The Cardiac Self-Efficacy Scale,a useful tool with potential to evaluate person-centred care

Abstract

Background:

Cardiac self-efficacy is a person’s belief in his/her ability to manage the challenges posed by a coronary disease, and its role has been evaluated in several coronary populations using the Cardiac Self-Efficacy Scale (CSE Scale). Self-efficacy has an important role in person-centred care, however there is a lack of appropriate instruments that evaluate person-centred interventions.

Aim:

The purpose of this study was to validate the CSE Scale by examining its psychometric properties as a first step in evaluating a person-centred care intervention in persons with acute coronary syndrome (ACS).

Methods:

The study sample consisted of 288 persons (72 women, 216 men) who completed the Swedish version of the CSE Scale two months after hospitalisation for an ACS event. Construct validity was psychometrically evaluated using confirmatory factor analysis. Additionally, convergent and discriminant validity were tested using correlation analyses.

Results:

The results revealed that the CSE Scale was represented by three dimensions (control symptoms, control illness and maintain functioning). The analyses also showed that the CSE Scale is suitable for providing a total summary score that represents a global cardiac self-efficacy dimension. Evaluation of convergent and discriminant validity showed the expected correlations.

Conclusion:

The CSE Scale is a valid and reliable measure when evaluating self-efficacy in patients with ACS. It also seems to be a useful tool to promote person-centred care in clinical practice since it may offer useful guidance in the dialogue with the patient in the common creation of a personal health plan.

Keywords

Acute coronary syndrome myocardial infarction patient-centered care person-centred care psychometric validation self-efficacy

Get full access to this article

View all access options for this article.

References

Nichols

Townsend

Scarborough

. Cardiovascular disease in Europe: Epidemiological update. Eur Heart J 2013; 34: 3028–3034.

Brink

Alsen

Herlitz

. General self-efficacy and health-related quality of life after myocardial infarction. Psychol Health Med 2012; 17: 346–355.

Schweikert

Hunger

Meisinger

. Quality of life several years after myocardial infarction: Comparing the MONICA/KORA registry to the general population. Eur Heart J 2009; 30: 436–443.

Roest

Martens

Denollet

. Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: A meta-analysis. Psychosom Med 2010; 72: 563–569.

Meijer

Conradi

Bos

. Adjusted prognostic association of depression following myocardial infarction with mortality and cardiovascular events: Individual patient data meta-analysis. Br J Psychiatry 2013; 203: 90–102.

Bandura

. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev 1977; 84: 191–215.

Ekman

Swedberg

Taft

. Person-centered care–ready for prime time. Eur J Cardiovasc Nurs 2011; 10: 248–251.

Schwarzer

Jerusalem

. Generalized Self-Efficacy scale. In: Weinman

Wright

Johnston

(eds) Measures in health psychology: A user’s portfolio causal and control beliefs. Windsor: NFER-Nelson, 1995, pp.35–37.

Luszczynska

Scholz

Schwarzer

. The general self-efficacy scale: multicultural validation studies. J Psychol 2005; 139: 439–457.

10.

Sol

van der Graaf

van Petersen

. The effect of self-efficacy on cardiovascular lifestyle. Eur J Cardiovasc Nurs 2011; 10: 180–186.

11.

Lau-Walker

. Importance of illness beliefs and self-efficacy for patients with coronary heart disease. J Adv Nurs 2007; 60: 187–198.

12.

Sullivan

LaCroix

Russo

. Self-efficacy and self-reported functional status in coronary heart disease: a six-month prospective study. Psychosom Med 1998; 60: 473–478.

13.

Sarkar

Ali

Whooley

. Self-efficacy as a marker of cardiac function and predictor of heart failure hospitalization and mortality in patients with stable coronary heart disease: findings from the Heart and Soul Study. Health Psychol 2009; 28: 166–173.

14.

Sarkar

Ali

Whooley

. Self-efficacy and health status in patients with coronary heart disease: findings from the heart and soul study. Psychosom Med 2007; 69: 306–312.

15.

