Development and Initial Evaluation of Reliability and Validity and Reliability of the Opioid-Taking Self-Efficacy Scale.

[[abstract]]Purpose/Objectives: To examine the reliability and validity of the Opioid-Taking Self-Efficacy Scale--Cancer (OTSES-CA). Design: Survey of two separate samples. Setting: Two teaching hospitals in the Taipei area of Taiwan. Sample: 30 (stage 2, pilot study) and a second cohort of 92 (stage 3) outpatients who had been prescribed opioid analgesics for cancerrelated pain. Methods: A preliminary set of 35 items was developed from qualitative interviews to assess the key domains of self-efficacy. The scale properties were evaluated with the first sample using face validity, test-retest reliability, and Cronbach alpha. Construct validity using exploratory factor analysis and concurrent validity were evaluated with the second sample. Main Research Variables: Opioid-taking self-efficacy. Findings: An initial pilot study supported face validity and test-retest reliability with stability coefficients for the subscales of the OTSES-CA, ranging from 0.68 (taking analgesics according to schedule) to 0.82 (communicating about pain and taking analgesics). An exploratory factor analysis demonstrated the multidimensionality of the OTSES-CA. Four factors were identified: communicating about pain and analgesictaking, tailoring the medication regimen, acquiring help, and managing treatment-related concerns. Cronbach alpha coefficients reached the 0.80 criterion for each of four subscales constructed from items loading on these factors. Significant correlations among the total score of the OTSES-CA and mean adherence rates, pain relief, and worst pain support the concurrent validity of the OTSES-CA. Conclusions: The data provide preliminary evidence of acceptable psychometric properties for the OTSES-CA designed to measure patients' self-efficacy with taking opioids. Further validation is recommended to confirm the four dimensions of the construct. Implications for Nursing: The OTSES-CA can be used in research and clinical settings to identify various impediments to opioid adherence. [Abstract for this article also available on page 602 of printed version. The full text of this article can be accessed at www.ons.org/publications/journals/ONF