Preliminary validation of a self-efficacy scale for pediatric chronic illness.

BACKGROUND: Tracking self-efficacy may be useful for identifying children at risk for medical noncompliance. We created the Pediatric Rating of Chronic Illness Self-Efficacy (PRCISE) to measure self-efficacy in youth dealing with a chronic illness.

METHOD: Data were collected from 217 families where one child aged 7-20 (Mage  = 13.62, SDage  = 2.92; 62.7% Latino, 58.1% female) had a chronic illness. Parent participants provided demographic information. Youth completed a depression measure, the Patient Health Questionnaire for Adolescents and the PRCISE. To determine the underlying latent structure of the scale, an exploratory factor analysis was conducted using parallel analysis. We also carried out two multiple linear regressions to explore the data and establish preliminary predictive validity.

RESULTS: The measure was reduced to 15 items, demonstrating a one-factor solution with strong reliability. Predictors of lower self-efficacy included having parents who had not attended college, being African American, and having higher Patient Health Questionnaire for Adolescents scores, R2  = .23, F(11, 174) = 5.62, p < .001. Main effects were qualified by a two-way interaction, such that the decrease in PRCISE scores associated with depressive symptoms was attenuated in children with less educated parents. In terms of predictive validity, higher PRCISE scores unexpectedly predicted more number of emergency room visits, R2  = .12, F(9, 113) = 2.73, p < .01.

CONCLUSIONS: The PRCISE appears to be a reliable measure of a single self-efficacy construct. Secondary analyses revealed important health disparities in pediatric chronic illness self-efficacy. Next steps may include validation of the PRCISE using confirmatory factor analysis.