Kang

Yang

. Cardiac self-efficacy and its predictors in patients with coronary artery diseases. J Clin Nurs 2013; 22: 2465–2473.

16.

Lauck

Johnson

Ratner

. Self-care behaviour and factors associated with patient outcomes following same-day discharge percutaneous coronary intervention. Eur J Cardiovasc Nurs 2009; 8: 190–199.

17.

Joekes

Van Elderen

Schreurs

. Self-efficacy and overprotection are related to quality of life, psychological well-being and self-management in cardiac patients. J Health Psychol 2007; 12: 4–16.

18.

Jackson

Leclerc

Erskine

. Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors. Heart 2005; 91: 10–14.

19.

Marks

Allegrante

Lorig

. A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II). Health Promot Pract 2005; 6: 148–156.

20.

Bandura

. The anatomy of stages of change. Am J Health Promot 1997; 12: 8–10.

21.

Brink

Persson

Karlson

. Coping with myocardial infarction: evaluation of a coping questionnaire. Scand J Caring Sci 2009; 23: 792–800.

22.

Overbaugh

. Acute coronary syndrome. Am J Nurs 2009; 109: 42–52; quiz 3.

23.

Nunnally

Bernstein

. Psychometric theory. New York: McGraw-Hill, 1994.

24.

Fayers

Machin

. Quality of life: assessment, analysis and interpretation. Chichester: Wiley, 2000.

25.

Rouquette

Falissard

. Sample size requirements for the internal validation of psychiatric scales. Int J Methods Psychiatr Res 2011; 20: 235–249.

26.

Muthén

. Mplus user’s guide. Los Angeles, California: Muthén & Muthén, 1998–2007.

27.

Gustafsson

J-E

Stahl

. STREAMS user’s guide. Version 3.0 for Windows. Mölndal, Sweden: MultivariateWare, 2005.

28.

Brown

. Confirmatory factor analysis for applied research. New York: Guilford Press, 2006.

29.

Muthén

Kaplan

Hollis

. On structural equation modeling with data that are not missing completely at random. Psychometrika 1987; 52: 431–462.

30.

Allison

. Missing data techniques for structural equation modeling. J Abnorm Psychol 2003; 112: 545–557.

31.

Schafer

Graham

. Missing data: Our view of the state of the art. Psychol Methods 2002; 7: 147–177.

32.

Fors

Dudas

Ekman

. Life is lived forwards and understood backwards – experiences of being affected by acute coronary syndrome: A narrative analysis. Int J Nurs Stud 2014; 51: 430–437.

33.

Ekman

Wolf

Olsson

. Effects of person-centred care in patients with chronic heart failure: The PCC-HF study. Eur Heart J 2012; 33: 1112–1119.

34.

Dudas

Olsson

Wolf

. Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care. Eur J Cardiovasc Nurs 2013; 12: 521–528.

35.

Kang

Yang

I-S

Kim

. Correlates of health behaviors in patients with coronary artery disease. Asian Nurs Res (Korean Soc Nurs Sci) 2010; 4: 45–55.

36.

Berkhuysen

Nieuwland

Buunk

. Change in self-efficacy during cardiac rehabilitation and the role of perceived overprotectiveness. Patient Educ Couns 1999; 38: 21–32.

37.

Herber

Jones

Smith

. Assessing acute coronary syndrome patients’ cardiac-related beliefs, motivation and mood over time to predict non-attendance at cardiac rehabilitation. J Adv Nurs 2012; 68: 2778–2788.

38.

McKinley

Fien

Riegel

. Complications after acute coronary syndrome are reduced by perceived control of cardiac illness. J Adv Nurs 2012; 68: 2320–2330.

39.

Bandura

. Self-efficacy: The exercise of control. Basingstoke: W. H. Freeman, 1997.

40.

Clark

Dodge

. Exploring self-efficacy as a predictor of disease management. Health Educ Behav 1999; 26: 72–89.

41.

Arnold

Ranchor

DeJongste

. The relationship between self-efficacy and self-reported physical functioning in chronic obstructive pulmonary disease and chronic heart failure. Behav Med 2005; 31: 107–115.