Evaluating self-efficacy for managing chronic disease: psychometric properties of the six-item Self-Efficacy Scale in Germany

J Eval Clin Pract. 2013 Feb;19(1):39-43. doi: 10.1111/j.1365-2753.2011.01764.x. Epub 2011 Aug 23.


Objective: Self-efficacy - the confidence to carry out certain behaviour in order to achieve a specific goal - has increasingly been recognized as an essential prerequisite of effective self-management of chronic diseases. Therefore, valid and reliable measures are needed to evaluate self-efficacy in both research and clinical practice. This study explored the psychometric properties of the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).

Methods: We performed standardized translation and cultural adaptation of the SES6G into German. The SES6G was externally validated with the German General Self-Efficacy Scale (SWE). Cronbach's alpha, descriptive statistics and principal component analysis were used to assess psychometric properties of the SES6G. We assessed the effect of the number of co-occurring chronic diseases on SES6G scores using linear regression modelling by controlling for age, gender and education level.

Results: We analysed data of 244 primary care patients in Germany. The SES6G showed good convergent construct validity to the SWE (spearman rank correlation 0.578, P < 0.001) and high internal consistency (Cronbach's alpha 0.930). Principal component analysis underlined the one-dimensional structure of the instrument. Adjusted for age and gender, increasing numbers of co-occurring chronic diseases were associated with lower SES6G scores (standardized β-value -0.27, P < 0.001). Education level showed no significant effect.

Conclusions: The SES6G is a reliable and valid instrument to assess patients' self-efficacy for managing chronic diseases. It may enhance further research in German-speaking countries and appears to be a valuable measure for clinical practice.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / psychology*
  • Chronic Disease / therapy*
  • Culture
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care
  • Principal Component Analysis
  • Psychometrics
  • Reproducibility of Results
  • Self Care / psychology*
  • Self Efficacy*
  • Socioeconomic Factors
  • Translations