Self-efficacy For Symptom Management Research Articles

Randomized controlled trial of supportive care interventions to manage psychological distress and symptoms in Latinas with breast cancer and their informal caregivers

Objective: The purpose of this study was to test two 2-month psychosocial interventions (Telephone Interpersonal Counseling [TIPC] and Supportive Health Education [SHE]) to improve quality of life (QOL) outcomes for Latinas with breast cancer and their informal caregivers. Methods: Two hundred and forty-one Latinas with breast cancer and their caregivers were assessed at baseline, immediately after the 2-month intervention, at 4 and 6 months after baseline. QOL outcomes were psychological distress, symptoms and social support. Results: Linear mixed effects models showed that for cancer survivors at 2 months, TIPC produced lower adjusted mean depression scores compared to SHE. At 4 months, SHE had reduced total number of symptoms, global symptom distress, and social isolation compared to TIPC. Only total number of symptoms was lower in SHE than in TIPC at 6 months. Among caregivers at 2 months, total number of symptoms, global symptom distress, and anxiety were lower, and self-efficacy for symptom management was higher in SHE compared to TIPC. Caregiver depression was lower in TIPC compared to SHE at 4 months. Conclusions: These telephone delivered interventions improved different outcomes. TIPC demonstrated superior benefits for depression management and SHE was more successful in anxiety and cancer-related symptom management.

The Meaning of Self-efficacy for Symptom Management in the Acute Phase of Hematopoietic Stem Cell Transplantation.

Hematopoietic stem cell transplantation (HSCT) is an intensive treatment that offers the potential for longer life or cure for some types of cancer. Hematopoietic stem cell transplant is associated with decreased quality of life and functional status and distressing symptoms. Self-efficacy for symptom management (SESM) is a person's belief in his/her ability to implement behaviors to manage these symptoms. Presence of SESM can affect symptom distress, healthcare utilization, and posttransplantation outcomes. The aim of this study was to explore the meaning of SESM in adults during the acute phase of HSCT. Interviews were conducted before and at 30 days after transplantation. Descriptive thematic analysis was performed on verbatim interview transcripts. Themes of confidence, being responsible, and caring for mind, body, and spirit were identified, with subthemes of self-confidence, confidence in others, confidence and symptom level, vigilance, self-advocacy, and normalcy. Participants reported having high SESM before transplantation and having much less or no SESM when symptom distress was the most severe. This is the first study to examine the patient's perspective of self-efficacy in the acute phase of HSCT. This contributes to existing literature on the concept of symptom management and expands nursing knowledge of SESM in patients undergoing HSCT. Nurses can assess SESM before transplantation and implement interventions to enhance SESM when symptoms are at their most distressing after HSCT. The findings from this study can provide the basis for creating behavioral interventions to enhance self-efficacy for symptom management in HSCT patients.

Self-Efficacy for Management of Symptoms and Symptom Distress in Adults With Cancer: An Integrative Review.

Self-efficacy for symptom management plays a key role in outcomes, such as quality of life (QOL), functional status, and symptom distress, for adults with cancer. This integrative review identified and assessed evidence regarding self-efficacy for management of symptoms and symptom distress in adults with cancer. The authors performed a search of literature published from 2006-2018, and articles that examined the relationship among self-reported self-efficacy, symptom management, symptom distress or frequency, and severity in adults with cancer were selected for inclusion. 22 articles met the inclusion criteria. All articles were critically appraised and met standards for methodologic quality. Evidence from this review showed that high self-efficacy was associated with low symptom occurrence and symptom distress and higher general health and QOL. High self-efficacy predicted physical and emotional well-being. Low self-efficacy was associated with higher symptom severity, poorer outcomes, and better overall functioning. Self-efficacy can be assessed using developed instruments. Presence of a theoretical model and validated instruments to measure self-efficacy for symptom management have set the groundwork for ongoing research.

Using a Heuristic App to Improve Symptom Self-Management in Adolescents and Young Adults with Cancer.

