Health Constructs and Measurement

II. Psychosocial Factors

 

Social Support, Social Connectedness, Social Interaction

Generalized Self-Efficacy

Self-Efficacy (Behavior-Specific)

Exercise Self-Efficacy Scale

Weight Efficacy Life-Style Questionnaire

Perceived Locus of Control

Coping Orientation

Self-Esteem

Body Image

Parenting Scales

Return to Measures List

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Social Support, Social Connectedness, Social Interaction

 

+Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

MOS-SS

Medical Outcomes Study- Social Support Survey

 

Sherbourne, C.D., & Stewart, A.L. (1991). The MOS Social Support Survey. Social Science & Medicine, 32, 705-714.

 

Measures strength of perceived social support available. Measures functional support (providing emotional support, tangible support, information, appraisal support, and companionship. One question also measures structural support (size of social network).

Five dimensions: emotional support (ES), 4 items+ informational support (IS), 4 items

 (ES+IS subscale=8 items),

tangible support (TS),

 4 items, positive social interaction (PSI), 4 item, and affection (A), 3 items.

 

Score emotional & informational items together to derive FOUR subscales.

Brief, self-administer questionnaire; indicator of the availability of four categories of social support that is currently available if needed.

Intended for survey research and can be used with general population samples.

Ordinal scale, 20 items, summated scores of the four subscales; 5-point answer scales

(range 1-5)

1: none of time

2: a little/time

3: some/time

4: most/time

5: all of time,

+  1 additional structural support item: Question # 1: number of close friends & relatives;

Patients with chronic conditions participating in the Medical Outcomes Study. Patients sampled using staged design (3 major city sites, settings, clinicians, and patients). Physicians (n=298) participated in main study and n=2987 patients participated in MOS-SS portion. Ages ranged from 18-98 (x=55), 39% male, 20% non-white, 68% married, 46% completed high school (x=13.3 years education)

Overall index internal-consistency reliability: α=0.97,

1-year test-retest stability= 0.78.

Internal-consistency reliability & 1-year stability for subscales:

ES/IS: α=0.96, stabil.=0.72;

TS: α=0.92, stabil.=0.74;

PSI: α=0.94,

Stabil.=0.72;

A: α=0.91,

Stabil.= 0.76.

 

Convergent validity: all items correlated highly (≥0.72). Item-scale correl ranged from:

0.72-0.87 (TS)

0.80-0.86 (A)

0.82-0.90 (ES + IS)

0.87-0.88 (PSI)

Discriminant validity: all items in subscales correlated higher by 2 SE with their own scale than with any other social support scale. Items also discriminated well from validity measures (distinct from measures of loneliness, mental health, current health, etc.).

Confirmatory factor analysis: high correl. btw emotional and information support (r=0.99). Standardized factor loadings ranged 0.76-0.93 (TS), 0.86-0.92 (A), 0.82-0.92 (ES/IS), 0.91-0.93 (PSI). Single-item structural support has low correlation with functional support items (0.18-0.24).

Disability populations used:

The Center for Research on Women with Disabilities (CROWD) has used this measure in studies of stress, depression, and health promotion in women with physical disabilities. CROWD also added a rating of overall satisfaction with relationships (question #21), not part of original MOS.

 

Social Connectedness Scales

 

(SCS)

 

Original Scale

 

Lee, R.M. & Robbins S.B. (1995). Measuring Belongingness: The Social Connectedness and the Social Assurance Scales. Journal of Counseling Psychology, 42 (2).

 

Measures construct of belongingness. The items portray a general emotional distance between self and others that may be experienced even among friends or close peers.

Measures difficulty feeling social connected, even in the presence of adequate social skills..

Connectedness (4 items), affiliation (3 items), and companionship (1 item);

Brief, self-administer questionnaire. Timing is present.

Original scale – Ordinal (6 point Likert) scale; 8 items; summated scores of the three subscales; Higher scores indicate greater sense of social connectedness and belongingness.

