Factorial structure of a scale: Strategies Used by People to Promote Health--Chinese version.

BACKGROUND: The Strategies Used by People to Promote Health (SUPPH) is an instrument used to measure self-reported self-efficacy in patient populations. Self-efficacy has a major impact on quality of life and psychological well-being. Previous findings of dimensionality of the SUPPH vary, and cultural differences exist suggesting the need for further investigation and psychometric testing to establish construct validity of the SUPPH in different cultures. OBJECTIVE: The purpose of this study was to examine the factorial structure of the Chinese version of the SUPPH (C-SUPPH). METHODS: Using reports from 764 oncology patients in China, the factorial structure of the C-SUPPH was assessed via 2 analytical strategies. First-order confirmatory factor analysis (CFA) models were used to examine the dimensionality of the C-SUPPH; a second-order CFA was used to determine the existence of a factorial structure hierarchy of the C-SUPPH. RESULTS: Compared with the 2- and 4-factor solutions, the 3-factor CFA of the C-SUPPH had a better fit with the data (comparative fit index = 0.94, Tucker-Lewis index = 0.94, root-mean-square error of approximation = 0.05, the close-fit test P = .565, and standardized root-mean-square residual = 0.04). Our findings confirmed the 3-scale structure: Positive Attitude, Stress Reduction, and Making Decisions; together, the 3 factors represent an underlying higher-order factor, that of general self-care self-efficacy. CONCLUSIONS: The C-SUPPH has a valid factorial structure and can be readily applied to studying self-efficacy in Chinese patients who are diagnosed with cancers. IMPLICATIONS FOR PRACTICE: Our findings provide support for a culturally sensitive, reliable, and valid self-efficacy measure (the C-SUPPH) of Chinese adult cancer patients' self-care self-efficacy.

Testing measurement invariance of the Chinese version of the Strategies Used by Patients to Promote Health among patients with cancer.

BACKGROUND AND PURPOSE: The Chinese version of the Strategies Used by Patients to Promote Health (C-SUPPH) is a self-report instrument used to measure self-efficacy among patients with cancer. The purpose of this article is to examine measurement invariance of C-SUPPH using data of 764 cancer patients recruited in China. METHODS: Multigroup confirmatory factor analysis (CFA) models were applied across the selected sociodemographic groups of gender, age, education, and monthly income levels. RESULTS: The factorial structure and factor loadings (relationships between items and their underlying factors) of C-SUPPH were invariant across all sociodemographic groups. CONCLUSIONS: The findings showed that the C-SUPPH measures the same latent constructs/factors in the same way when administered to different sociodemographic groups and thus can be readily applied to studying self-efficacy of cancer patients in China.

Self-efficacy difference among patients with cancer with different socioeconomic status: application of latent class analysis and standardization and decomposition analysis.

INTRODUCTION: Although the relationship between partial socioeconomic status (SES) and self-efficacy has been studied in previous studies, few research have examined self-efficacy difference among patients with cancer with different SES. METHODS: A cross-sectional survey involving 764 patients with cancer was completed. Latent class analysis (LCA) was applied to identify distinct groups of patients with cancer using four SES indicators (education, income, employment status and health insurance status). Standardization and decomposition analysis (SDA) was then used to examine differences in patients' self-efficacy among SES groups and the components of the differences attributed to confounding factors, such as gender, age, anxiety, depression and social support. RESULTS: Participants were classified into four distinctive SES groups via using LCA method, and the observed self-efficacy level significantly varied by SES groups; as theorized, higher self-efficacy was associated with higher SES. The self-efficacy differences by SES groups were decomposed into "real" group differences and factor component effects that are attributed to group differences in confounding factor compositions. CONCLUSION: Self-efficacy significantly varies by SES. Social support significantly confounded the observed differences in self-efficacy between different SES groups among Chinese patients with cancer.