Adolescents and young adults (AYAs) with cancer need self-management strategies to cope with multiple symptoms. Self-efficacy, self-regulation, and negotiated collaboration are key theoretical components of the self-management process and have not been fully explored with AYAs with cancer. This study examined the effects of a heuristic symptom assessment tool on AYAs' self-efficacy for symptom management, AYAs' self-regulation abilities related to their symptoms, and communication with their providers about symptoms. AYAs (15-29 years of age) receiving chemotherapy used the Computerized Symptom Capture Assessment Tool (C-SCAT) to illustrate their symptom experience and discuss their symptoms with providers during two clinic visits. Participants completed the PROMIS Self-efficacy for Managing Symptoms Scale, a measure of satisfaction with provider communication, and a short interview about self-regulation and communication behaviors at baseline and after each provider visit. Eighty-five AYAs who used the C-SCAT showed improved self-efficacy for managing symptoms. Qualitative data suggest that the C-SCAT was useful for enhancing a number of AYAs' self-regulation abilities related to symptom management, such as awareness and recall of symptoms, how symptoms were related, and how they planned to talk about their symptoms to providers. AYAs reported C-SCAT facilitated communication with providers about symptoms and symptom management because it was a visual prompt showing priority and related symptoms. Because AYAs continue to experience multiple distressing symptoms, symptom self-management remains an important area for practice and research. Use of heuristic tools, such as the C-SCAT, may help AYAs more effectively self-manage their symptoms for better health outcomes.

Young adults’ adjustment to a recent diagnosis of multiple sclerosis: The role of identity satisfaction and self-efficacy

BackgroundAlthough multiple sclerosis (MS) is often diagnosed during young adulthood (18–30 years), there is a lack of knowledge on the psychological adjustment to the illness among recently diagnosed young adult patients. Objective/hypothesisThe aims of the study were to describe the adjustment to MS (depression, positive and negative affect) in a group of young adult patients and to investigate the role of identity satisfaction and self-efficacy in MS on adjustment. We hypothesized that the relationship between identity satisfaction and adjustment was mediated by self-efficacy (goal setting and symptom management). MethodsThe cross-sectional study involved 66 patients (63.6% women) with a mean age of 25.2 years (SD = 3.4) who had been diagnosed for no more than three years. Patients completed measures of identity satisfaction (Identity Motives Scale), Self-efficacy in MS (SEMS), Depression (CESD-10), Positive and Negative Affect (PANAS). Data were analyzed through factorial ANOVAs and hierarchical regression analysis. ResultsThirty-eight percent of patients reported depressive symptoms and negative affect mean score was higher than in the general population. Higher identity satisfaction was directly related to lower depression. Self-efficacy in goal setting partially mediated the relationship between identity satisfaction and positive affect, whereas self-efficacy in symptom management totally mediated the effect of identity satisfaction on negative affect. All results were significant at p < 0.05. ConclusionsThe results suggest the usefulness of addressing identity redefinition and self-efficacy in psychological interventions aimed at promoting young adults’ adjustment to MS in an early phase of the illness.

FEASBILITY AND ACCEPTABILITY OF A PILOT INTERVENTION FOR VIETNAMESE DEMENTIA CAREGIVERS

This ongoing pilot study examines the feasibility and acceptability of a culturally adapted intervention to reduce stress and enhance the health of Vietnamese dementia caregivers and quality of life for their care recipients. Thus far, a total of 8 caregivers have been recruited into the intervention via the Alzheimer's Association, Vietnamese language newspapers, and word-of-mouth. Feasibility outcomes were assessed as follows: recruitment: number of caregivers screened in order to identify caregivers (and time/resources required to recruit); retention in the intervention (i.e. % of dyads engaged in the initial session, % completing at least 3 sessions, and % completing all sessions); and administration of study measures: % of baseline, post-, and 3-month assessments completed. Acceptability was assessed through a short qualitative interview assessing the perceptions of the intervention by caregivers. While assessing efficacy was not a primary goal of this pilot, we also describe pre-post differences in caregiver's Alzheimer's disease (AD) knowledge and psychosocial outcomes. Feasibility outcomes are as follows: out of the 62 individuals contacted, 15 were eligible, and of these, 8 enrolled in the intervention; 100% came to five of the six sessions; 7 of the 8 caregivers completed all baseline, post-, and 3-month follow-up data (one caregiver whose care recipient died did not complete follow-up data). Qualitative data indicated participants enjoyed and benefited from the intervention. Additionally, Wilcoxon tests comparing pre- and post-intervention data showed significant increases in caregiver's AD knowledge (20.57 vs. 22.57, p< .05) and self-efficacy in using support services (2.51 vs. 5.35, p < .05), and a significant decrease in perceived stress (15.50 vs. 11.44, p< .05). Although not significant, there were also increases in care recipient quality of life and caregiver self-efficacy in symptom management, and decreases in caregiver burden, depression, anxiety, somatization, and intention to use services. Results indicated that the six-week intervention is feasible and acceptable for Vietnamese dementia caregivers, although challenges with recruitment were encountered. Promising trends for pre-post outcomes were also observed. Moving into the randomized controlled trial next, recruitment strategies have been changed and these will be discussed.