Unlike SCS-R: Ranges from (1=strongly agree to 6=strongly disagree), with a mean of 38.85 (SC=8.09, and potential range of 8-48. Item content reflects the inverse of social connectedness (social disconnectedness and detachment)

N=313 nonclinical adult population (college students)

 

Internally reliable; 2-week test-retest: r= 0.96

high internal item consistency α = .91

Cross-validated SocCconn with Social Assurance scales; α= .91 and .77, respectively.  (91% of total score variance for soc conn and 77% for social assr. were due to the true score variance. Pearson product-moment r for the two scales was .341; also tested confirmatory factor analysis. Correlation between scales (r=.221, p<.05). Strong goodness of fit between social ssurance scale (incremental fit index=.92). Positively correlated with global self-esteem and goal instability (Lee & Scott, 1997).

Social Connectedness Scales-Revised

 

(SCS-R)

 

Lee, R.M. Draper, M., & Lee, S. (2001). Journal of Counseling Psychology 48 (3), 310-318. Social Connectedness, Dysfunctional Interpersonal Behaviors, and Psychological Distress: Testing a Mediator Model

Revised version of the Soc-con scale. Social connectedness is a personal attribute reflecting enduring closeness with the social world in general. Represents patterns of interpersonal relatedness. Doesn’t measure belongingness (group membership) or loss of specific relationships

The revised version contains both positively and negatively worded items.

Now a 20-item scale, 10 pos and 10 neg.; no subscales

Brief, Self-report. Timing is present.

Revised scale, 20-items, summated scores, ordinal data, 6 point Likert scale; ranges from 1 strongly disagree to 6 = strongly agree

Higher scores indicate more social connectedness.

n=218 undergraduates (112 men, 105 women) from large, public, southwestern university; 9 African Americans, 29 Asian-Am, 136 European Am, 32 Hispanics, and 12 unidentif.

Internal item reliability: α = .92; no significant differences by gender and race. Test-retest not examined in this study.

Used maximum likelihood, exploratory factor analysis with unrotated factors; χ2 (df=133)=243.05, p<.0001. The first factor accounted for the largest % of total variance (46%); 2nd=8%, 3rd=6%. Convergent validity: positively correlated with measures of independent self-construal and collective self-esteem. Social connectedness significantly correlated with loneliness (r=-.80), self-esteem, and distress (r=-.55). ; discriminant validity: not sign. correlated with measures of interdependent self-construal, collective identify, somatization, OCD, phobic anxiety, and too much interpersonal responsibility and controlling behaviors. May be some confounding with loneliness that needs to be addressed in future research (may be due to the loneliness scale that was used).

Disability populations used:

Researchers at the Center for Research on Women with Disabilities (CROWD) have used the revised version of the Social Connectedness Scales in studies of stress, depression, and healthy aging with women with physical disabilities.

 

Perceived Social Support

(PSS)

 

Procidano, M.E., & Heller, K. (1983). Measures of perceived social support from friends and from family: Three validation studies. American Journal of Community Psychology, 11, 1-24.

Perceived social support is the degree that one perceives his or her needs for support are fulfilled by friends and family.

Two scales, one measuring perceived social support from friends (20 items), one measuring perceived social support from family (20 items).

Brief, self-administered. Timing is present status.

Both scales are 20 items, participants may respond “yes”, “no”, or “don’t know”. Summated scores, with each “yes” answer scoring +1.  Items 2, 6, 7, 15, 18, and 20 are reversed scored (a “no” is scored as +1). Range: 0 to 20. Higher scores indicate greater perceived support.

222 undergraduate psychology students. Mean age = 19 years. Mean for PSS-Fr was 15.15 (SD=5.08) and Mean for PSS-Fa was 13.40 (SD=4.83).

The original PSS has an alpha of 0.90, indicating the scale has excellent internal consistency. The alpha for the final PSS-Fa ranged from .88 to .91 and the alpha for the PSS-Fr ranged from .84 to .90. Test-retest coefficient over a one-month period was 0.83.

Good concurrent validity was demonstrated; scores are correlated with psychological distress and social competence, and both measures are associated with psychological symptoms. Scores on the PSS-Fr were predicted by length of time as a member in the social network and the degree or reciprocity in the relationship, while scores on the PSS-Fa were predicted by both intangible and tangible support from family members. Participants categorized as high and low in perceived social support by the PSS differed in verbal disclosure. Clinical and nonclinical samples differed on both measures.

