New England College of Optometry, 424 Beacon St., Boston, MA, 02115, USA.
Department of Ophthalmology, University of California, Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA, USA.
Health Qual Life Outcomes. 2024 Oct 23;22(1):90. doi: 10.1186/s12955-024-02306-2.
While general self-efficacy is known to relate to achievement in many areas, it has rarely been evaluated in individuals with low vision. Here we explore the psychometric properties and targeting of the New General Self Efficacy Scale (NGSES) using Rasch analysis in data collected from older adult clinical trial participants with low vision.
Participants (n = 121) completed pre-intervention telephone questionnaires (i.e., NGSES, Activity Inventory (AI), Beck Depression Inventory (BDI), SF-36, and the Telephone Interview for Cognitive Status (TICS). Rasch analysis using the Method of Successive Dichotomizations (MSD) was applied to NGSES, AI, and BDI datasets to estimate person and item measures, and ordered rating category thresholds. NGSES infit mean square statistics and standard errors were analyzed to test whether data fit Rasch model requirements, and targeting was assessed by comparing distributions of person and item measures. Multiple linear regression evaluated the influence of participant characteristics on NGSES person measures.
There was a significant difference (p = 0.01) in the distributions of NGSES person measures (mean = 0.85, range -2.1-3.2) and item measures (mean = 0, range -1.0-0.72). Infit mean square statistics and standard errors for item and person measures conformed to expectations of the Rasch model. Greater NGSES person measure was related to lower BDI person measure (β = -0.48, p < 0.0005, 95% CI -0.67--0.28) and higher AI person measure (β = 0.11, p = 0.047, 95% CI 0.0013 - 0.22) after controlling for cognitive status (TICS). Other variables including SF-36, visual acuity, and patient demographics were not related to NGSES person measure.
While NGSES person measures estimated from a low vision patient population conformed to basic Rasch model requirements, the significant differences in the person and item measure distributions indicate poor NGSES targeting, specifically a ceiling effect. Therefore, there is limited discrimination between persons at the upper end of the scale. While further work can evaluate how self-efficacy may be associated with other factors in the low vision patient population, the ceiling effect found in this study cautions interpretation of NGSES results for those with high general self-efficacy.
Pre-registered on clinicaltrials.gov, identifier NCT04926974.
虽然一般自我效能感被认为与许多领域的成就有关，但在低视力人群中很少对其进行评估。在这里，我们使用 Rasch 分析探讨了新一般自我效能感量表（NGSES）在低视力老年临床试验参与者数据中的心理测量特性和针对性。
参与者（n=121）在干预前通过电话完成了问卷调查（即 NGSES、活动量表（AI）、贝克抑郁量表（BDI）、SF-36 和电话认知状态测试（TICS）。使用连续二分法（MSD）的 Rasch 分析应用于 NGSES、AI 和 BDI 数据集，以估计人和项目的测量值以及有序评分类别阈值。分析 NGSES 内特均方统计和标准误差，以测试数据是否符合 Rasch 模型要求，并通过比较人和项目测量值的分布来评估针对性。多元线性回归评估参与者特征对 NGSES 人的测量值的影响。
NGSES 人的测量值（均值=0.85，范围-2.1-3.2）和项目测量值（均值=0，范围-1.0-0.72）的分布存在显著差异（p=0.01）。项目和人的测量值的内特均方统计和标准误差符合 Rasch 模型的预期。NGSES 人的测量值越高，BDI 人的测量值越低（β=-0.48，p<0.0005，95%置信区间-0.67--0.28），AI 人的测量值越高（β=0.11，p=0.047，95%置信区间 0.0013-0.22），而认知状态（TICS）则越低。控制认知状态（TICS）后，其他变量，包括 SF-36、视力和患者人口统计学特征与 NGSES 人的测量值无关。
虽然从低视力患者群体中估算出的 NGSES 人的测量值符合基本的 Rasch 模型要求，但人和项目测量值分布的显著差异表明 NGSES 针对性差，特别是存在天花板效应。因此，在量表的较高端，人与人之间的区分度有限。虽然进一步的工作可以评估自我效能感如何与低视力患者群体中的其他因素相关，但本研究中发现的天花板效应告诫人们，在那些具有高一般自我效能感的人身上，对 NGSES 结果的解释应持谨慎态度。
在 clinicaltrials.gov 上预先注册，标识符 NCT04926974。
