Abstract
Purpose
This purpose of this study was to develop and validate a Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B).
Methods
The SESSM-B was developed and validated as follows: Item generation, pilot study, and tests of validity and reliability. Twenty-one items were developed through evaluation by 10 experts and 13 items were finally confirmed through item analysis and factor analysis. Psychometric testing was performed with a convenience sample of 303 women with breast cancer. Data were analyzed using factor analysis, Pearson correlation coefficients, and Cronbach’s alpha.
Results
Five factors evolved from the factor analysis, which explained 69.8% of the total variance. The first factor ‘coping with psycho-informational demand’ explained 17.2%, 2nd factor ‘maintenance of healthy lifestyle’ 14.5%. 3rd factor ‘management of side-effects' 13.3%, 4th factor ‘therapeutic compliance’ 12.8%, and 5th factor ‘sexual life’ 11.9%. SESSM-B also demonstrated a concurrent validity with health-related quality of life scale, EORTC QLQ-C30 & BR23. The internal consistency, Cronbach’s alpha, was .78, and reliability of the subscales ranged from .61 to .79.
References
Aaronson N. K.., Ahmedzai S.., Bergman B.., Bullinger M.., Cull A.., Duez N. J., et al1993. The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute. 85:365–376. http://dx.doi.org/10.1093/jnci/85.5.365.
Akin S.., Can G.., Durna Z.., Aydiner, A. 2008. The quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy. European Journal of Oncology Nursing. 12:449–456. http://dx.doi.org/10.1016/j.ejon.2008.07.006.
Bandura, A. 1977. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 84:191–215. http://dx.doi.org/10.1037/0033-295X.84.2.191.
Blacklock R.., Rhodes R.., Blanchard C.., Gaul, C. 2010. Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncology Nursing Forum. 37:206–212. http://dx.doi.org/10.1188/10.ONF.206-212.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Hwang S. Y.., Park B. W.., Lee I.S. 2002. A psychoeducational group intervention for women with primary breast carcinoma. Korean Journal of Social Welfare. 51:93–118.
Akin S.., Can G.., Durna Z.., Aydiner, A. 2008. The quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy. European Journal of Oncology Nursing. 12:449–456. http://dx.doi.org/10.1016/j.ejon.2008.07.006.
Bandura, A. 1977. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 84:191–215. http://dx.doi.org/10.1037/0033-295X.84.2.191.
Blacklock R.., Rhodes R.., Blanchard C.., Gaul, C. 2010. Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncology Nursing Forum. 37:206–212. http://dx.doi.org/10.1188/10.ONF.206-212.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Hwang S. Y.., Park B. W.., Lee I.S. 2002. A psychoeducational group intervention for women with primary breast carcinoma. Korean Journal of Social Welfare. 51:93–118.
Bandura, A. 1977. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 84:191–215. http://dx.doi.org/10.1037/0033-295X.84.2.191.
Blacklock R.., Rhodes R.., Blanchard C.., Gaul, C. 2010. Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncology Nursing Forum. 37:206–212. http://dx.doi.org/10.1188/10.ONF.206-212.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Hwang S. Y.., Park B. W.., Lee I.S. 2002. A psychoeducational group intervention for women with primary breast carcinoma. Korean Journal of Social Welfare. 51:93–118.
Blacklock R.., Rhodes R.., Blanchard C.., Gaul, C. 2010. Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncology Nursing Forum. 37:206–212. http://dx.doi.org/10.1188/10.ONF.206-212.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Hwang S. Y.., Park B. W.., Lee I.S. 2002. A psychoeducational group intervention for women with primary breast carcinoma. Korean Journal of Social Welfare. 51:93–118.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Hwang S. Y.., Park B. W.., Lee I.S. 2002. A psychoeducational group intervention for women with primary breast carcinoma. Korean Journal of Social Welfare. 51:93–118.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Hoffman A. J.., von Eye A.., Gift A. G.., Given B. A.., Given C. W.., Rothert, M. 2009. Testing a theoretical model of perceived self-efficacy for cancer-related fatigue self-management and optimal physical functional status. Nursing Research. 58:32–41. http://dx.doi.org/10.1097/NNR.0b013e3181903d7b.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Fayer P. M.., Machin, D. 2009. Quality of life: Assessment, analysis and interpretation. 2nd ed.Chichester, West Sussex: John Wiley & Sons.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Damush T. M.., Perkins A.., Miller, K. 2006. The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors. Psycho-Oncology. 15:884–890. http://dx.doi.org/10.1002/pon.1020.
