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Development and Initial Evaluation of Reliability and Validity of the Opioid-Taking Self-Efficacy Scale

Shu-Yuan Liang
Patsy Yates
Helen Edwards
Shiow-Luan Tsay
ONF 2008, 35(4), E62-E69 DOI: 10.1188/08.ONF.E62-E69

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.

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