001), confirming study hypotheses.
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.
针对包括风湿性疾病在内的慢性病患者的自我管理项目,旨在提高其进行健康管理行为的自我效能感。目前尚无针对系统性硬化症(SSc;硬皮病)患者的自我效能感测量方法得到验证。本研究的目的是评估慢性病自我管理效能感(SEMCD)量表在SSc患者中的有效性和内部一致性信度。
纳入2014年3月至2015年6月期间在硬皮病患者中心干预网络队列中,于基线评估时完成SEMCD量表的英语为母语的SSc患者。患者来自加拿大、美国和英国的21个地点。采用验证性因子分析(CFA)评估SEMCD量表的因子结构。计算Cronbach's α系数以评估内部一致性信度。提出并检验了关于与心理和身体结局指标的Pearson相关性方向和大小的假设,以检验聚合效度。
共纳入553例患者。CFA支持SEMCD量表的单因子结构(塔克-刘易斯指数=0.99,比较拟合指数=0.99,近似均方根误差=0.10)。内部一致性较高(α=0.93),与心理和身体功能指标的相关性为中度至高度(|r|=0.48 - 0.67,P<0.001),证实了研究假设。
SEMCD量表的得分对于测量SSc患者的自我效能感是有效的,结果支持将该量表作为一种结局指标来评估SSc患者自我管理项目的有效性。