Chest
Original ResearchCOPDMeasuring a Change in Self-Efficacy Following Pulmonary Rehabilitation: An Evaluation of the PRAISE Tool
Section snippets
Pulmonary Rehabilitation Adapted Index of Self-Efficacy
We adapted the General Self-Efficacy Scale (GSES) specifically for the population of patients in PR. The original tool is a validated 10-item scale.11 Currently, the original scale has been translated into 26 languages. It measures generalized perceived self-efficacy at any given time and has been reported extensively in the literature. Typical items are “Thanks to my resourcefulness, I know how to handle unforeseen situations” and “When I am confronted with a problem, I can usually find
Reliability Study
The mean change in score was 0.72 (95% CI, −2.27-0.89; P = .34). The intraclass correlation coefficient was r = 0.99 (P ≤ .001). A Cronbach α was calculated on all items of the scale (0.95). A Bland and Altman plot is also provided in e-Figure 1.
Sensitivity Study
The mean change of 3.59 in PRAISE score was statistically significant (P = .015). The mean change in the ISWT was 83.44 m (P < .0005). The 38 patients who dropped out from the study did score lower overall before PR in ISWT, CRQ-SR, HADS, and PRAISE,
Discussion
This article describes the development and testing of a self-efficacy scale specifically for use in PR. There is no other tool currently available. The GSES adapted for PR, PRAISE, demonstrates test-retest reliability and internal consistency. PRAISE is also sensitive to change, enabling us to document an improvement in the patient's level of self-efficacy after a course of PR. This correlates with previous research findings suggesting that PR may have a direct effect upon specific
Conclusions
This study indicates that PRAISE is both reproducible and sensitive in this population, although it is unable to determine those patients who may drop out of PR. PRAISE is sensitive to change in PR patients, easy to use, and well tolerated. PRAISE can, therefore, be proposed as a practical instrument that explores a different psychologic dimension for those patients attending PR.
Acknowledgments
Author contributions: Ms Vincent: conceived the original idea, developed the protocol, completed the analysis, and wrote the manuscript.
Dr Sewell: completed analysis and approved the manuscript.
Ms Wagg: completed analysis and approved the manuscript.
Dr Deacon: supported data collection and approved the manuscript.
Ms Williams: completed analysis and approved the manuscript.
Dr Singh: developed the protocol, gave overall supervision, and revised the manuscript for intellectual content.
References (19)
- et al.
Effects of treatment on two types of self-efficacy in people with chronic obstructive pulmonary disease
J Pain Symptom Manage
(2006) - et al.
Self-management strategies in chronic obstructive pulmonary disease
Clin Chest Med
(2007) - et al.
Self-efficacy as a predictor of improvement in health status and overall quality of life in pulmonary rehabilitation—an exploratory study
Patient Educ Couns
(2010) - et al.
The COPD Self-Efficacy Scale
Chest
(1991) Functional and self-efficacy changes of patients admitted to a Geriatric Rehabilitation Unit
J Adv Nurs
(2004)- et al.
Testing a theoretical model of exercise behavior for older adults
Nurs Res
(2003) - et al.
American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation
Am J Respir Crit Care Med
(2006) Self-efficacy: The Exercise of Control
(1997)- et al.
Impact of pulmonary rehabilitation on self-efficacy, quality of life, and exercise tolerance
Rehabil Psychol
(1999)
Cited by (0)
Funding/Support: This study was supported by a project grant from the British Lung Foundation.
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