The status of self-efficacy and its influencing factors of the patients with bronchiectasis

Objective To investigate the current situation of self-efficacy in patients with bronchiectasis, and to analyze the influencing factors in order to improve their self-efficacy. Methods Self-efficacy scale and the general situation questionnaire was used to investigate the self-efficacy and its influencing factors of 150 patients with bronchiectasis by using the convenience sampling method. Results The scores of self-efficacy of the 150 patients with bronchiectasis were: self-efficacy (5.36 ± 1.48) points, symptom management self-efficacy (5.57 ± 1.74) points, common disease management self-efficacy (5.19 ± 1.62) points.Gender, educational level, smoking status and first diagnosis were all related to self-efficacy scores, and the differences were statistically significant (P<0.05). Patients' self-efficacy was positively correlated with their first diagnosis and smoking status. Conclusions The self-efficacy of patients with bronchiectasis needs to be improved.For long-term smokers, health care workers should strengthen self-management to improve their self-efficacy and improve their health. Key words: Bronchiectasis; Self-efficacy; Influencing factors

Understanding the predisposing, enabling, and reinforcing factors influencing the use of a mobile-based HIV management app: A real-world usability evaluation

ObjectiveTo conduct an in-depth analysis of users’ experiences using an HIV self-management app. Materials and MethodsWe conducted four follow-up focus groups at the end of a 3-month randomized feasibility trial. All focus group sessions were audio-recorded and transcribed. A thematic analysis was conducted to explore emerging themes. All of the themes were categorized into three factors of the PRECEDE component of the PRECEDE-PROCEED framework. For a finer granularity of analysis, the codes of each theme were broken into positive, negative, and neutral codes by study group. Results36 participants, including 24 from the intervention group and 12 from the control group, participated in the focus group sessions. A total of 14 themes organized by the PRECEDE factors were identified from focus group transcripts. Five themes related to predisposing factors were: 1) ease of app use; 2) user-friendly functionality; 3) self-efficacy for symptom management; 4) design preference of illustrated strategies with videos; and 5) user-control (convenience vs. security). Four themes related to enabling factors were: 1) information needs of symptom management; 2) symptom-tracking; 3) fit in lifestyle/schedule/living conditions; and 4) additional languages (e.g., Spanish). Five themes related to reinforcing factors were: 1) communication with healthcare providers; 2) individual-tailored information visualization; 3) social networking; 4) individual-tailored information quality; and 5) improvement in quality of life. Discussion and ConclusionUsability evaluation in a real-world setting enabled us to measure users’ actual experiences when interacting with the app during their everyday lives. Our work highlights the importance of using mobile technology for persons living with HIV, specifically those with low income/housing instability, and adds to the body of literature on the potential for implementation and dissemination of symptom self-management strategies through a mobile platform.

An analysis of relationship between self perceived burdenand self efficacy, coping style in patients with chronic obstructive pulmonary disease

