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Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic review.

ABSTRACT: BACKGROUND: Measurement of self-efficacy requires carefully developed and validated instruments. It is currently unclear whether available self-efficacy instruments for chronic diseases fulfill these requirements. Our aim was to systematically identify all existing self-efficacy scales for five major chronic diseases and to assess their development and validation process. METHODS: We conducted a systematic literature search in electronic databases (MEDLINE, PSYCHINFO, and EMBASE) to identify studies describing the development and/or validation process of self-efficacy instruments for the five chronic diseases diabetes, chronic obstructive pulmonary disease (COPD), asthma, arthritis, and heart failure. Two members of the review team independently selected articles meeting inclusion criteria. The self-efficacy instruments were evaluated in terms of their development (aim of instrument, a priori considerations, identification of items, selection of items, development of domains, answer options) and validation (test-retest reliability, internal consistency reliability, validity, responsiveness) process. RESULTS: Of 584 potentially eligible papers we included 25 (13 for diabetes, 5 for asthma, 4 for arthritis, 3 for COPD, 0 for heart failure) which covered 26 different self-efficacy instrument versions. For 8 instruments (30.8%), the authors described the aim before the scales were developed whereas for the other instruments the aim was unclear. In one study (3.8%) a priori considerations were specified. In none of the studies a systematic literature search was carried out to identify items. The item selection process was often not clearly described (38.5%). Test-retest reliability was assessed for 9 instruments (34.6%), validity using a correlational approach for 18 (69.2%), and responsiveness to change for 3 (11.5%) instruments. CONCLUSION: The development and validation process of the majority of the self-efficacy instruments had major limitations. The aim of the instruments was often not specified and for most instruments, not all measurement properties that are important to support the specific aim of the instrument (for example responsiveness for evaluative instruments) were assessed. Researchers who develop and validate self-efficacy instruments should adhere more closely to important methodological concepts for development and validation of patient-reported outcomes and report their methods more transparently. We propose a systematic five step approach for the development and validation of self-efficacy instruments.

SUBMITTER: Frei A

PROVIDER: S-EPMC2761851 | biostudies-other | 2009

REPOSITORIES: biostudies-other

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Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic review.

Frei Anja A Svarin Anna A Steurer-Stey Claudia C Puhan Milo A MA

Health and quality of life outcomes 20090926

<h4>Background</h4>Measurement of self-efficacy requires carefully developed and validated instruments. It is currently unclear whether available self-efficacy instruments for chronic diseases fulfill these requirements. Our aim was to systematically identify all existing self-efficacy scales for five major chronic diseases and to assess their development and validation process.<h4>Methods</h4>We conducted a systematic literature search in electronic databases (MEDLINE, PSYCHINFO, and EMBASE) to ...[more]

PMID: 19781095

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Project description:BackgroundDespite the potentially life-saving benefits of the implantable cardioverter-defibrillator (ICD), a significant group of patients experiences emotional distress after ICD implantation. Different psychosocial interventions have been employed to improve this condition, but previous reviews have suggested that methodological issues may limit the validity of such interventions.AimTo review the methodology of previously published studies of psychosocial interventions in ICD patients, according to CONSORT statement guidelines for non-pharmacological interventions, and provide recommendations for future research.MethodsWe electronically searched the PubMed, PsycInfo and Cochrane databases. To be included, studies needed to be published in a peer-reviewed journal between 1980 and 2008, to involve a human population aged 18+ years and to have an experimental design.ResultsTwelve studies met the eligibility criteria. Samples were generally small. Interventions were very heterogeneous; most studies used cognitive behavioural therapy (CBT) and exercise programs either as unique interventions or as part of a multi-component program. Overall, studies showed a favourable effect on anxiety (6/9) and depression (4/8). CBT appeared to be the most effective intervention. There was no effect on the number of shocks and arrhythmic events, probably because studies were not powered to detect such an effect. Physical functioning improved in the three studies evaluating this outcome. Lack of information about the indication for ICD implantation (primary vs. secondary prevention), limited or no information regarding use of anti-arrhythmic (9/12) and psychotropic (10/12) treatment, lack of assessments of providers' treatment fidelity (12/12) and patients' adherence to the intervention (11/12) were the most common methodological limitations.ConclusionsOverall, this review supports preliminary evidence of a positive effect of psychosocial interventions on anxiety and physical functioning in ICD patients. However, these initial findings must be interpreted cautiously because of important methodological limitations. Future studies should be designed as large RCTs, whose design takes into account the specific challenges associated with the evaluation of behavioural interventions.

