Instruments to assess self-efficacy for symptom self-management by children with cancer and parents

Context School-age children with cancer and their parents must develop self-efficacy to self-manage physical and psychosocial symptoms associated with the child's disease and treatment. Instruments to measure self-efficacy for symptom self-management among children and parents and evaluate interventions to enhance self-efficacy are lacking.Objectives We sought to develop and evaluate two instruments: Self-Efficacy for Symptom Self-Management-Child Version (SE-SSM-Child) and Self-Efficacy for Symptom Self-Management-Parent Version (SE-SSM-Parent).Methods Phase 1 established content validity and reading level of proposed items from perspectives of 11 children (7-12 years; median 11) and 10 parents using cognitive interviews and a content review survey. Phase 2 enrolled 95 children (6-12 years; mean 9.1) and parents to validate the tools. Exploratory factor analysis examined the tools' underlying structure. Internal consistency reliability was evaluated with McDonald omega coefficients. Evidence of concurrent validity was examined through correlations between SE-SSM measures and related constructs measured by the PedsQL Cancer Module 3.0 and Memorial Symptom Assessment Scale 7-12.Results The final 6-item SE-SSM-Child and 8-item SE-SSM-Parent had similar 2-factor structures reflecting self-efficacy for self-initiated actions and interdependent actions related to symptom self-management. Internal consistency reliability was supported with McDonald omega coefficients of 0.70 (SE-SSM-Child) and 0.92 (SE-SSM-Parent). Positive correlations between SE-SSM total scores and PedsQL total scores (SE-SSM-Child r = 0.29, p Conclusion Psychometric properties of the SE-SSM-Child and SE-SSM-Parent support preliminary reliability and validity. These instruments have potential use in future studies to improve self-efficacy and enhance symptom self-management.