Abstract
The aim of this study was to develop a scale to assess the levels of specific self-efficacy in order to enhance adherence to a gluten-free diet and the life quality of celiac patients. Celiac disease is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed people. The only treatment is a strict lifelong gluten-free diet. Within the framework of Social Cognitive Theory, expectation of self-efficacy is understood as the degree in which a person believes himself to be capable of performing a certain task (e.g., adhering to a gluten-free diet), a construct which has been widely studied in its relation with adopting healthy behaviors, but scarcely in relation to celiac disease. A validation study was carried out in various stages: preparation of the protocol; construction of the questionnaire and a pilot run with 20 patients; validation of the scale with 563 patients and statistical analysis. A 25-item scale was developed. Feasibility was excellent (99.82% of participants completed all the questions). Factorial analysis pointed to the existence of five factors that explained 70.98% of the variance with a Cronbach alpha of 0.81 for the scale overall and between 0.64 and 0.90 for each factor. The scale showed a Spearman's Rho coefficient of 0.279 with the General self-efficacy Scale. This easily administered scale provides good psychometric properties for evaluating specific self-efficacy of celiac patients in adhering to treatment. It seeks to be the first scale that provides not only a measurement of specific self-efficacy in celiac disease, but also to determine its levels for each of the areas as a first step toward designing interventions of self-management and empowerment programs to cope with the disease.
Highlights
Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed people (Ludvigsson et al, 2013)
We developed a scale to assess specific selfefficacy as a determinant in adherence to gluten-free diet (GFD) and subsequently be able to investigate its impact on the quality of life in celiac patients
The highest values for each item are shown in boldface with two exceptions: item 1 “When I have to ask people to clean machines, utensils or surfaces, for example at the butcher’s” and item 22 “When identifying myself as a celiac sufferer in the business or students’ meal” load onto factor 1, we have considered their second highest load to keep them in their original areas, due to their meaning and importance in dealing with GFD and we will wait for future studies to either eliminate them or rewrite them and assign them to other area
Summary
Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed people (Ludvigsson et al, 2013). The expectation of self-efficacy has been widely studied in many spheres such as physical activity (Schwarzer et al, 2008), tobacco addiction (Hendricks et al, 2010), multiple sclerosis (Chiu et al, 2011), or patients with arthritis (Lorig et al, 2014). It has received scant attention for celiac disease (Ford et al, 2012). Self-efficacy has been linked to better adherence to GFD and better quality of life in celiac patients (Ford et al, 2012)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