Project description:BackgroundFalls efficacy is a widely-studied latent construct in community-dwelling older adults. Various self-reported instruments have been used to measure falls efficacy. In order to be informed of the choice of the best measurement instrument for a specific purpose, empirical evidence of the development and measurement properties of falls efficacy related instruments is needed.MethodsThe Consensus-based Standards for the Selection of Health Measurement Intruments (COSMIN) checklist was used to summarise evidence on the development, content validity, and structural validity of instruments measuring falls efficacy in community-dwelling older adults. Databases including MEDLINE, Web of Science, PsychINFO, SCOPUS, CINAHL were searched (May 2019). Records on the development of instruments and studies assessing content validity or structural validity of falls efficacy related scales were included. COSMIN methodology was used to guide the review of eligible studies and in the assessment of their methodological quality. Evidence of content validity: relevance, comprehensiveness and comprehensibility and unidimensionality for structural validity were synthesised. A modified GRADE approach was applied to evidence synthesis.ResultsThirty-five studies, of which 18 instruments had been identified, were included in the review. High-quality evidence showed that the Modified Falls Efficacy Scale (FES)-13 items (MFES-13) has sufficient relevance, yet insufficient comprehensiveness for measuring falls efficacy. Moderate quality evidence supported that the FES-10 has sufficient relevance, and MFES-14 has sufficient comprehensibility. Activities-specific Balance Confidence (ABC) Scale-Simplified (ABC-15) has sufficient relevance in measuring balance confidence supported by moderate-quality evidence. Low to very low-quality evidence underpinned the content validity of other instruments. High-quality evidence supported sufficient unidimensionality for eight instruments (FES-10, MFES-14, ABC-6, ABC-15, ABC-16, Iconographical FES (Icon-FES), FES-International (FES-I) and Perceived Ability to Prevent and Manage Fall Risks (PAPMFR)).ConclusionContent validity of instruments to measure falls efficacy is understudied. Structural validity is sufficient for a number of widely-used instruments. Measuring balance confidence is a subset of falls efficacy. Further work is needed to investigate a broader construct for falls efficacy.

Project description:ObjectiveTo evaluate systematically the quality of the cohort studies on rheumatic diseases in China.MethodsRelevant databases were searched to find cohort studies on rheumatic diseases in China, and the basic information included in the literature was extracted and analyzed. Chinese and English literature were then compared with regard to methodological quality, according to the Newcastle-Ottawa Scale (NOS).ResultsIn total, we included 46 cohort studies, with 19 studies published in English and 27 studies published in Chinese. With regard to the basic characteristics of the literature, 78.26% of the studies were published in the past four years; 16 studies were associated with hyperuricemia, followed by eight studies involving systemic lupus erythematosus. The sample size of the studies in Chinese was lower than that in English studies (P< 0.05). The English literature was superior to the Chinese literature in terms of informed consent, ethical review and selection of statistical analysis methods. The methodology quality of the 46 included studies showed that the English and Chinese NOS scores were 5.59 ± 1.25 and 6.06 ± 1.11, respectively, and the difference was significant (P< 0.01). The "representativeness of the exposed group", "demonstration that outcome of interest was not present at start of study", and the "adequacy of follow up of cohorts" scores were relatively low in Chinese and English studies. The score for "was follow-up long enough for outcomes to occur" item in English was higher than that in the Chinese studies; however, the "study controls for the most important factor" score for Chinese papers was better than that for the English papers.ConclusionThe Chinese rheumatic disease cohort studies started late, with a small sample size and fewer types of rheumatism. The quality of Chinese studies was better than English studies, and all reports were insufficient. In particular, "selecting exposed groups", "controlling the outcomes before study implementation" and "adequacy of follow-up" needed improvement.

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Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic review.

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Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations--a systematic review.

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