Development and Psychometric Properties of the Self-Efficacy Scale for Symptom Management and Self-Care in Patients With Cardiac Surgery.

Background and Purpose: Evaluating self-efficacy for symptom management and self-care is crucial for ensuring follow-up care after cardiac surgery. As there is not yet a validated measurement tool for this evaluation, the aim of this study was to develop the Self-Efficacy Scale for Symptom Management and Self-Care (SESMSC: Cardiac Surgery) in patients with cardiac surgery and to examine its psychometric properties. Methods: The Symptom Management Theory and Bandura's Self-Efficacy Theory were used as the theoretical background for scale development. A multiphase design was utilized. The initial development phase consisted of item generation and expert panel review. The second phase comprised a three-step validation process: (a) face and content validity analysis, (b) exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for construct validity, and (c) Cronbach's α, test-retest, and item-total correlation analysis to assess internal consistency reliability. The sample (n = 401) was randomly divided into two subsamples for EFA and CFA (EFA group: n = 201; CFA group: n = 200). Results: EFA suggested a 20-item, two-factor structure with factor loadings of .342-0.782. The two subscales of the scale were labeled symptom management self-efficacy and self-efficacy for self-care activities. Goodness-of-fit indices indicated a good model fit. Cronbach's α, test-retest, and item-total correlation results demonstrated acceptable internal consistency reliability. Implications for Practice: The SESMSC: Cardiac Surgery may be a useful tool to evaluate self-efficacy for symptom management and self-care after cardiac surgery. Further evaluation in independent samples is needed to investigate its psychometric properties and usefulness in clinical practice.