The study aimed to translate and assess the validity and reliability of the Traditional Chinese version of the Medication Understanding and Use Self-Efficacy Scale (MUSE-TC) among patients with type 2 diabetes (T2D) in Taiwan.
The original 8-item MUSE was translated into Traditional Chinese using a forward and backward translation method. The translations were reviewed by four experts in pharmacy practice and educational psychology. The validity and reliability of the MUSE-TC were assessed in a cross-sectional study among adults with T2D who were taking diabetes medications. Participants were recruited from five community pharmacies in Taiwan between June 2023 and May 2024. Internal consistency of the MUSE-TC was measured using McDonald's omega (ω), while construct validity was evaluated through confirmatory factor analysis. Criterion validity was established by examining the relationship between self-efficacy and medication adherence.
A total of 274 patients participated in the study. Confirmatory factor analysis identified a two-factor structure for the 8-item MUSE-TC, consisting of the “taking medication” and “learning about medication” domains. All items loaded onto their intended factors, with factor loadings ranging from 0.433 to 0.511. The scale demonstrated excellent internal consistency, with McDonald's ω values of 0.914 for the “taking medication” domain and 0.906 for the “learning about medication” domain. These robust psychometric properties were further supported by criterion validity, as self-efficacy was shown to be associated with medication adherence. Specifically, the “taking medication” domain was positively correlated with fewer barriers to medication-taking (r = 0.382, p < 0.001), suggesting that individuals with higher self-efficacy tend to adhere to their prescribed medication regimen.
This study presents the MUSE-TC with psychometrically sound properties that will enable healthcare professionals to prospectively assess self-efficacy in medication use and evaluate the impact of self-efficacy on a variety of health outcomes across patients with different chronic diseases.
Patients, pharmacists, pharmacy staff, and academic experts worked together on the translation and validation of this self-efficacy scale for medication adherence among individuals with chronic illnesses. Community engagement played a key role in translating the scale, recruiting participants, collecting data, conducting analysis, and interpreting the findings. These collaborative efforts ensure the study relevance and applicability to patient care in routine healthcare settings.