School of Nursing, Tianjin Medical University, Tianjin, China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Neurogastroenterol Motil. 2022 Jan;34(1):e14255. doi: 10.1111/nmo.14255. Epub 2021 Sep 7.
Self-efficacy in defecation plays an important role on behavioral therapy for functional constipation (FC). There is an unmet need for valid child self-report measures of task-specific self-efficacy for pediatric FC. Our aim was to cross-culturally validate the Self-Efficacy for Functional Constipation Questionnaire (SEFCQ) and to explore the salient factor(s) of self-efficacy in defecation that correlate with anxiety and constipation symptom severity among Chinese children.
The SEFCQ was adapted to Chinese version following the Rome Foundation guidelines for the translation of questionnaires. Two hundred and three children with FC were involved in psychometric testing. Confirmatory factor analysis was conducted to determine the structure of the SEFCQ. Construct validity was evaluated by testing the relationship between the SEFCQ and both anxiety and the Patient Assessment of Constipation Symptoms (PAC-SYM). Test-retest reliability, internal consistency, and interfactor correlation were used to evaluate reliability. Hierarchical multiple regression was used to identify salient self-efficacy for FC that correlates with anxiety and constipation symptom severity.
Confirmatory factor analysis supports the two-factor structure of the SEFCQ. Adequate test-retest reliability (r = 0.973, p<0.001) and internal consistency (Cronbach's α = 0.871) were obtained. Both self-efficacy factors were significantly associated with anxiety (r = -0.227 to -0.350, p<0.001) and PAC-SYM (r = -0.495 to -0.602, p<0.001), with emotional self-efficacy being the most salient factor for predicting the symptom severity of constipation after controlling for sex, age, quality of parents' marriage, and family history.
The SEFCQ showed satisfactory psychometric properties. Low self-efficacy in defecation correlates with anxiety and may contribute to poor adherence to behavior change, which exacerbates the symptoms of constipation. Further study is needed to apply social cognitive intervention to increase children's self-efficacy in defecation and assess its effect on treatment outcomes.
自我效能感在功能性便秘（FC）的行为治疗中起着重要作用。目前，对于儿科 FC 患者，仍缺乏有效的针对特定排便任务的自我效能感的儿童自评量表。本研究旨在对功能性便秘自我效能量表（SEFCQ）进行跨文化验证，并探讨与中国儿童焦虑和便秘症状严重程度相关的排便自我效能感的显著因素。
根据罗马基金会问卷翻译指南对 SEFCQ 进行适应性调整。共有 203 例 FC 患儿参与了心理测量学测试。采用验证性因子分析确定 SEFCQ 的结构。通过测试 SEFCQ 与焦虑和患者便秘症状评估（PAC-SYM）的关系来评估结构效度。使用重测信度、内部一致性和因子间相关性来评估信度。采用分层多元回归分析确定与焦虑和便秘症状严重程度相关的 FC 自我效能感的显著因素。
验证性因子分析支持 SEFCQ 的两因素结构。重测信度（r=0.973，p<0.001）和内部一致性（Cronbach's α=0.871）均良好。两个自我效能感因子均与焦虑（r=-0.227 至-0.350，p<0.001）和 PAC-SYM（r=-0.495 至-0.602，p<0.001）显著相关，在控制性别、年龄、父母婚姻质量和家族史后，情绪自我效能感是预测便秘症状严重程度的最显著因素。
SEFCQ 具有良好的心理测量学特性。排便自我效能感低与焦虑相关，可能导致对行为改变的依从性差，从而使便秘症状恶化。需要进一步研究应用社会认知干预来提高儿童的排便自我效能感，并评估其对治疗结果的影响。
