Aim: The Self-Care Self-Efficacy Scale (SCSES) was newly developed as a self-report measure for self-care self-efficacy for chronic illness. This study investigated its measurement equivalence (ME) in different cultural groups, including United States, China (Hong Kong), Italy, and Brazil.
Design: A multi-national study for cross-cultural validation of the Scale.
Methods: From January 2015 - December 2018, investigators recruited 957 patients (United State: 200; Hong Kong: 300; Italy: 285; and Brazil: 142) with chronic illness from inpatient and outpatient settings. The SCSES was administered and clinical and demographic data were collected from participants. Based on the Meredith framework, multi-group confirmatory factor analysis evaluated the configural, metric, scalar, and strict invariance of the scale across the four populations through a series of nested models, with evaluation of reliability and coherence of the factor solution.
Results: The mean ages of the groups ranged from 65-77 years, 56.4% was male. The Cronbach's alpha coefficients of the single-factor SCSES were 0.93, 0.89, 0.92, and 0.90 for the United States, China (Hong Kong), Italy, and Brazil, respectively. Three of the four levels of ME were partially or totally supported. The highest level achieved was partial scalar invariance level (χ2 [52] = 313.4, p < 0.001; RMSEA = 0.067; 95% CI = 0.056-0.077; CFI = 0.966; TLI = 0.960, SRMR = 0.080).
Conclusion: Patients from the four countries shared the same philosophical orientation towards scale items, although some of the items contributed differently to represent the concept and participants shared the same schemata for score interpretation.
Impact: Self-efficacy is important in producing effective and sustainable self-care behavioural changes. Cultural ideation shapes the ways individuals interpret and report their self-care self-efficacy. The study findings support cross-cultural and cross-national utility of the SCSES for research on self-care across United States, China (Hong Kong), Italy, and Brazil.
目的: 自我护理自我效能量表(SCSES)是一种最新制定的对慢性病自我护理自我效能的自我报告测量方法。本研究调查了其在美国、中国(香港)、意大利、巴西等不同文化群体的测量等效性(ME)。 设计: 量表跨文化验证的跨国研究。 方法: 自2015年1月至2018年12月,研究员招募了957位患有慢性病的住院患者和门诊患者(美国:200;香港:300;意大利:285;以及巴西:142)进行了自我护理自我效能量表测量,并收集了参与者的门诊和人口数据。基于Meredith框架,多组验证性因素分析通过一系列嵌套模型评估了这四类人群的量表构型、度量、标量以及严格等值,并评估了因素解决方案的可靠性和一致性。 结果: 各组的平均年龄为65岁至77岁,其中男性占总参与者人数的56.4%。美国的单因素自我护理自我效能量表的克隆巴赫系数为0.93、中国(香港)为0.89、意大利为0.92、巴西为0.90。测量等效性的四个等级中的三个得到了部分或全部支持。达到的最高等级为部分标量不变性等级。(χ2 [52] = 313.4、 p < 0.001、 RMSEA = 0.067、95% CI = 0.056-0.077、CFI = 0.966、TLI = 0.960、SRMR = 0.080) 结论: 尽管部分项目不同(观念不同),但是来自四个国家的患者在思想上对量表项目有着相同的选择,并且参与者有着相同的评分解读图解。 影响: 在有效并持续改变自我护理行为时,自我效能非常重要。文化观念的形成塑造了个人解释和报告其自我护理自我效能的方式。研究调查结果支持在美国、中国(香港)、意大利和巴西的自我护理研究中采用跨文化跨国的自我护理自我效能量表。.
Keywords: chronic disease; cross-cultural comparison; disease management; illness behaviour; nursing care; psychometrics; self-care; self-efficacy; survey and questionnaire.
© 2020 John Wiley & Sons Ltd.