Disability populations used:

The Center for Research on Women with Disabilities (CROWD) has used this measure in studies of women with physical disabilities..

 

 

Personal Resource Questionnaire

(PRQ 85)

 

Weinert, C., and Brandt, P.A., (1987). Measuring social support with personal resource questionnaire. Western Journal of Nursing Research, 9, 589-602.

Measures perceived social support as multiple dimensions of interpersonal relationships.

 

Self-report.

25 items, (1=strongly disagree, 7= strongly agree). Scores range from 25 to 175, higher scores indicate higher levels of perceived support.

Adults with chronic conditions and 100 community-residing adults.

Test-retest reliability in community-residing adults was .72. Pearson product-moment correlation was .72. Internal consistency is high, ranging from .92 to .94.

Content, construct, and criteria-related validity have been established.

Disability populations used:

Stuifbergen, Seraphine, and Roberts (2000) used this scale in a study of persons with multiple sclerosis titled Health Promotion and Quality of Life in Chronic Illness. Harrison and Stuifbergen (2001) used this scale in a study of disability, social support, and depressive symptoms in 201 mothers with multiple sclerosis. Mean scores in this sample was 137.4, with a standard deviation of 23.1, and range of 58 to 175.

Stuifbergen, A., Seraphine, A., & Roberts, G., (2000). An explanatory model of health promotion and quality of life in chronic illness. Nursing Research, 49 (3), 122-129.

Harrison, T., Stuifbergen, A., (2001). Disability, social support, and concern for children: Depression in mothers with multiple sclerosis. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31 (4), 444-453.

 

Sallis Social Support Scale

 

 

 

 

 

 

 

 

Disability populations used:

The Center for Research on Women with Disabilities (CROWD) has submitted a grant proposing to use the Sallis Social Support Scale in a weight-management study of women with physical disabilities.

 

 

Rand Social Health Battery

 

Donald, C.A., Ware Jr. J.E., Brook, R.H., et al. (1978). Conceptualization and measurement of health for adults in the health insurance study:  Volume IV, Social health. Santa Monica, CA: Rand.

Assesses indicators of social resources while excluding situations not requiring interaction.

None.

Self-Report. Timing is past month.

Responses are made primarily on a 7-point scale indicating the frequency of social connections over the previous month. 

 

The internal consistency coefficient was .68 for the overall index, and one-year test-retest coefficients were .55 - .68.

 

Disability populations used:

Researchers at the Center for Research on Women with Disabilities (CROWD) used a 10-item version of the original 11-item scale in a study of the cost of depression and secondary conditions in women with physical disabilities. One item of the scale, on writing letters, was omitted per the authors’ recommendations. The social index scores showed moderate deterioration with increased disease activity in multiple sclerosis (Harper and Harper, 1986).

 Harper, A.C., Harper, D.A., (1986). An epidemiological description of physical, social, and psychological problems in multiple sclerosis.  Journal of Chronic Disease, 39, 305-10.

 

Mutual Connectedness Scale

(MCS)

 

CROWD instrument – no citation

Measures mutual connectedness as a separate construct from social support or social connectedness; implies an interaction or connection between other people.

None

Self-administered, current relationships with others.

12 items, ordinal (Likert) scale.

Range:

1=never

2=rarely

3=sometimes

4=often

5=always

 

 

 

 

Disability populations used:

The Center for Research on Women with Disabilities (CROWD) developed the MCS for use in studies of stress, depression, and health promoting behaviors in women with physical disabilities.

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Generalized Self-Efficacy

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Generalized Self-Efficacy Scale

(GSE)

 

Jerusalem & Schwarzer (1992). Self-efficacy as a resource factor in stress appraisal processes. In Self-Efficacy: Thought Control of Action. Washington DC: Hemisphere.

 

(Original instrument developed in German)

 

 

Self-efficacy can be measured as a general, dispositional trait which is relatively stable over time, not just in terms of confidence to perform a specific behavior. Assesses the strength of a person’s belief in ability to deal with any obstacles or setbacks.

None

Self-administered, current or present timing.

Ordinal scale, 10 items,

4-point answer scales

(range 1-4)

1:not at all true

2:barely true

3:moder. true

4: exactly true

 

summated scores (range from 10-40, with higher scores indicate greater confidence in generalized self-efficacy).

