RCMAR Measurement Tools

Self Efficacy Scales

Generalized Self-Efficacy Scale (GSE)

• Authors: R. Schwarzer and M. Jerusalem (1995)
• Administration: The GSE is a 10-item scale with a score for each question ranging from 1 to 4. Higher scores indicate stronger patient’s belief in self-efficacy.
• Constructs Measured: The GSE is designed to assess optimistic self-beliefs used to cope with a variety of demands in life. The scale was designed to assess self efficacy, i.e., the belief that one’s actions are responsible for successful outcomes.
• Reliability and Validity: Several studies have shown that the GSE has high reliability, stability, and construct validity. The scale was found to be configurally equivalent across 28 nations, and it forms only one global dimension.
• Assessment in Minorities and Elderly: The GSE has been translated into over 28 languages.  Subjects have ranged in age from 16 to 86.
• Costs: None.
• Detailed Notes

Arthritis Self-Efficacy Scale (ASES)

• Authors: Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. (1989)
• Administration: The ASES has three subscales: Pain (PSE - 5 items), Function (FSE - 9 items), and Other Symptoms (OSE - 6 items).  Each item is scored on a scale of 10-100 where higher scores correspond to greater self-efficacy. The score for each subscale is the mean of the scores of each item. 
• Constructs Measured: The ASES measures a patient's perceived self-efficacy to cope with the consequences of chronic arthritis..
• Reliability and Validity: The reliability of the three subscales is good (Cronbach alpha 0.76 to 0.89).  Test-retest reliability for the three subscales ranged from 0.85 to 0.90.
• Assessment in Minorities and Elderly: The ASES has been translated into several languages including Spanish, German, and Swedish.  All versions have good reliability.  The Spanish version was tested among Hispanic Americans
• Costs: None.
• Detailed Notes

Cardiac Self-Efficacy Scale (CSE)

• Authors: Sullivan MD. Andrea Z, Russo J, Katon WJ (1998)
• Administration: The 13 questions of the CSE are each scored on a 5-point Likert scale (0-4) to assess the patient's confidence of knowing or acting on each item.
• Constructs Measured: The CSE measures two facets of self efficacy among patients after cardiac surgery: Control symptoms and Maintain function.
• Reliability and Validity: The two facets of the CSE are both internally reliable (Cronbach alpha > 0.85) and externally valid.
• Assessment in Minorities and Elderly: The age range of the initial study population was 45 to 85.  The CSE has not been tested in minorities.
• Costs: None.
• Detailed Notes

Medication Adherence Self-Efficacy Scale (MASE)

• Authors: Ogedegbe G, Mancuso CA, Allegrante JP, Charlson ME (2003)
• Administration: For each of the 26 situations presented on the MASE, patients are asked to rate how sure they are that they can take their blood pressure medications ALL OF THE TIME: Not at all sure, Somewhat sure, Very sure.
• Constructs Measured: The objective was to develop and evaluate a medication adherence self-efficacy scale among hypertensive African Americans. The MASE consists of a single factor.
• Reliability and Validity: The internal reliability of the MASE is excellent (Cronbach alpha = 0.95). There is no external validation that results of the scoring equate with medication compliance or control of hypertension.
• Assessment in Minorities and Elderly: The MASE was designed and tested in a population of African-Americans (mean age 56).
• Costs: None.
• Detailed Notes

Osteoporosis Self-Efficacy Scale (OSE)

• Authors: Horan ML, Kim KK, Gendler P, Froman RD, Patel MD (1998)
• Administration: The format is a visual analog in which the lower anchor of a 10 cm line was "not at all confident" and the upper end was "very confident". The phrase “If it were recommended that you do any of the following this week, how confident would you be that you could” was used as the stem for the 21 items on the scale. The degree of confidence was measured to the nearest 1 mm. 
• Constructs Measured: The final version of the OSE scale contains items reflecting initiation, maintenance, and persistence at osteoporosis preventive behaviors.  The items load on two factors: Exercise and Calcium Intake.  The scale does not measure behaviors among patients currently with osteoporosis.
• Reliability and Validity: The two factors (OSE-Exercise and OSE-Calcium) have Cronbach alphas of 0.94 and 0.93, respectively.  The factors also provide a significant degree of explanation of an individual's exercise level and calcium intake.
• Assessment in Minorities and Elderly: The average age of the initial tested population was 56.  The OSE has not been tested specifically in minorities.
• Costs: None.
• Detailed Notes

Outcome Expectations for Exercise Scale (OEE)

• Authors: Resnick, B, SI Zimmerman, D Orwig, A-L Furstenberg, J Magaziner (2000)
• Administration: The OEE consists of nine statements about the benefits of exercising. The subject is asked to rate his agreement with each statement from 1 (Strongly Disagree) to 5 (Strongly Agree).  The total score is the sum of all nine items.
• Constructs Measured: The OEE was developed to identify elderly individuals with low expectations for the effects of exercise.  Interventions can then be implemented to help these individuals strengthen their outcome expectations, which may subsequently improve exercise behavior. The OEE scale specifically focuses on the perceived consequences of exercise for older adults .
• Reliability and Validity: Internal reliability of the scale is good (Cronbach alpha = 0.89). 
• Assessment in Minorities and Elderly: The OEE was specifically designed for older adults and developed from a nursing home population.  The OEE was subsequently tested in a population of elderly African- and Latino-Americans and found to have high reliability and validity within these populations.
• Costs: None.
• Detailed Notes

Self-Efficacy for Exercise Scale (SEE)

• Authors: Resnick and Jenkins (2000)
• Administration: The SEE consists of nine situations that might affect participation in exercise.  For each one, the subject uses the scale from 0 (Not Confident) to 10 (Very Confident) to describe his current confidence that he could exercise 3 times a week for 20 minutes each time.
• Constructs Measured: The SEE scale is a revision of McAuley's (1990) self-efficacy barriers to exercise measure, a 13-item instrument that focuses on self-efficacy expectations related to the ability to continue exercising in the face of barriers to exercise. This measure was developed initially for sedentary adults in the community who participated in an outpatient exercise program including biking, rowing, and walking.
• Reliability and Validity: The SEE shows excellent internal reliability (alpha=0.92) and validity in comparison to other measures of exercise and mental health.
• Assessment in Minorities and Elderly: The SEE was designed specifically for elderly individuals and has been tested and used in minority populations including African, Latino, and Native Americans.
• Costs: None.
• Detailed Notes

Self-Efficacy for Rehabilitation Outcome Scale (SER)

• Authors: Waldrop D, Lightsey OR, Ethington CA, Woemmel CA, Coke AL (2001)
• Administration: The SER consists of 12 items asking about the patient's ability to perform rehabilitation behaviors.   Each is answered on a scale of 0 (I cannot do) to 10 (certain I can do).  The final SER score is the mean of the 12 items.
• Constructs Measured: The scale measures the patient's beliefs about whether he/she can perform behaviors typical in physical rehabilitation for knee and hip surgery. Further studies have indicated that the SER can be separated into 2 subscales measuring factors associated with ‘self-efficacy in overcoming barriers’ and ‘self-efficacy for rehabilitation therapy exercises’.
• Reliability and Validity: The scale has excellent internal reliability and external validity.  Cronbach alpha for the entire scale is 0.94, and for the two sub-scales is 0.94 and 0.87.
• Assessment in Minorities and Elderly: The original population in which the scale was tested had an average age of 73 and consisted of 17% Blacks.  A Dutch version of the SER has been developed and tested.
• Costs: None.
• Detailed Notes