Measuring self-efficacy in U.S. older adults with chronic disease: a systematic review

Objectives: Self-efficacy (SE), confidence in one’s abilities, is an integral concept in behavior change among older adults with chronic disease. SE improvements boost better health outcomes, such as decreases in blood glucose or pain. Although self-efficacy is a widely studied construct, the most commonly used measures in older adults with chronic disease remain unclear. Methods: A systematic literature search was conducted to identify how self-efficacy was operationalized and measured in US older adults with chronic diseases. Studies with validated SE measures for the top 10 chronic medical conditions (arthritis, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, dementia, depression, diabetes, hypertension, hypercholesterolemia, and heart failure) in older adults were included. Results: 131 articles were identified using 45 validated SE scales. Self-efficacy measurement was most robustly represented in the arthritis and cardiovascular literature with fewer studies in chronic kidney disease and dementia. The top 9 SE scales were identified and domains within each of those scales explored. Conclusions: SE measurement is a key part of self-management. Its analysis is limited by the large number of SE scales and potential psychometric shortcomings. Measurement best practices and expansions in the concept of SE are discussed.