 

Published norms based upon 1,660 community-dwelling adults in Germany suggest mean of 29.98 (SD 4.6)

 

High internal consistency. Alpha coefficients for five samples in Germany ranged from 0.82 to 0.93. Two-year test-retest reliability values ranged from 0.47 among migrants in East Germany.

Concurrent validity was supported by findings of expected associations between other psychosocial variables. The GSES correlates negatively with depression, anxiety, and physical symptoms (lower GSES scores are associated with higher levels of depression). Factor analyses confirmed that the scale is unidimensional.

 

Generalized Self-Efficacy Scale

(GSE)

 

Barlow, J., Williams, B., & Wright, C. (1996). The generalized self-efficacy scale in people with arthritis. Arthritis Care and Research, 9 (3), 189-196.

 

(English Version)

Same as original measure.

none

Self-administered, current or present timing.

Ordinal scale, 10 items,

4-point answer scales

(range 1-4)

1:not at all true

2:barely true

3:moder. true

4: exactly true

 

summated scores (range from 10-40, with higher scores indicate greater confidence in generalized self-efficacy).

 

 

Describes 4 studies; study 1 (n=53) persons with arthritis) tested comprehensibility; study 2 (n=80 older people with arthritis), study 3 (n=79 adults with arthritis), & study 4 (n=66 adult education sample) tested validity and reliability. Most participants had RA and OA. Mean scores were 29.05 (SD 5.1), 28.71 (S.D. 5.9), and 30.23 (S.D. 4.8), for each of the 3 studies, resp.

Inter-item correlations ranged 0.08 to 0.83 across the 3 studies. (Item 2 assoc with several insignificant correlations, and corrected item total correlations ranged from 0.30 to 0.81, all significant). Cronbach’s alphas were 0.88, 0.91, and 0.89 resp. Stability over 4-month period, with test-retest reliability coefficient of 0.63 (p<0.0001).

Factor analyses with sampling adequacy confirmed by Kaiser-Meyer-Olkin measure, factor model supported by Bartlett’s test. A unidimensional solution accounted for 49.9%, 56.9%, and 52.4% of total variance, respectively for each study; factor loadings ranged from 0.36 to 0.87 (lowest for item 2 across all three studies).

Only one significant association found between GSES scores and demographic variables (being male- higher; r=-0.27, p=0.029). No assoc. between physical health status, pain, or fatigue and GSES. GSES was inversely related w/depression and positively associated with positive affect and social support in all 3 studies. In study 2 (sample of older people), GSES was positively associated with social support and negatively associated with health distress. Controlling for demographic and physical variables and using hierarchical regression analyses, GSES was significantly associated with depression (β=-0.30, P=0.018), and positive affect (β =0.49,P=0.0001).

Disability populations used:

Researchers have used this scale in persons with arthritis (see below). The Center for Research on Women with Disabilities (CROWD) has used this measure in studies of stress, depression, and health promotion in women with physical disabilities.

 

General Self-Efficacy Scale

(GSES)

 

Sherer, M., Maddux, J.E., Mercandante, B., et al., (1982). The self-efficacy scale: Construction and validation. Psychological Reports, 51, 663-671.

Measures degree of agreement with perceived personal ability to affect outcomes in various situations.

None.

Self-report, present/ current timing.

17-items, 5-point Likert scale. Summated scores range from 17-85. Higher scores indicated greater general self-efficacy.

 

Cronbach alpha coefficient of .86.

Construct validity is established by confirmation of expected relationships with other psychological constructs.

Disability populations used:

Used by Becker, Stuifbergen, Ingalsbe, and Sands (1989) in a study of health promoting attitudes and behaviors among people with disabilities. Stuifbergen and Becker (1994) report the alpha coefficient in this population was .87. Tate and colleagues (2002) used this scale in a health promotion study of people with spinal cord injury.

 

Becker, H.A., Stuifbergen, A.K., Ingalsbe, K., and Sands, D., (1989). Health promoting attitudes and behaviors among persons with disabilities. International Journal of Rehabilitation Research, 12 (3), 235-250.

