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coronary disease, factor analysis, psychometrics, reliability and validity, self-efficacy, self-management



  1. Mares, Maria BN(Hons), RN
  2. Salamonson, Yenna PhD, MA, GDNEduc, BSc, RN
  3. Maneze, Della PhD, MD
  4. Elmir, Rakime PhD, RM
  5. Everett, Bronwyn PhD, MSc(Hons), BAppSc, RN


Background: Self-management is important in reducing coronary risk factors and in preventing recurrent cardiac events. An enabling factor that promotes self-management among patients with coronary heart disease (CHD) is self-efficacy. However, there is no standardized measure that captures self-efficacy and self-management concurrently in this population.


Aim: The authors of this study report on the development and validation of a brief scale to measure self-efficacy and self-management in patients with CHD.


Methods: Scale development and testing comprised (1) item generation, (2) content validity, and (3) pilot testing. The Heart Health Self-Efficacy and Self-Management (HH-SESM) scale includes 2 constructs: self-efficacy and self-management, measured concurrently. Components of the HH-SESM scale consisted of items related to behavioral and coronary risk factor modification. Survey data from 143 participants were used in exploratory factor analyses to test the factorial validity and internal consistency of the scale.


Results: Twelve items with the same response format were included in the exploratory factor analysis. The factor analysis revealed a single-factor solution accounting for 36.7% and 36.5% of the variance in scores of the self-efficacy and self-management scales, respectively. The correlation (r = 0.72, P < .001) between the self-efficacy and self-management constructs indicates moderate convergent validity. Cronbach [alpha] of self-efficacy (0.83) and self-management (0.81) constructs showed good internal consistency.


Conclusion: The HH-SESM is a brief, easy-to-administer, and reliable measure of self-efficacy and self-management in patients with CHD.