Objective To investigate the characteristics of self perceived burden (SPB) in patients with chronic obstructive pulmonary disease (COPD) and explore the relationship between the perceived burden and self-efficacy, coping style. Methods A total of 96 cases with COPD in our hospital from January 2015 to June 2017 were enrolled in the study. The clinical data of patients were retrospectively analyzed. The patients were surveyed by self perceived burden scale, self-efficacy scale and coping style scale. The relationship between self perceived burden and self efficacy, coping style were investigated. Results The self perceived burden score of COPD patients was (33.76±7.65)points with moderate level. The symptom management self-efficacy, common disease management self-efficacy score of COPD patients were (8.13±1.09) and (8.22±1.13) respectively with moderate self-efficacy. The total score of coping style in COPD patients was (35.09±10.83) points with positive coping style. The each dimension and the total score of self perceived burden were negatively correlated with positive coping style in COPD patients (P 0.05). The each dimension and the total score of self perceived burden were negatively correlated with the each dimension scores and total scores of self-efficacy in COPD patients (P<0.05). Conclusions There are significant correlation between SPB and self-efficacy and coping style in COPD patients. Medical staff should strengthen communication with patients, and guide them with positive coping style in the face of disease, which can effectively improve their self-efficacy and reduce the self perceived burden and promote physical and mental health. Key words: Pulmonary disease, chronic obstructive; Self efficacy; Questionnaires

The Investigation of the Relationship Between Cancer Coping and Symptom Management Self-Efficacy, Perceived Social Support, Uncertainty and Life Orientation in Breast Cancer Female Survivors

The Investigation of the Relationship Between Cancer Coping and Symptom Management Self-Efficacy, Perceived Social Support, Uncertainty and Life Orientation in Breast Cancer Female Survivors

Comorbid Posttraumatic Stress Disorder and Traumatic Brain Injury: Generalization of Prolonged-Exposure PTSD Treatment Outcomes to Postconcussive Symptoms, Cognition, and Self-Efficacy in Veterans and Active Duty Service Members.

To examine (a) generalization of the effectiveness of prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD) in improving postconcussive symptoms (PCSs) and other outcomes in military service members and Veterans (VA) with histories of mild to severe traumatic brain injury (TBI), and (b) factors associated with PCS reduction. VA polytrauma medical center. Consecutive referrals for PTSD treatment of Active Duty (n = 17) or Veterans (n = 27) diagnosed with PTSD and TBI (N = 44). Neurobehavioral Symptom Inventory, Key Behaviors Change Inventory, Self-Efficacy for Symptom Management, Posttraumatic Stress Disorder Checklist, and Beck Depression Inventory, 2nd edition. Post hoc analysis of archival clinical effectiveness program evaluation data. PE for PTSD. There were significant improvements on all outcome measures with large effect sizes (Cohen's d ranging from 0.68 to 2.02). Improvement on PCS (Cohen's d = 1.21) was associated with lower levels of VA service-connected disability and PE treatment completion. PE treatment-related improvements for participants with comorbid PTSD and TBI generalize from PTSD outcomes to PCS and other TBI-related outcomes. Positive outcomes were independent of TBI severity, treatment setting, or Veteran status, but dependent upon PE treatment completion and lower levels of VA service-connected disability.

Perceived Self-Efficacy: A Concept Analysis for Symptom Management in Patients With Cancer .

Perceived self-efficacy (PSE) for symptom management plays a key role in outcomes for patients with cancer, such as quality of life, functional status, symptom distress, and healthcare use. Definition of the concept is necessary for use in research and to guide the development of interventions to facilitate PSE for symptom management in patients with cancer. . This analysis will describe the concept of PSE for symptom management in patients with cancer. . A database search was performed for related publications from 2006-2016. Landmark publications published prior to 2006 that informed the concept analysis were included. . Greater PSE for symptom management predicts improved performance outcomes, including functional health status, cognitive function, and disease status. Clarification of the concept of PSE for symptom management will accelerate the progress of self-management research and allow for comparison of research data and intervention development.

Self-efficacy in Activities of daily living and symptom management in people with dizziness: a focus group study