Stuifbergen, A.K., and Becker, H.A., (1994). Predictors of health promoting lifestyles in persons with disabilities. Research in Nursing and Health, 17, 3-13.

Tate, D.G., Chiodo, A., Nelson, V., et al., (2002). The effect of a holistic health promotion program

 on individuals with spinal cord injury. Final Report of Study Findings. University of Michigan Health System: Department of Physical Medicine and Rehabilitation.

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Self-Efficacy (Behavior-Specific)

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Arthritis Self-Efficacy Scale

 

Lorig, K., Chastain, R.L., Ung, E., Shoor, S., and Holman, H., (1989). Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis and Rheumatism, 32 (1), 37-44.

Measures perceived self-efficacy (SE) to cope with chronic arthritis. Based upon Bandura’s self-efficacy theory, and assumption that self-efficacy is behavior-specific (can not be considered as generalized).

Subscales: Pain (PSE), 5 items, function in performing activities in daily living (FSE), 9 items, and other symptoms (OSE) (e.g. fatigue, aggravating arthritis), 6 items.

Self-report, current/ present timing.

Scale of 10 (very uncertain) to 100 (very certain); 50 represents moderately uncertain. Each subscale is scored separately by taking the mean of the subscale items. In the event of missing data, score is a mean of completed data.

97 persons with chronic arthritis participating in an arthritis self-management course.

High internal reliability. Alpha coefficients were 0.93 for FSE and 0.90 for OSE. Results were replicated with another sample of 144 participants with arthritis, and coefficient alphas for internal reliability were .89 for FSE, 0.87 for OSE, and 0.76 for PSE. Test-retest reliability in a third sample of 91 participants with arthritis was also conducted. Item reliabilities ranged from 0.71 to 0.85, subscale reliabilities were 0.85 for FSE, 0.90 for OSE, and 0.87 for PSE. Average time between completion of scales was 9.4 days (range=2-9 days).

Construct validity was established by finding of association between present and future health status, as self-efficacy theory predicts. Significant correlations were observed between baseline self-efficacy and baseline health status, and between 4-month SE and 4-month health status. OSE was highly related to depression as measured by the BDI-II, FSE was highly correlated with function (disability) as measured by the Stanford HAQ. FSE items were tested for concurrent validity by a masked trained observer who rated degree of difficulty for performing ADLs. Actual performance and self-efficacy were moderately correlated. Confirmatory subscales analyses were also conducted.

Disability populations used:

Persons with chronic arthritis participating in a self-management program (Lorig et al., 1996).

 

 

Lorig, K. Stewart, A., Ritter, P., Gonzalez, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications.

 

 

 

 

People with arthritis (and other chronic health conditions)

 

 

 

Disability populations used:

This scale has been used with persons with chronic arthritis participating in a self-management program (Lorig et al., 1996).

 

 

Self-Rated Abilities for Health Practices Scale

(SRAHP)

 

Becker, H., Stuifbergen, A., Oh, H.S., & Hall, A., (1993). The self-rated abilities for health practices scale: A health-efficacy measure. Health Values, 17, 42-50.

Measures beliefs (self-efficacy) about one’s abilities to perform specific health promoting behaviors.

Domains: nutrition, physical activity/ exercise, psychological well-being, and responsible health practices.

Self-rated, current or present timing. Stem, “I am able to”.

28 items, 5-point Likert scale (0=not at all, 4=completely). Summated scores, range 0-112 (higher scores indicated greater self-efficacy).

Pilot tested with 15 persons with disabilities, and samples of 188 health fair participants and 111 undergraduate nursing students.

Cronbach’s alpha for the total scale was .94 in both the health fair and nursing student samples. Two-week test-retest reliability in the nursing student sample was .70, two-week test retest reliability in undergraduate samples was .73.

Principal components factor analysis from the health fair sample supported that the four-factor solution accounted for 61% of the total variance. The Self-Rated Abilities for Health Practices Scale was correlated with other health attitude and behavior measures, supporting concurrent validity of the scale. Scores were negatively correlated with the Barriers to Health Promotion Scale and positively correlated with the Health Promoting Lifestyle Profile.

