Date Presented 03/26/20
The Traditional Chinese version of the Revised Self-Efficacy Scale showed adequate goodness of fit when applied to schizophrenic patients in Taiwan. That means this scale can measure the subjective feelings of self-efficacy in schizophrenic people, specifically relating to their positive and negative symptoms and interpersonal deficits. Future studies would be suggested to apply the same validation method for this disease-specific self-efficacy scale in other cultures.
Primary Author and Speaker: Lin-Jye Huang
Additional Authors and Speakers: Fu-Chang Hu, Chien-Te Wu, Yi-Hong Yang, Shu-Chun Lee, Powen Lin, Shih-Jui Hu
1. PURPOSE – This study aimed to apply the confirmatory factor analysis to validate the Traditional-Chinese version of the Revised Self-Efficacy Scale (TCRSES) for persons with schizophrenia. Because in OT mental health practice, it is essential to have more useful tools to measure subjective feelings of self-efficacy, which are specifically related to the schizophrenic patients’ positive and negative symptoms of schizophrenia, and their interpersonal deficits.
2. RATIONALE/BACKGROUND – Self-efficacy refers to the individual’s belief in the ability to reach goals that decide if an individual can demonstrate coping behaviors, expended efforts, and lasting time when encountering challenges or difficulties. Based on the self-efficacy theory, when the individual experiences mastery in the subjectively threatening activities, the feelings of security may produce and further increase the self-efficacy and reduce the protective behaviors. Furthermore, some researches have confirmed that the role of self-efficacy may mediate the relationships between symptoms and psychosocial functioning in schizophrenia people. Accordingly, the Revised Self-Efficacy Scale was developed for measuring the subjectively perceived self-efficacy in people with schizophrenia, including two subscales: positive symptoms and negative symptoms/social interaction. However, this disease-specific scale was not validated by conducting any factor analysis methods. Given that the scale above was translated into the Traditional-Chinese version and conducted by exploratory factor analysis in previous literature, little is known about the results of confirmatory factor analysis while applying TCRSES in the schizophrenic people.
3. DESIGN – Cross-sectional design.
4. PARTICIPANTS – We recruited 246 adults diagnosed with schizophrenia or schizoaffective disorder from psychiatric outpatient clinics, day hospitals, and vocational rehabilitation programs in Taipei, Taiwan.
5. METHODS TO OBTAIN DATA – We administered the TCRSES in this study. According to Yu and Chung (2004), this scale contained 56 items with three factors, including social skills, coping skills to psychiatric symptoms, and avoiding negative thinking. A five-point Likert scale was used for each item on scoring from 1 (strongly unconfident) to 5 (strongly confident).
6. ANALYTICAL METHODS – We used the software Lisrel 10.20 to apply the exploratory factor analysis (EFA) for the sample covariance matrix using the principal factor estimation method and the oblique promax rotation to explore the factor structures. Based on the EFA results, we took this ten-factor model to conduct the confirmatory factor analysis (CFA) using the same sample covariance matrix to refine the measurement structures. To warrant the quality of analysis results, we performed stepwise variable selection by iterating the following two actions, including using Wald’s t test to delete an insignificant structural parameter, and applying Modification Index (MI) to add an extra meaningful structural parameter. Then we assessed the adequacy of model fit by checking Chi-square goodness-of-fit test, Root Mean Square Error of Approximation (RMSEA), and Comparative Fit Index (CFI).
7. RESULTS – The results showed that the TCRSES existed ten factors for first-order and one factor for second-order (Chi-Square=2180.55, df=1331, p value=0.000, RMSEA=0.049, CFI=0.915) with all the 56 items retained.
8. CONCLUSION – Due to the usual cut-off values for well-fitted factor models in CFA are RMSEA < 0.06, and CFI > 0.95, the TCRSES showed adequate goodness of fit when applied to the schizophrenic patients in Taiwan.
9. IMPACT STATEMENT – The study suggests that the TCRSES may serve as one of the useful tools for the applications in mental health research and practice.
References
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191-215.
McDermott, B. E. (1995). Development of an instrument for assessing self-efficacy in schizophrenic spectrum disorders. Journal of Clinical Psychology, 51(3), 320-331.
Yu, C. Y., & Chung, H. H. (2004). Exploring the life events self-efficacy of schizophrenic outpatients. Hu li za zhi The journal of nursing, 51(1), 45-51.
Kline, R. B. (2016). Principles and Practice of Structural Equation Modeling, 4th Ed. New York, NY: The Guilford Press.
