Measures of self‐efficacy: Arthritis Self‐Efficacy Scale (ASES), Arthritis Self‐Efficacy Scale‐8 Item (ASES‐8), Children's Arthritis Self‐Efficacy Scale (CASE), Chronic Disease Self‐Efficacy Scale (CDSES), Parent's Arthritis Self‐Efficacy Scale (PASE), and Rheumatoid Arthritis Self‐Efficacy Scale (R

Enhancing self-efficacy has become an essential feature of many arthritis management interventions because of its robust relationships with health behaviors and health status. Empirical studies document that self-efficacy predicts health behaviors such as physical activity, eating behaviors, and pain coping strategies (1). In rheumatoid arthritis and osteoarthritis, self-efficacy has also been correlated with measures of health status such as daily pain and mood ratings (2), pain, stiffness, function, and physical and mental well-being (3); it has also been correlated with changes in pain, function, and depression (4). Adherence with medications and other health recommendations has also been associated with self-efficacy (5,6). In addition to evidence that self-efficacy is associated with health behaviors, current and future health status, and adherence to health recommendations, the fact that self-efficacy can change through efficacy-enhancing interventions makes it a rich target of arthritis interventions (1). Self-efficacy, defined in Bandura’s seminal 1977 article as “the conviction that one can successfully execute the behavior required to produce the outcomes” (7), was hypothesized to influence whether a behavior was initiated and sustained despite obstacles or adverse experiences, and to influence the level of effort invested in the behavior. Bandura’s definition of self-efficacy evolved slightly over time; in his 1997 publication, Bandura defined self-efficacy as “belief in one’s capability to organize and execute the courses of action required to produce given attainments” (8). Bandura has consistently described self-efficacy as domain specific and distinct from other constructs in social learning theory such as outcome expectations, defined as a person’s estimate that a given behavior will lead to certain outcomes (7). Self-efficacy beliefs are also conceptualized as distinct from actual ability to perform a task (e.g., can I ride a bicycle), actual task performance (e.g., do I ride a bicycle), or intention to perform task (e.g., do I intend to ride a bicycle) (8,9). These different types of beliefs are clearly distinguished in Gecht et al’s survey of exercise beliefs and habits among people with arthritis (10). In that survey, respondents were asked about their self-efficacy expectations regarding exercise (“If I want to exercise, I know I can do it”), and their outcome expectations regarding exercise (“regular exercise will probably make my arthritis worse in the future”); they were also asked to report their actual behavior (how often they did specific exercises in the past 2 weeks). Self-efficacy theory hypothesizes that both efficacy expectations and outcome expectations influence whether or not an individual will initiate and sustain a specific behavior (7). Gecht et al found that positive outcome expectations and self-efficacy for exercise were associated with participation in exercise (10). Conversely, self-efficacy theory predicts that if a patient believes that they can exercise (self-efficacy expectation) but also believes that exercise will be harmful for their arthritis (outcome expectation), the patient would be less likely to exercise than if they expected positive outcomes from exercise (7). Social learning theory suggests that it is important for clinicians and others hoping to help a person adopt health behaviors to understand both whether the person believes they can perform the behavior, and whether they believe that behavior will lead to positive outcomes. Outcome expectations have received very little attention in arthritis-related research, but self-efficacy has been measured extensively (11). This review focuses on self-efficacy measures in the domain of arthritis management, and measures frequently used in arthritis management intervention studies (i.e., Arthritis Self-Efficacy Scales [12], Rheumatoid Arthritis Self-Efficacy Scale [13]). One nonarthritis specific measure, the Chronic Diseases Self-Efficacy Scale The findings and conclusions herein are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Teresa J. Brady, PhD: Centers for Disease Control and Prevention, Atlanta, Georgia. Address correspondence to Teresa J. Brady, PhD, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS K-51, Atlanta, GA 30341. E-mail: Tob9@cdc.gov. Submitted for publication March 29, 2011; accepted in revised form July 20, 2011. Arthritis Care & Research Vol. 63, No. S11, November 2011, pp S473–S485 DOI 10.1002/acr.20567 © 2011, American College of Rheumatology