Boehmer S.., Luszczynska A.., Schwarzer, R. 2007. Coping and quality of life after tumor surgery: Personal and social resources promote different domains of quality of life. Anxiety, Stress and Coping. 20:61–75. http://dx.doi.org/10.1080/10615800701195439.
Cho N.K. 2008. A study on breast cancer patients’ improvement of self- efficacy and health-outcome expectation through dance sport participation. Journal of Leisure and Recreation Studies. 32:211–219.
Aaronson N. K.., Ahmedzai S.., Bergman B.., Bullinger M.., Cull A.., Duez N. J., et al1993. The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute. 85:365–376. http://dx.doi.org/10.1093/jnci/85.5.365.
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Table 1.
Characteristics | Categories | n (%) | M±SD |
---|---|---|---|
Age (yr) | <40 | 51 (16.8) | 47.7±8.7 |
40-49 | 139 (45.9) | ||
50-59 | 78 (25.7) | ||
≥60 | 35 (11.6) | ||
Marital status | Married | 250 (82.5) | |
Widowed/ Divorced | 30 (9.9) | ||
Unmarried | 23 (7.6) | ||
Educational level | ≤Middle school | 64 (21.1) | |
High school | 143 (47.2) | ||
College or University | 96 (31.7) | ||
Monthly income (10,000 won) | <200 | 89 (29.3) | |
≥200 | 214 (70.7) | ||
Religion | Yes | 229 (75.6) | |
No | 74 (24.4) | ||
Job | Yes | 85 (28.1) | |
No | 218 (71.9) | ||
Menopause (n=302) | Yes | 171 (56.6) | |
No | 131 (43.4) | ||
Duration since diagnosis (yr) (n=297) | 1.0-2.0 | 167 (56.2) | 3.4±3.6 |
2.1-4.0 | 55 (18.5) | ||
≥4 | 75 (25.3) | ||
Stage (n=300) | 0 or I | 102 (34.0) | |
II | 102 (34.0) | ||
III | 51 (17.0) | ||
IV | 45 (15.0) | ||
Metastasis | Yes | 48 (15.8) | |
No | 255 (84.2) | ||
Type of surgery (n=285) | Mastectomy | 80 (28.0) | |
Breast conserving surgery | 189 (66.1) | ||
Mastectomy+Reconstruction | 16 (5.6) | ||
Treatment trajectory | During treatment | 163 (53.8) | |
After treatment | 140 (46.2) | ||
Treatment modality*(n=163) | Surgery | 35 (21.5) | |
Radiation therapy | 44 (27.0) | ||
Chemotherapy | 86 (52.8) | ||
Herceptin therapy | 6 (3.7) | ||
Current anti-hormone therapy | Yes | 140 (46.2) | |
No | 163 (53.8) |
Table 2.
Table 3.
Table 4.
Table 5.
EORTC QLQ-C30=European Organization of Research and Treatment for Cancer Quality of Life Questionnaire Core 30 items; EORTC QLQ-BR23=EORTC Breast Cancer Specific Module; SESSM-B=Self-Efficacy Scale for Self-Management of Breast Cancer; CPD=Coping with psycho-informational demand; MSE=Management of side effects; MHL=Maintenance of healthy lifestyle; TC=Therapeutic compliance; SL=Sexual life.