Multidimensionality of the PROMIS self-efficacy measure for managing chronic conditions

Qual Life Res. 2019 Jun;28(6):1595-1603. doi: 10.1007/s11136-019-02116-w. Epub 2019 Feb 26.


Purpose: This study investigated the PROMIS Self-Efficacy Measure for Managing Chronic Conditions (PROMIS-SE) domain distributions and examined the factor structure of the PROMIS-SE.

Methods: A total of 1087 individuals with chronic conditions participated in this study. PROMIS-SE's item banks and two short forms (eight-item and four-item) measuring five behavioral domains (daily activities(DA), Emotions(EM), medications and treatments(MT), social interactions(SS), and Symptoms(SX)) were examined. PROMIS-SE's T-score ranges and distributions were examined to identify domain metric distributions and confirmatory factor analysis (CFA) was conducted to test a multidimensional model fit to the PROMIS-SE.

Results: PROMIS-SE domains showed different T-score ranges and distributions for item banks and two short forms across all five domains. While PROMIS-SE EM demonstrated the highest T-scores (least negatively skewed), MT had the lowest T-scores (most negatively skewed) for all three forms. In general, respondents were more likely to achieve highest self-efficacy ratings (very confident) for domains DA, MT, and SS as compared to domains EM and SX. CFA confirmed that a multidimensional model adequately fit all three PROMIS-SE forms.

Conclusion: Our results indicate that self-efficacy T-distributions are not consistent across domains (i.e., managing medications and treatments domain was more negatively skewed difficult than other domains), which is a requirement for making inter-domain comparisons. A multidimensional model could be used to enhance the PROMIS-SE's estimate accuracy and clinical utility.

Keywords: Multidimensionality; PROMIS; Patient-reported outcome measure; Self-efficacy.

MeSH terms

  • Chronic Disease / psychology*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Self Efficacy
  • Surveys and Questionnaires