This study used a multidimensional categorical model to concurrently estimate individual’s self-efficacy for managing their chronic conditions across five related domains measured with the Patient-Reported Outcomes Measurement Information System Self-Efficacy Measure for managing chronic conditions (PROMIS-SE). A total of 1087 individuals with chronic conditions was analyzed in this study. A Diagnostic Classification Model (DCM) was applied to PROMIS-SE’s 4-item short forms measuring five behavioral domains (daily activities, emotions, medications and treatments, social interactions, and symptoms) to provide patient multidimensional categorical outcomes (high, transition, or low self-efficacy). Psychometric properties were examined using classification consistency, model fit, entropy value, domain and item-level information, and patient profiles. DCM PROMIS-SE showed adequate classification consistency, fit, and high entropy values. Five domains demonstrated different average probabilities of having high self-efficacy for patients with chronic conditions from 42.0% (emotions) to 70% (medications and treatments). Rating scale analysis indicated the rating 5 (very confident) most critically discriminated patients with high or low self-efficacy for managing chronic conditions across all domains. Only four common patient profile groups contained more than 5% of the sample. Acceptable psychometric properties indicate that DCM PROMIS-SE satisfactorily classified patients with chronic conditions. This study demonstrates a feasible approach for other existing multidimensional measures to classify patients’ conditions and support clinical judgment.
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The study was funded by the National Institutes of Health, Grant 1U01AR057967–01, “Development and Validation of a Self–Efficacy Item Bank,” awarded to Lisa Shulman (Principal Investigator) and Ann Gruber-Baldini, Sergio Romero, and Craig Velozo (Co-Investigators). The results and conclusions presented in this paper are those of the authors and are independent from the funding source. The scales and item banks described in this paper are freely available at: http://www.healthmeasures.net/explore-measurement-systems/promis.
Conflict of Interest
Mi Jung Lee declares that she has no conflict of interest. Sergio Romero declares that he has no conflict of interest. Ren Liu declares that he has no conflict of interest. Craig Velozo declares that he has no conflict of interest. Ann L. Gruber-Baldini declares that she has no conflict of interest. Lisa M. Shulman declares that she has no conflict of interest.
This study was approved by the Institutional review boards (IRB) of the Medical University of South Carolina (#Pro00033397), the University of Florida (#261–2010), and the University of Maryland (#HP-000432550). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Lee, M.J., Romero, S., Liu, R. et al. Multidimensional PROMIS Self-Efficacy Measure for Managing Chronic Conditions. Applied Research Quality Life (2020). https://doi.org/10.1007/s11482-020-09842-1
- Patient-reported outcome measure
- And multidimensionality