International Journal of Behavioral Medicine

, Volume 21, Issue 2, pp 394–401 | Cite as

Psychometric Properties of the Exercise Self-efficacy Scale in Dutch Primary Care Patients with Type 2 Diabetes Mellitus

  • M. M. P. van der Heijden
  • F. Pouwer
  • V. J. M. Pop
Article

Abstract

Background

Excercise self-efficacy is believed to influence physical activity bahavior.

Purpose

The purpose of this study is to assess the psychometric aspects of the Exercise Self-efficacy Scale (ESS) in a type 2 diabetes Dutch Primary care sample.

Method

Type 2 diabetes patients (n = 322; <80 years old) filled in the ESS and the short questionnaire to assess health enhancing physical activity (SQUASH). The structural validity of the ESS was assessed by means of principal axis factor analyses and confirmatory factor analysis. In addition, reliability and concurrent validity with the SQUASH outcomes “total” and “leisure time minutes/week of moderate to vigorous intensity physical activity” were evaluated. T tests and ANOVAs were used to examine ESS scores in subgroups. In addition, a 13-item version of the ESS was developed.

Results

Analyses were performed on complete cases (n = 255). Exploratory factor analysis suggested one underlying factor (total explained variance 54 %), with good internal consistency (α = 0.95). Confirmatory factor analysis showed a poor fit, as did a three-factor model suggested in an earlier research. Therefore, a 13-item ESS was developed with one underlying factor (total explained variance 59 %) and good internal consistency (α = 0.95). Both the 18-item and 13-item ESS correlated significantly with total and leisure time physical activity. ESS scores differed significantly between categories of education level and physical activity level.

Conclusion

The 13-item ESS had sound psychometric properties in a large sample of primary care type 2 diabetes patients. The 13-item ESS could be useful in (intervention) research on physical activity in type 2 diabetes patients.

Keywords

Self-efficacy Exercise/physical activity Psychometrics Type 2 diabetes Primary care 

Notes

Acknowledgments

This study was financially supported by CZ Health Insurance. We thank PoZoB for their participation.

References

  1. 1.
    Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.PubMedCrossRefGoogle Scholar
  2. 2.
    Williams R, Van Gaal L, Lucioni C. Assessing the impact of complications on the costs of type II diabetes. Diabetologia. 2002;45:S13–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Sullivan PW, Morrato EH, Ghushchyan V, Wyatt HR, Hill JO. Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000–2002. Diabetes Care. 2005;28:1599–603.PubMedCrossRefGoogle Scholar
  4. 4.
    American Diabetes Association. Standards of medical care in diabetes—2011. Diabetes Care. 2011;34 Suppl 1:S11–61.PubMedCentralCrossRefGoogle Scholar
  5. 5.
    American College of Sports Medicine and the American Diabetes Association. Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Med Sci Sports Exerc. 2010;42:2282–303.CrossRefGoogle Scholar
  6. 6.
    Marwick TH, Hordern MD, Miller T, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119:3244–62.PubMedCrossRefGoogle Scholar
  7. 7.
    Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care. 2007;30:203–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Plotnikoff RC, Johnson ST, Loucaides CA, Bauman AE, Karunamuni ND, Pickering MA. Population-based estimates of physical activity for adults with type 2 diabetes: a cautionary tale of potential confounding by weight status. J Obes. 2011. doi:10.1155/2011/561432.Google Scholar
  9. 9.
    Nelson KM, Reiber G, Boyko EJ. Diet and exercise among adults with type 2 diabetes: findings from the third national health and nutrition examination survey (NHANES III). Diabetes Care. 2002;25:1722–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Trost SG, Owen N, Bauman AE, Sallis JF, Brown W. Correlates of adults' participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34:1996–2001.PubMedCrossRefGoogle Scholar
  11. 11.
    Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.Google Scholar
  12. 12.
    Allen NA. Social cognitive theory in diabetes exercise research: an integrative literature review. Diabetes Educ. 2004;30:805–19.PubMedCrossRefGoogle Scholar
  13. 13.
    Bandura A. Guide for constructing self-efficacy scales. In: Pajares F, Urdan T, editors. Self-efficacy beliefs of adolescents. Greenwich: Information Age Publishing; 2006. p. 307–37.Google Scholar
  14. 14.
    Everett B, Salamonson Y, Davidson PM. Bandura's exercise self-efficacy scale: validation in an Australian cardiac rehabilitation setting. Int J Nurs Stud. 2009;46:824–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Shin Y, Jang H, Pender NJ. Psychometric evaluation of the exercise self-efficacy scale among Korean adults with chronic diseases. Res Nurs Health. 2001;24:68–76.PubMedCrossRefGoogle Scholar
  16. 16.
    Noroozi A, Ghofranipour F, Heydarnia AR, Nabipour I, Tahmasebi R, Tavafian S. The Iranian version of the exercise self-efficacy scale (ESES): factor structure, internal consistency and construct validity. Health Educ J. 2011;70:21–31.CrossRefGoogle Scholar
  17. 17.
    Koopmans B, Pouwer F, de Bie RA, van Rooij ES, Leusink GL, Pop VJ. Depressive symptoms are associated with physical inactivity in patients with type 2 diabetes. The DIAZOB Primary Care Diabetes study. Fam Pract. 2009;26:171–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D. Reproducibility and relative validity of the Short QUestionnaire to ASsess Health-enhancing physical activity. J Clin Epidemiol. 2003;56:1163–9.PubMedCrossRefGoogle Scholar
  19. 19.
    McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4:293–307.PubMedCrossRefGoogle Scholar
  20. 20.
    Brown TA. Confirmatory factor analysis for applied research. New York: The Guilford Press; 2006.Google Scholar
  21. 21.
    Sijtsma K, Molenaar IW. Introduction to Nonparametric Item Response Theory. California: SAGE; 2002.Google Scholar
  22. 22.
    Lipsey M. Design sensitivity: statistical power for experimental research. Newbury Park: Sage Publications; 1990. p. 54–76.Google Scholar
  23. 23.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New York: Psychology Press; 1988.Google Scholar
  24. 24.
    Koopmans B, Pouwer F, de Bie RA, Leusink GL, Denollet JK, Pop VJ. Associations between vascular co-morbidities and depression in insulin-naive diabetes patients: the DIAZOB Primary Care Diabetes study. Diabetologia. 2009;52:2056–63.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Clark DO, Patrick DL, Grembowski D, Durham ML. Socioeconomic status and exercise self-efficacy in late life. J Behav Med. 1995;18:355–76.PubMedCrossRefGoogle Scholar
  26. 26.
    Hagstromer M, Oja P, Sjostrom M. Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc. 2007;39:1502–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Dutton GR, Tan F, Provost BC, Sorenson JL, Allen B, Smith D. Relationship between self-efficacy and physical activity among patients with type 2 diabetes. J Behav Med. 2009;32:270–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Lee LL, Arthur A, Avis M. Using self-efficacy theory to develop interventions that help older people overcome psychological barriers to physical activity: a discussion paper. Int J Nurs Stud. 2008;45:1690–9.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • M. M. P. van der Heijden
    • 1
  • F. Pouwer
    • 1
  • V. J. M. Pop
    • 1
  1. 1.Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS)Tilburg UniversityTilburgThe Netherlands

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