Development and Initial Evaluation of Reliability and Validity of the Opioid-Taking Self-Efficacy Scale
Purpose/Objectives: To examine the reliability and validity of the Opioid-Taking Self-Efficacy Scale-Cancer (OTSES-CA).
Design: Survey of two separate samples.
Setting: Two teaching hospitals in the Taipei area of Taiwan.
Sample: 30 (stage 2, pilot study) and a second cohort of 92 (stage 3) outpatients who had been prescribed opioid analgesics for cancer-related pain.
Methods: A preliminary set of 35 items was developed from qualitative interviews to assess the key domains of self-efficacy. The scale properties were evaluated with the first sample using face validity, test-retest reliability, and Cronbach alpha. Construct validity using exploratory factor analysis and concurrent validity were evaluated with the second sample.
Main Research Variables: Opioid-taking self-efficacy.
Findings: An initial pilot study supported face validity and test-retest reliability with stability coefficients for the subscales of the OTSES-CA, ranging from 0.68 (taking analgesics according to schedule) to 0.82 (communicating about pain and taking analgesics). An exploratory factor analysis demonstrated the multidimensionality of the OTSES-CA. Four factors were identified: communicating about pain and analgesic-taking, tailoring the medication regimen, acquiring help, and managing treatment-related concerns. Cronbach alpha coefficients reached the 0.80 criterion for each of four subscales constructed from items loading on these factors. Significant correlations among the total score of the OTSES-CA and mean adherence rates, pain relief, and worst pain support the concurrent validity of the OTSES-CA.
Conclusions: The data provide preliminary evidence of acceptable psychometric properties for the OTSES-CA designed to measure patients' self-efficacy with taking opioids. Further validation is recommended to confirm the four dimensions of the construct.
Implications for Nursing: The OTSES-CA can be used in research and clinical settings to identify various impediments to opioid adherence.
Lai, Y. H., Keefe, F. J., Sun, W. Z., Tsai, L. Y., Cheng, P. L., Chiou, J. F., et al. (2002). Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: A preliminary study. <i>Journal of Pain and Symptom Management</i>, <b>24</b>(4), 415-423.
Liang, S. Y., Yates, P., Edwards, H., & Tsai, S. L. (in press). Opioid-taking tasks and behaviours in Taiwanese outpatients with cancer. <i>Journal of Clinical Nursing</i>.
Lin, C. C. (1999). Disclosure of the cancer diagnosis as it relates to the quality of pain management among patients with cancer pain in Taiwan. <i>Journal of Pain and Symptom Management</i>, <b>18</b>(5), 331-337.
Chiu, T. Y. (1997). Pain control in terminal cancer patients. <i>Formosan Journal of Medicine</i>, <b>1</b>, 198-208.
DiIorio, C. K. (2005). <i>Measurement in health behaviour: Methods for research and evaluation.</i> San Francisco, CA: John Wiley and Sons.
Du Pen, S. L., Du Pen, A. R., Polissar, N., Hansberry, J., Draybill, B. M., Stillman, M., et al. (1999). Implementing guidelines for cancer pain management: Results of a randomized controlled clinical trial. <i>Journal of Clinical Oncology</i>, <b>77</b>(1), 361-370.
Fishbein, M., & Ajzen, I. (1975). <i>Belief, attitude, intention and behaviour.</i> Reading, MA: Addison-Welsey.
Ger, L. P., Chang, C. Y., Ho, S. T., Lee, M. C., Chiang, H. H., Chao, C. S., et al. (2004). Effects of a continuing education program on nurses' practices of cancer pain assessment and their acceptance of patients' pain reports. <i>Journal of Pain and Symptom Management</i>, <b>27</b>(1), 61-71.
Ger, L. P., Ho, S. T., Wang, J. J., & Cherng, C. H. (1998). The prevalence and severity of cancer pain: A study of newly-diagnosed cancer patients in Taiwan. <i>Journal of Pain and Symptom Management</i>, <b>15</b>(5), 285-293.
Holtan, A., Aass, N., Nordoy, T., Haugen, D. F., Kaasa, S., Mohr, W., et al. (2007). Prevalence of pain in hospitalised cancer patients in Norway: A national survey. <i>Palliative Medicine</i>, <b>21</b>(1), 7-13.
Hsieh, R. K. (2005). Pain control in Taiwanese patients with cancer: A multicenter, patient-oriented survey. <i>Journal of the Formosan Medical Association</i>, <b>104</b>(12), 913-919.
Klepstad P., Loge, J. H., Borchgrevink, P. C., Mendoza, T. R., Cleeland, C. S., Kaasa, S. (2002). The Norwegian Brief Pain Inventory Questionnaire: Translation and validation in cancer pain patients. <i>Journal of Pain and Symptom Management</i>, <b>24</b>(5), 517-525.
Knoke, D., & Bohrnstedt, G. W. (1994). <i>Statistics for social data analysis</i> (3rd ed.). Itasca, IL: F. E. Peacock.
Lin, C. C. (2001). Congruity of cancer pain perceptions between Taiwanese patients and family caregivers: Relationship to patients' concerns about reporting pain and using analgesics. <i>Journal of Pain and Symptom Management</i>, <b>21</b>(1), 18-26.
MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. <i>Psychological Methods</i>, <b>4</b>(1), 84-99.
Miaskowski, C., Dodd, M. J., West, C., Paul, S. M., Tripathy, D., Koo, P., et al. (2001). Lack of adherence with the analgesic regimen: A significant barrier to effective cancer pain management. <i>Journal of Clinical Oncology</i>, <b>19</b>(23), 4275-4279.