Disability populations used:

Stuifbergen and Becker (1994) used this scale in a study of 117 persons with disabilities. Stuifbergen, Becker, Blozis, Timmerman, and Kullberg, (2000) used this instrument in a sample of 142 women with multiple sclerosis. Stuifbergen, Seraphine, and Roberts (2000) have used this scale in a sample of persons with multiple sclerosis in a study titled Health Promotion and Quality of Life in Chronic Illness. Tate and colleagues (2002) used this scale in a health promotion study of people with spinal cord injury.

 

Stuifbergen, A.K., and Becker, H.A., (1994). Predictors of health promoting lifestyles in persons with disabilities. Research in Nursing and Health, 17, 3-13.

Stuifbergen, A.K., Becker, H.A., Blozis, S., Timmerman, G., and Kullberg, V., (2000). A randomized clinical trial of a wellness intervention for women with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 84, (April), 467-476.

Stuifbergen, A., Seraphine, A., & Roberts, G., (2000). An explanatory model of health promotion and quality of life in chronic illness. Nursing Research, 49 (3), 122-129.

Tate, D.G., Chiodo, A., Nelson, V., et al., (2002). The effect of a holistic health promotion program  on individuals with spinal cord injury. Final Report of Study Findings. University of Michigan Health System: Department of Physical Medicine and Rehabilitation.

 

Confidence

 

(self-efficacy for physical activity)

 

CROWD-developed measure modeled from the format used by Lorig, Stewart, Ritter, Gonzalez, Laurent, and Lynch, 1996

Assesses self-efficacy for exercise using three questions

concerning exercise (confidence to do gentle flexibility exercise, confidence to do gentle exercises for muscle strength 3-4 x week), confidence to do aerobic exercise 3-4 x week), exercise that will not make symptoms worse

N/A

Self-administered, present status

4 items, interval scale; higher scores indicate greater self-efficacy.

Range:

1=not at all confident to

10 = totally confident;

Women with physical disabilities (Health Promotion Pilot study), women with physical disabilities over the age of 45 (Healthy Aging Study)

As measured by Cronbach’s alpha, the internal consistency was 0.78 and 0.74 for post-test.

 

Confidence – nutrition/diet

 

(self-efficacy for diet and nutritional supplements)

 

This measure was modeled from the format used by Lorig, Stewart, Ritter, Gonzalez, Laurent, and Lynch, 1996

5 questions concerning nutrition and vitamin (confidence to eat a well-balanced diet, to follow doctor-recommended diet, select foods to help maintain ideal weight, select vitamins when needed, read food labels)

N/A

Self-administered, present status

5 items, interval scale; higher scores indicate greater self-efficacy.

Range:

1=not at all confident to

10 = totally confident;

 

Women with physical disabilities (Health Promotion Pilot study), women with physical disabilities over the age of 45 (Healthy Aging Study)

As measured by Cronbach’s alpha, the internal consistency was 0.89 and 0.78 for post-test.

 

Confidence for non-smoking


(self-efficacy for non-smoking)

 

CROWD (no reference);developed based on format used by Lorig, Stewart, Ritter, Gonzalez, Laurent, and Lynch, 1996.

 

 

 

2 questions concerning smoking; the first asks how confident are you that you could quit, the second asks how confident that you could avoid smoking permanently once you quit.

N/A

Self-administered, present status

2 items, interval scale; higher scores indicate greater self-efficacy.

Range:

1=not at all confident to

10 = totally confident

Women with physical disabilities (Health Promotion Pilot study), women with physical disabilities over the age of 45 (Healthy Aging Study)

Internal reliability has not yet been established.

 

Confidence for medical care


(self-efficacy)

This measure was modeled from the format used by Lorig, Stewart, Ritter, Gonzalez, Laurent, and Lynch, 1996

2 items concerning active participation in medical care.(confidence that you can get medical care when you need it & judge when changes in your health mean you should visit a doctor)

N/A

Self-administered, present status

2 items, interval scale; higher scores indicate greater self-efficacy. Range:

1 to 10 (as above)

Women with physical disabilities (Health Promotion Pilot study), women with physical disabilities over the age of 45 (Healthy Aging Study)

Cronbach’s alpha: 0.56 for pre-test, 0.42 for post-test.

