Chest
Volume 99, Issue 5, May 1991, Pages 1193-1196
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Clinical Investigations
The COPD Self-Efficacy Scale

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Many individuals with COPD develop a lack of confidence regarding their ability to avoid breathing difficulty while participating in certain activities, however minimal the physical demands of the activity may be. This lack of confidence may be expressed as low self-efficacy. As a result of low self-efficacy, COPD patients may refrain from many routine activities of daily living. Identifying situations in which individuals with COPD experience low self-efficacy would allow the development of specific treatment interventions designed to increase the patient's self-efficacy in those situations and consequently increase activity. We developed a 34-item COPD Self-Efficacy Scale (CSES) to assess self-efficacy in individuals afflicted with COPD. The CSES has good test-retest reliability (r = .77), excellent internal consistency (Cronbach's alpha = .95), and a five-factor structure (negative affect, intense emotional arousal, physical exertion, weather/environmental, and behavioral risk factors). (Chest 1991; 99:1193-96)

Section snippets

Subjects

The subjects were recruited from a group of 250 individuals with COPD who were referred by physicians, lung association directors, and respiratory therapists across the state of Ohio. From these referrals, 124 individuals initially agreed to participate in the study. However, 14 individuals subsequently withdrew their participation due to poor health. In addition, eight individuals failed to return portions of their data; the data for these eight individuals were excluded from the analyses.

RESULTS

The CSES proved to be both reliable and internally consistent. The Pearson product-moment correlation coefficient between the first and second administrations of the CSES was r = .77, p<.001. Coefficient alpha was .95 for the first administration and .96 for the second administration of the CSES, demonstrating that the CSES is internally consistent. A two-tailed Student's t-test between the two administrations of the CSES revealed that there were no significant differences in the subjects'

DISCUSSION

The CSES will allow physicians, behavioral scientists, and other health care personnel to assess the confidence of COPD patients in their ability to avoid or to manage breathing difficulty in certain situations. Although physicians may repeatedly offer advice to patients about how they should manage their condition, patients frequently ignore such advice. Sometimes physicians may conclude that patients did not understand instructions provided to them.10 However, the problem may not be a lack of

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This research was supported in part by grant HL 32538 from the Division of Lung Diseases, National Heart, Lung, and Blood Institute.

Manuscript received August 13; revision accepted October 15.

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