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NIH PROMIS Self Efficacy

NIH PROMIS for Self Efficacy is an electronic standard assessment patient reported subjective outcomes. The electronic delivery is often beneficial compared to paper assessments as they reduce data entry errors and increase enrollment. Qolty PROMIS Self Efficacy is the ePRO system, and can be configured as a PRO tool that provides a short and reliable assessment for self efficacy with only the most informative items for an individual patient from an item bank based on the prior answers given by the patient.

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PROMIS Self-Efficacy for Managing Chronic Conditions is a Questionnaire that evaluates one’s confidence in achieving a goal despite stressful events, physical obstacles, and health conditions.

The term ‘self-efficacy,’ presented by Bandura as one of the main compounds in the field of positive psychology, is the belief that people’s perceptions influence and predict a certain outcome better than real events. In other words, if you feel confident that you can overcome the consequences of a stroke, for instance, you will recover quicker in spite of the severity of the situation.

PROMIS Self-Efficacy for Managing Chronic Conditions is used for adults (over 18) living with a chronic health condition, either neurological or general. It is crucial to mention that the items in the questionnaire are not disease-specific as they are designed for a broad range of patients with a chronic disease, their subjective experience, and mental health.

The survey consists of 140 items in total, divided into five scales: Self-Efficacy for Managing 1) Daily Activities; 2) Symptoms; 3) Medications and Treatments; 4) Emotions, and 5) Social Interactions. All banks have been calibrated for Computerized Adaptive Tests (CAT). Now, Qolty makes assessment more accessible, as patients can complete the surveys simply by using their Smartphones.

Self-efficacy is crucial in today’s healthcare as higher levels of self-efficacy are related to positive outcomes and better self-management skills. Self-efficacy scales are vital not only for chronic conditions but smoking cessation, eating disorders and pain management.PROMIS Self-Efficacy for Managing Chronic Conditions is a result of an in-depth literature research, focus groups, qualitative and quantitative analysis. A Delphi panel of 23 experts (Gruber-Baldini, et. al., 2017) provided the following definition used to describe the purpose of the questionnaire: “Self-efficacy for Managing Chronic Conditions is defined as an individual’s confidence in his/her ability to successfully perform specific tasks or behaviors related to one’s health in a variety of situations.”

PROMIS Self-Efficacy for Managing Chronic Conditions (chronic neurological conditions: epilepsy, etc.; and general medical conditions: arthritis, etc.) consists of five scales of 140 items in total. These scales are Self-Efficacy for Managing: Daily Activities (36 items), Symptoms (28 items), Medications and Treatments (26 items), Emotions (27 items), and Social Interactions (23 items).

The questionnaire has been created and validated after the assessment of 1087 subjects (mean age=53.8): 837 subjects, registered with a chronic disease, and 250 subjects, an online sample. Statistics revealed good consistency and validity.

All items are self-completed and scored on a 5-point Likert scale: 1 (I am not at all confident); 2 (I am a little confident); 3 (I am somewhat confident); 4 (I am quite confident); and 5 (I am very confident); no reverse items.PROMIS Self-Efficacy for Managing Chronic Conditions is not disease-specific but evaluates patients with chronic neurological conditions, such as epilepsy, Parkinson, frontotemporal dementia, stroke, etc.; and general medical conditions, such as arthritis, asthma, HIV, etc. The questionnaire is designed for people over 18.

  • Self-Efficacy for Managing Daily Activities assesses the subject’s confidence in performing various activities of daily living (ADLs) – exercising, sex, traveling, etc., without assistance (Hong, et. al., 2016).
  • Self-Efficacy for Managing Medications and Treatments tests how well people manage medications, treatment, and visits, including when adverse effects are present, as some patients might become forgetful or negligent.
  • Self-Efficacy for Managing Symptoms relate to the ability of the patient to deal with symptoms without letting their condition interfere with work and recreational activities at the same time.
  • Self-Efficacy for Managing Emotions assesses patients’ emotions and stress as living with a condition can easily lead to depression, fatigue, anger, and apathy.
  • Self-Efficacy for Managing Social Interactions is designed to evaluate people’s ability to continue leading a fulfilling social life despite one’s condition.

Various scales exist and measure disease-specific self-efficacy, including multiple sclerosis, cancer, etc. However, limiting the scales to specific conditions cannot present all aspects of chronic diseases. Only one scale – the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEMCD6) evaluates multiple health conditions, which makes it the closest questionnaire to PROMIS Self-Efficacy for Managing Chronic Conditions. Although SEMCD6 measures stress, pain, fatigue, symptoms, tasks and other aspects, it does not provide different subscales.PROMIS Self-efficacy for Managing Chronic Conditions is a unique test to assess self-efficacy and chronic conditions, needed worldwide. Currently, it is only in the English language.Regardless of the type of questionnaire, examiners should take an Item Response Theory (IRT) approach when analyzing the data.

A sample data depicts the factors that may influence self-efficacy in patients. As expected, people with higher age, higher education and family will score higher on self-efficacy (Figure 1).

Another sample data can be visualized by comparing the mean scores of the all the scales with respect to the first and second Qolty survey taken by the individual (Figure 2).

 PROMIS Self-Efficacy for Managing Chronic Conditions has good reliability indexes (Schwartz, et. al., 1996).

The scales have good high internal consistency and test-retest reliability. In particular, Self-Efficacy for Managing Daily Activities shows excellent internal consistency (Chronach’s Alpha=0.97) and cross-section validity.

The psychometrics of the questionnaire might open more opportunities for further validation, CATs, and translations.

 PROMIS Self-Efficacy for Managing Chronic Conditions assesses one of the main aspects related to mental health – self-efficacy in patients with a chronic disease.

The questionnaire is not disease-specific, and it is designed for patients over 18.

Items assess five scales: 1) Daily Activities; 2) Symptoms; 3) Medications and Treatments; 4) Emotions; and 5) Social Interactions.One of the main advantages of PROMIS Self-Efficacy for Managing Chronic Conditions is that it assesses patients across five different scales without being disease-specific.

The test is self-completed, and it does not assess the potential role of an interviewer in the process. In addition, the CAT forms do not take into consideration the cognitive overload when working with a computer, especially for older patients. Still, the biggest advantage is the easy accessibility for patients and health professionals on their smartphones, and results are only a click away.Bandura, Al. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol.4, pp.71-81). New York: Academic Press. (Reprinted in H. Friedman , Encyclopedia of mental health, San Diego: Academic Press, 1998).

Chen, G., Gully, S. M., & Eden, D. (2001). Validation of a new General Self-Efficacy Scale. Organizational Research Methods, 4, 62-83.

Gruber-Baldini, A., Velozo, C., Romero, S., & Shulman, L. (2017). Validation of the PROMIS measures of self-efficacy for managing chronic conditions. Qual Life Res.

Hong, I., Velozo, C., Li, Ch., Romero, S., Gruber-Baldini, A., & Shulman, L. (2016). Assessment of the psychometrics of a PROMIS item bank: Self-efficacy for managing daily activities. Qual Life Res.

Lee, C., & Bobko, P. (1994). Self-efficacy beliefs: Comparison of five measures. Journal of Applied Psychology, 79, 364-369.

Schwartz, C., Coulthard-Morris., L., Zeng, Q., Retzslaff, P. (1996). Measuring Self-Efficacy in People with Multiple Sclerosis: A validation Study. Arch Phys Med Rehabil, 77, 394-8.