 

Disability populations used:

The Center for Research on Women with Disabilities (CROWD) has developed and used these confidence scales in studies of health promotion and healthy aging in women with physical disabilities.

 

Diabetes Management Self-Efficacy Scale

 

The psychometric properties of the Diabetes Management Self-Efficacy Scale for patients with type 2 diabetes mellitus.

Bijl, J., Poelgeest-Eeltink, A., and Shortridge-Baggett, L., (1999). Journal of Advanced Nursing, 30 (2), 352-359.

Measures respondents’ belief in ability to carry out self-care activities in order to manage their diabetes.

None.

Self-report, current or present timing.

20 items, 5-point Likert scale:

Yes, surely

Probably yes

Maybe yes/maybe no

Probably not

No, surely not

105 patients with Type 2 diabetes, 94 participated in the retest. The average age was 64 (range 21 to 83), and 47% were men, 53% women. Average time with diabetes was 3 years.

Internal consistency (Cronbach’s alpha) was α = 0.81; 5-week test-retest reliability was r=.79 (p<0.001).

Construct and content validity was supported.

Disability populations used:

 

 

Lo, R., (1999). Correlates of expected success at adherence to health regimen of people with IDDM. Journal of Advanced Nursing, 30 (2), 418-424.

 

 

 

 

 

 

 

Disability populations used:

 

 

Exercise Self-Efficacy Scale

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Weight Efficacy Life-Style Questionnaire

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Perceived Locus of Control

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Multidimensional Health Locus of Control

(MHLC)

 

Wallston, B.S., Wallston, K.A., Kaplan, G.D., and Maides, S.A., (1976). Development and validation of the health locus of control (HLC) scale. Journal of Consulting and Clinical Psychology, 44, 580-585.

 

Three scores can be obtained:
Internal score (belief person controls own health), Powerful Others Externality Score (belief one’s health is controlled by powerful others), and Chance Externality Score (belief health is matter of chance).

 

 

18 items

 

 

 

Disability populations used:

The MHLC was used by Becker, Stuifbergen, Ingalsbe, and Sands in a study of health promoting attitudes and behaviors among people with disabilities. The HLC has been used in a study of persons with chronic arthritis participating in a self-management program (Lorig et al., 1985).

 

Becker, H.A., Stuifbergen, A.K., Ingalsbe, K., and Sands, D., (1989). International Journal of Rehabilitation Research, 12 (3), 235-250.

Lorig, K., Lubeck, D., Kraines, R.G., Seleznick, M., Holman, H.R., (1985). Outcomes of self-help education for patients with arthritis. Arthritis and Rheumatism, 28 (6), 680-685.

 

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Coping Orientation

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

 

Coping Styles Inventory

 

Billings, A.G., & Moos, R.H. (1981). The role of coping responses and social resources in attenuating the stress of life events. Behavioral Medicine, 4(2), 139-157.

 

 

 

Assesses 3 coping methods: active-cognitive, active behavioral, and avoidance.

Active-cognitive (6 items), active behavioral (6 items), and avoidance (5 items). Also classified into two focus of coping forms: Problem-focused (6 items) and emotion focused (11 items).

Self-administered; based upon past-tense (previous stressful life event)

Respondents identify one recent stressful life event and then respond to 19 “yes” or “no” items assessing how they dealt with the event.

 

Moderate internal consistency with Cronbach’s alpha of 0.62. Alpha was reported as 0.80 for active- behavioral, 0.72 for active-cognitive, and 0.44 for avoidance coping.

 

Disability populations used:

 

 

Coping Strategies Questionnaire

(CSQ)

 

Keefe, F.J., Brown, G.K., Wallston, K.A., (1989). Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy. Pain, 37, 51-56.

 

Swartzman, L.C., Gwadry, F.G., Shapiro, A.P, Teasell, R.W., (1994). The factor structure of the Coping Strategies Questionnaire. Pain, 57, 311-316.

 

 

Assesses use of coping strategies in response to pain.

8 subscales represent pain-related coping strategies:

diverting attention, reinterpreting pain sensations, coping self-statements, ignoring pain sensations, praying or hoping, increasing activities, pain behaviors, and catastrophizing.

Self-report, current/present timing.

48 items, 7 point LIkert. Participants endorse the extent of their use of each strategy in response to pain (3=sometimes).

