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Qual Life Res. 2019 Feb 26. doi: 10.1007/s11136-019-02116-w. [Epub ahead of print]

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

Author information

1
Department of Occupational Therapy, University of Florida, PO BOX 100164, Gainesville, FL, 32610, USA.
2
Center of Innovation on Disability and Rehabilitation Research (CINDRR), Department of Veterans Affairs, 101 SE 2nd Place Ste 104, Gainesville, FL, 32601, USA.
3
Department of Occupational Therapy, University of Florida, PO BOX 100164, Gainesville, FL, 32610, USA. sromero@phhp.ufl.edu.
4
Center of Innovation on Disability and Rehabilitation Research (CINDRR), Department of Veterans Affairs, 101 SE 2nd Place Ste 104, Gainesville, FL, 32601, USA. sromero@phhp.ufl.edu.
5
Division of Occupational Therapy, Medical University of South Carolina, 151-B Rutledge Avenue, MSC 962, Charleston, SC, 29425, USA.
6
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.
7
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.

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.

KEYWORDS:

Multidimensionality; PROMIS; Patient-reported outcome measure; Self-efficacy

PMID:
30806873
DOI:
10.1007/s11136-019-02116-w

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