Background: Self-efficacy is associated with health status, health behaviour and health behaviour change in various chronic health conditions.Purpose: To describe self-efficacy in relation to Activities of daily living and symptom management in people with dizziness.Material and methods: Thirteen women and three men, aged 45–82 years, with persistent dizziness (duration 4 months to 30 years) were recruited from an outpatient physiotherapy unit. A qualitative study was conducted using four focus groups and one individual interview and was then analysed with qualitative content analysis.Results: The participants conveyed, in-depth information concerning two predefined main categories. Self-efficacy in Activities of daily living was related to challenging body positions and motions, environments, social activities, work tasks, and complex cognitive behaviours. Self-efficacy in symptom management was related to distress and aggravated symptoms, unfamiliar environment, and unknown people.Conclusions: People with dizziness describe how self-efficacy for specific activities varies according to the perceived difficulty of the task, the context of the activity, and day-to-day variations in general wellbeing. The results underscore the importance of targeting self-efficacy in the rehabilitation of people with dizziness. Our findings can guide the rehabilitation process by providing a deeper understanding of self-efficacy judgements in relation to Activities of daily living and symptom management in people with dizziness.Implication for rehabilitationThis study adds important in-depth knowledge to the rehabilitation area on self-efficacy beliefs in relation to Activities of daily living and symptom management in people with dizziness.Self-efficacy for specific activities varies according to the perceived difficulty of the task, the context in which the activity takes place and day-to-day variations in perceived general well-being.The results can be used as a topic list to guide rehabilitation efforts in exploring and intervening aspects of people’s everyday activities that are affected by low self-efficacy judgements.Activities perceived to be crucial to everyday life and important for well-being should be targeted in rehabilitation to increase self-efficacy and thereby activity performance and participation in people with dizziness.

HIV symptom management self-efficacy mediates the relationship of internalized stigma and quality of life among people living with HIV in China.

HIV-related stigma negatively influences quality of life among people living with HIV. Little is known about psychological protective factors that mitigate negative impacts. This study aims to examine the role of self-efficacy in reducing effects of stigma on quality of life. A total of 2987 people living with HIV (age: M = 42.46 years, SD = 12.83; time since diagnosis: M = 3.23 years, SD = 2.39) provided data on internalized stigma, HIV symptom management self-efficacy, and health-related quality of life, as well as covariates. Using structural equation modeling, we found that self-efficacy mediated the relationship of stigma and quality of life. Future interventions to promote quality of life in people living with HIV need to focus on increasing HIV symptom management self-efficacy.

Using patient reported outcomes in oncology clinical practice

Background and aimsPatient reported outcomes (PROs) are increasingly being implemented into the care of patients with cancer. The use of a standard set of PROs (e.g., pain) in cancer is becoming established and there is interest in what additional PROs might provide valuable information. The goal of this observational study was to examine how the PROs of self-efficacy for pain and other symptoms assessed at the point of service were associated with pain, symptom severity and distress, and physical and psychosocial functioning in a sample of breast and gastrointestinal patients. We also sought to examine differences in these relationships by cancer type (breast and gastrointestinal) as well as understand differences in self-assessment mode (paper/pencil or electronic tablet). Methods178 patients with breast (n=65) and gastrointestinal cancer (n=113) completed the Chronic Pain Self Efficacy Scale, M.D. Anderson Symptom Inventory, and Functional Assessment of Cancer Therapy – General questionnaires. Measures were completed with paper and pencil and electronically using a tablet computer while patients waited for their clinical appointment. Responses from the initial completed questionnaires on both the paper and electronic instruments were analyzed. ResultsPatients’ self-efficacy scores for pain and other symptoms correlated positively with pain, symptom severity and distress, and physical and psychosocial functioning; patients with lower levels of self-efficacy reported poorer outcomes and functioning overall. The results were independent of cancer type and mode of assessment. No statistically significant differences were found in the PROs when collected by electronic technology versus paper-pencil mode; patients were very satisfied with using the tablet computer to complete the PRO measures. Conclusions and implicationsOur results suggest that self-efficacy for pain and symptom management may be a beneficial addition to clinic-based PRO assessment batteries for patients with cancer and other chronic diseases. Existing short, validated symptom self-efficacy scales could easily be integrated into clinical practice to help healthcare providers identify patients that might benefit from intervention. Study results also support existing research that suggests electronic approaches are a practical way to collect PRO data, including self-efficacy data, in the clinic. Overall, our data suggest that patients who have particularly low levels of self-efficacy for pain and symptom management may be at risk for higher levels of pain and disability. Thus, if self-efficacy for pain and symptom management were routinely collected at the time of clinical service, psychosocial interventions to improve self-efficacy for pain and symptom management, and in turn overall quality of life, could be implemented in a timely fashion.

Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors.

Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships. Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs. Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management. Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy. Copyright © 2016 John Wiley & Sons, Ltd.

Symptom-Management Self-efficacy Mediates the Effects of Symptom Distress on the Quality of Life Among Taiwanese Oncology Outpatients With Breast Cancer.

Theory has suggested that self-efficacy plays an important role in facilitating health behaviors and, in turn, promoting healthy outcomes. However, limited research has focused on the mechanisms through which symptom-management self-efficacy acts as a mediator between symptom distress and quality of life (QOL) for patients with breast cancer who have undergone chemotherapy. The purpose of this study is to examine the association between symptom distress and QOL among Taiwanese oncology outpatients with breast cancer and proposed symptom-management self-efficacy as a mediator between symptom distress and QOL. This cross-sectional study included 201 oncology outpatients in 1 teaching hospital in the Taipei area of Taiwan. The research instruments included the Symptom-Management Self-Efficacy Scale-Breast Cancer, the symptom distress scale, and the European Organization for Research and Treatment of Cancer Quality of Life Group Questionnaire. Bootstrapping was used to statistically assess the possible mediating effects of self-efficacy on QOL. Symptom-management self-efficacy mediated the association between symptom distress and global QOL (indirect effect, -6.33; 95% confidence interval [CI], -9.63 to -3.74), functional QOL (indirect effect, -4.47; 95% CI, -7.05 to -2.36), and symptom QOL (indirect effect, 2.59; 95% CI, 1.07-4.83). All of the 95% CIs were significant. The lower symptom distress that patients experienced was indirectly associated with better QOL through higher self-efficacy. Symptom management self-efficacy may be a crucial mechanism through which symptom distress influences patients' QOL. Clinicians may incorporate strategies focused on improving patients' self-efficacy in relation to managing their symptoms caused by chemotherapy to improve patients' QOL.

Determining the quality of life of depressed patients in Singapore through a multiple mediation framework.

Quality of Life (QOL) is reported to be lower for patients with depression than the general population. This study aims to investigate the mediational effects of protective resource factors (PSFs), such as depressive symptom management ability, self-efficacy, social support and problem-focused coping act, in the relationship between dysfunctional attitudes and QOL. It is hypothesized that these PSFs have different mediating strengths. Self-report questionnaires which aimed to determine the influences of these PSFs through a multiple mediation framework were completed by 80 depressed adult outpatients from the National University Hospital of Singapore. PSFs have different influence on mental and physical QOL. Depressive symptom management ability is the most important PSF mediating both domains and better problem-focused coping abilities demonstrate improvement in the physical domain of QOL. Self-efficacy and social support are shown to be non-significant mediators. The results suggest for future effective interventions to focus primarily on improving depression patients' symptom management ability and problem-focused coping skills to raise their life quality. Furthermore, findings from this study have implications on the future investigation of QOL as a unitary construct.

Development and Preliminary Evaluation of Psychometric Properties of Symptom-Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy

The purpose of this study was to develop and preliminarily evaluate the reliability and validity of the Symptom-Management Self-Efficacy Scale-Breast Cancer (SMSES-BC) related to chemotherapy. The study included three stages. This paper presents the results of stage 2 and stage 3. In total, 34 items in the SMSES-BC were found during stage 1 from qualitative findings, a literature review, and expert suggestions; the 34 items were used for the psychometric properties test. Test-retest reliability and Cronbach α were assessed in the first sample, which included 45 participants for the pilot test (stage 2). The second sample, which included 152 patients, was used to assess the construct validity and concurrent validity (stage 3). The pilot test results revealed a test-retest reliability of .73 (p < .001) and Cronbach α coefficient of .96 for the total scale. Three factors (managing chemotherapy-related symptoms, acquiring problem solving, and managing emotional and interpersonal disturbances) were identified from exploratory factor analysis. Correlation coefficient r was .40 (p < .001), which supported the association between SMSES-BC and the General Self-Efficacy Scale for concurrent validity. The study results demonstrate acceptable reliability and validity for the SMSES-BC that was developed for measuring symptom-management self-efficacy related to chemotherapy for patients with breast cancer. This study suggests further research to validate the construct of the SMSES-BC.

Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being

We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients. We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group. We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden. An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.