Nicholas, M. K. (2007). The pain self-efficacy questionnaire: Taking pain into account. <i>European Journal of Pain</i>, <b>11</b>(2), 153-163.
Nunnally, J. C. (1978). <i>Psychometric theory</i> (2nd ed.). New York: McGraw-Hill.
Nunnally, J. C., & Bernstein, I. H. (1994). <i>Psychometric theory</i> (3rd ed.). New York: McGraw-Hill.
Ozdamar, K. (1999). <i>Statistical data analysis with standard statistical programs</i> (2nd ed.). Eskisehir, Turkey: Kaan Publishing.
Pajares, F., Hartley, J., & Valiante, G. (2001). Response format in writing self-efficacy assessment: Greater discrimination increases prediction. <i>Measurement and Evaluation in Counseling and Development</i>, <b>33</b>(4), 214.
Radbruch, L., Loick, G., Kiencke, P., Lindena, G., Sabatowski, R., Grend, S., et al. (1999). Validation of the German version of the Brief Pain Inventory. <i>Journal of Pain and Symptom Management</i>, <b>18</b>(3), 180-187
Reder, R. F. (2001). Opioid formulations: Tailoring to the needs in chronic pain. <i>European Journal of Pain</i>, <b>5</b>(Suppl. A), 109-111.
Reyes-Gibby, C. C., Ba Duc, N., Phi Yen, N., Hoai Nga, N., Van Tran, T., Guo, H., et al. (2006). Status of cancer pain in Hanoi, Vietnam: A hospital-wide survey in a tertiary cancer treatment center. <i>Journal of Pain and Symptom Management</i>, <b>31</b>(5), 431-439.
Riddell, A., & Fitch, M. I. (1997). Patients' knowledge of and attitudes toward the management of cancer pain. <i>Oncology Nursing Forum</i>, <b>24</b>(10), 1775-1784.
Schumacher, K. L., Koresawa, S., West, C., Hawkins, C., Johnson, C., Wais, E., et al. (2002). Putting cancer pain management regimens into practice at home. <i>Journal of Pain and Symptom Management</i>, <b>23</b>(5), 369-382.
Simoni, J. M., Frick, P. A., & Huang, B. (2006). A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy. <i>Health Psychology</i>, <b>25</b>(1), 74-81.
Sweeney, S., Taylor, G., & Calin, A. (2002). The effect of a home based exercise intervention package on outcome in ankylosing spondylitis: A randomized controlled trial. <i>Journal of Rheumatology</i>, <b>29</b>(4), 763-766.
Thomas, J. J., Shuford, D. M., Duke, J. C., & Cipriani, D. J., III. (2007). Development and psychometric properties of the Self-Efficacy Scale for transfers for caregivers of children requiring transfer assistance. <i>Archives of Physical Medicine and Rehabilitation</i>, <b>88</b>(4), 481-488.
Wang, X. S., Mendoza, T. R., Gao, S. Z., & Cleeland, C. S. (1996). The Chinese version of the Brief Pain Inventory (BPI-C): Its development and use in a study of cancer pain. <i>Pain</i>, <b>67</b>(2-3), 407-416.
Yates, P., Edwards, H., Nash, R., Aranda, S., Purdie, D., Najman, J., et al. (2004). A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings. <i>Patient Education and Counseling</i>, <b>53</b>(2), 227-237.
Zeppetella, G. (1999). How do terminally ill patients at home take their medication? <i>Palliative Medicine</i>, <b>13</b>(6), 469-475.
American Pain Society. (2003). <i>Principles of analgesic use in the treatment of acute pain and cancer pain</i> (5th ed.). Glenview, IL: Author.
Avemark, C., Ericsson, K., & Ljunggren, G. (2003). Gender differences in experienced pain, mood, energy, appetite, and sleep by cancer patients in palliative care. <i>Nursing Science and Research in the Nordic Countries</i>, <b>23</b>(1), 42-46.
Bandura, A. (2001). Social cognitive theory: An agentic perspective. <i>Annual Review of Psychology</i>, <b>52</b>, 1-26.
Bandura, A. (2004). Health promotion by social cognitive means. <i>Health Education and Behavior</i>, <b>31</b>(2), 143-164.
Bandura, A. (2006). Guide for constructing self-efficacy scales. In F. Pajares & T. Urdan (Eds.), <i>Adolescence and education, Vol. 4: Self-efficacy beliefs of adolescents.</i> Glenview, CT: Information Age Publishing.
Beck, S. L. (1998). A systematic evaluation of opioid availability and use in the Republic of South Africa. <i>Journal of Pharmaceutical Care in Pain and Symptom Control</i>, <b>6</b>(4), 5-22.
Becker, M. H. (1974). <i>The health belief model and personal health behaviour.</i> Thorofare, NJ: Charles B. Slack.
Burke, L. E., Dunbar-Jacob, J., Sereika, S., & Ewart, C. K. (2003). Development and testing of the Cholesterol-Lowering Diet Self-Efficacy Scale. <i>European Journal of Cardiovascular Nursing</i>, <b>2</b>(4), 265-273.
Chang, M., Chang, Y., Chiou, J., Tsou, T., & Lin, C. (2002). Overcoming patient-related barriers to cancer pain management for home care patients: A pilot study. <i>Cancer Nursing</i>, <b>25</b>(6), 470-476.