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Multidimensionality of the PROMIS self-efficacy measure for managing chronic conditions

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Abstract

Purpose

This study investigated the PROMIS Self-Efficacy Measure for Managing Chronic Conditions (PROMIS-SE) domain distributions and examined the factor structure of the PROMIS-SE.

Methods

A total of 1087 individuals with chronic conditions participated in this study. PROMIS-SE’s item banks and two short forms (eight-item and four-item) measuring five behavioral domains (daily activities(DA), Emotions(EM), medications and treatments(MT), social interactions(SS), and Symptoms(SX)) were examined. PROMIS-SE’s T-score ranges and distributions were examined to identify domain metric distributions and confirmatory factor analysis (CFA) was conducted to test a multidimensional model fit to the PROMIS-SE.

Results

PROMIS-SE domains showed different T-score ranges and distributions for item banks and two short forms across all five domains. While PROMIS-SE EM demonstrated the highest T-scores (least negatively skewed), MT had the lowest T-scores (most negatively skewed) for all three forms. In general, respondents were more likely to achieve highest self-efficacy ratings (very confident) for domains DA, MT, and SS as compared to domains EM and SX. CFA confirmed that a multidimensional model adequately fit all three PROMIS-SE forms.

Conclusion

Our results indicate that self-efficacy T-distributions are not consistent across domains (i.e., managing medications and treatments domain was more negatively skewed difficult than other domains), which is a requirement for making inter-domain comparisons. A multidimensional model could be used to enhance the PROMIS-SE’s estimate accuracy and clinical utility.

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Funding

The study was funded by the National Institutes of Health, Development and Validation of a Self–Efficacy Item Bank (Grant No. 1U01AR057967-01, Lisa Shulman (PI)). The presented results and conclusions in this paper are from the authors; the findings from this study are independent from the funding source. The fully developed measures of self-efficacy for self-management of chronic diseases can be found at http://www.healthmeasures.net/.

Author information

Authors and Affiliations

  1. Department of Occupational Therapy, University of Florida, PO BOX 100164, Gainesville, FL, 32610, USA

    Mi Jung Lee & Sergio Romero

  2. Center of Innovation on Disability and Rehabilitation Research (CINDRR), Department of Veterans Affairs, 101 SE 2nd Place Ste 104, Gainesville, FL, 32601, USA

    Mi Jung Lee & Sergio Romero

  3. Division of Occupational Therapy, Medical University of South Carolina, 151-B Rutledge Avenue, MSC 962, Charleston, SC, 29425, USA

    Craig A. Velozo

  4. Division of Gerontology, Department of Epidemiology & Public Health, University of Maryland School of Medicine, Rm 213, Howard Hall, 660 west redwood, Baltimore, MD, 21201, USA

    Ann L. Gruber-Baldini

  5. Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Maryland School of Medicine, 110 S. Paca Street, Rm 3-S-127, Baltimore, MD, 21201, USA

    Lisa M. Shulman

Authors
  1. Mi Jung Lee
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  2. Sergio Romero
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  3. Craig A. Velozo
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  4. Ann L. Gruber-Baldini
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  5. Lisa M. Shulman
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Corresponding author

Correspondence to Sergio Romero.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional review boards (IRB) of the Medical University of South Carolina (#Pro00033397), the University of Florida (#261–2010), and the University of Maryland (#HP-000432550). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All participants were treated and reimbursed as consultants. Therefore, informed consent was not required.

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Lee, M.J., Romero, S., Velozo, C.A. et al. Multidimensionality of the PROMIS self-efficacy measure for managing chronic conditions. Qual Life Res 28, 1595–1603 (2019). https://doi.org/10.1007/s11136-019-02116-w

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  • DOI: https://doi.org/10.1007/s11136-019-02116-w

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