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Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic
Anja Frei1, Anna Svarin, Claudia Steurer-Stey
1Department of General Practice and Health Services Research, University Hospital of Zurich, Switzerland. anja.frei@usz.ch
Health and Quality of Life Outcomes
|September 29, 2009
Summary
Most self-efficacy instruments for chronic diseases have significant development and validation flaws. Improved methodology and transparent reporting are crucial for accurate patient-reported outcomes in chronic disease self-efficacy measurement.
Area of Science:
- Health Psychology
- Clinical Research Methodology
- Patient-Reported Outcomes
Background:
- Accurate measurement of self-efficacy is vital for chronic disease management.
- Existing self-efficacy instruments for chronic diseases may lack rigorous development and validation.
- A systematic assessment of these instruments is needed.
Purpose of the Study:
- To systematically identify self-efficacy scales for diabetes, COPD, asthma, arthritis, and heart failure.
- To evaluate the development and validation processes of these identified instruments.
Main Methods:
- Systematic literature search across MEDLINE, PSYCHINFO, and EMBASE.
- Inclusion criteria focused on studies detailing instrument development and/or validation.
- Evaluation of instruments based on development (aim, item generation, domains, response options) and validation (reliability, validity, responsiveness) criteria.
Main Results:
- 26 self-efficacy instrument versions were identified across four chronic diseases (diabetes, asthma, arthritis, COPD); none for heart failure.
- Many instruments lacked clear aims (69.2%) or specified a priori considerations (96.2%).
- Item generation was not systematically described in any study, and test-retest reliability, validity, and responsiveness were assessed in only 34.6%, 69.2%, and 11.5% of instruments, respectively.
Conclusions:
- The majority of self-efficacy instruments for chronic diseases exhibit significant limitations in their development and validation.
- Lack of specified aims and incomplete assessment of measurement properties (e.g., responsiveness) are common issues.
- Researchers should adopt rigorous methodological standards for developing and validating patient-reported outcome measures, ensuring transparent reporting and proposing a systematic approach.
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