 

Adequate internal consistency and high degree of stability over time (6-month test-retest reliability=.81).

Construct validity has been established for most subscales.

Disability populations used:

The CSQ has been used in samples of persons with chronic back pain (Rosenstiel & Keefe, 1983), persons with rheumatoid arthritis pain (Keefe, Brown, and Wallston, 1989), and in women with fibromyalgia (Hassett, Cone, Patella, and Sigal, 2000).

Hassett, A.L., Cone, J.D., Patella, S.J., and Sigal, L.H., (2000). The role of catastrophizing in the pain and depression of women with fibromyalgia syndrome. Arthritis and Rheumatism, 42 (11), 2493-2500.

Keefe, F.J., Brown, G.K., and Wallston, K.A., (1989). Coping with rheumatoid arthritis pain: catastrophizing as a maladaptive strategy. Pain, 37, 51-56.

Rosenstiel, A.K., and Keefe, F.J., (1983). The use of coping strategies in chronic low back pain patients: relationships to patient characteristics and current adjustment. Pain, 17, 33-40.

 

 

 

Cole, J.D., (1988). Psychotherapy with the chronic pain patient using coping skills development:  Outcome study. Journal of Occupational Health Psychology 3(3):217-226.

 

 

 

 

 

 

 

 

Disability populations used:

 

 

 

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Self-Esteem

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Rosenberg Self-Esteem Scale (RSE)

 

Rosenberg, M. (1965). Society and the adolescent self-image. Appendix D: Scales and scores. (pp.305-319). Princeton, NJ: Princeton University Press.

 

none

Self-administered, present tense

10-item Guttman scale rating. Participants rate their agreement (1=strongly agree to 4=strongly disagree) with each of the 10 statements, and items are summed such that lower overall scores reflect greater self-esteem.

 

 

 

Disability populations used:

Used extensively with adults who have physical disabilities, including women (Nosek, Hughes, in press). In a CROWD study of the mediators of self-esteem in a sample of women with physical disabilities, an alpha coefficient of 0.70 was obtained for a sample of 881 women.

Index of Self-Esteem

 

(ISE)

 

Hudson, W.W. (1982). The Clinical Measurement Package: A Field Manual. Chicago, IL: Dorsey Press.

Measures the extent to which an individual has a problem with self-esteem.

none

Self-admin

25-item scale; participants indicate how they see themselves by rating each statement on a 5-point scale (1= rarely or none of the time to 5= most or all of the time). The scale consists of items reflecting high as well as low self-esteem, and scores are summed such that lower overall scores reflect greater self-esteem.

 

The ISE has a mean alpha across studies of 0.93, indicating excellent internal consistency, a test-retest correlation of 0.92

Evidence has been obtained indicating it has construct validity.

Disability populations used:

Used extensively with adults who have physical disabilities, including women (Nosek, Hughes, in press). In a CROWD study of the mediators of self-esteem in a sample of women with physical disabilities, an alpha coefficient of 0.70 was obtained for a sample of 881 women.

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Body Image

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Body Areas Satisfaction Scale

(BASS)

 

 

 

 

 

 

 

 

Disability populations used:

 

Body Image Quality of Life Inventory (Weight Management)

 

 

 

 

 

 

 

 

Disability populations used:

 

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Parenting Scales

Instrument Name and Original Reference

Instrument Description & Construct

Measured

Dimensions/

subscales

Indicator (Timing + Source of Data)

Variables (Number of Items, Scale, & Range)

Test Population

Instrument Reliability

Psychometric Review of Instrument Validity

Concern for Children Scale

 

Harrison, T., Stuifbergen, A., (2001). Disability, social support, and concern for children: Depression in mothers with multiple sclerosis. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31 (4), 444-453.

 

 

 

 

5 items:

0=not at all

4=extremely

Mothers with multiple sclerosis.

Cronbach’s alpha =.79.

 

Disability populations used:

Scale created by Harrison and Stuifbergen (2001) based upon items from the Demands of Illness (DOI) Inventory.

Harrison, T., Stuifbergen, A., (2001). Disability, social support, and concern for children: Depression in mothers with multiple sclerosis. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 31 (4), 444-453.

 

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