The Norwegian version of the chronic obstructive pulmonary disease self-efficacy scale (CSES): a validation and reliability study

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Abstract
The aim of this study was to evaluate the feasibility, internal consistency and face and construct validity of the Norwegian version of the Chronic Obstructive Pulmonary Disease Self-Efficacy Scale (CSES). The CSES was translated into Norwegian according to standard procedures for forward and backward translation, and administered to 100 patients with chronic obstructive pulmonary disease (COPD) (51% men, mean age 66.1 years, range 42-82) prior to their participation in an outpatient pulmonary rehabilitation programme. The CSES-N (translated version) consists of 34 items comprising five subscales describing negative affect, intense emotional arousal, physical exertion, weather/environment and behavioural risk factors. Each scale ranges from 1 to 5, with higher scores indicating better self-efficacy. For validation purposes, we measured lung function (FEV(1) , FEV(1) % predicted) and exercise capacity (ISWT), and administered the St. George's Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS). A pilot study confirmed that the CSES-N was clear, understandable and easy to self-administer. Cronbach's alpha was 0.98 for the total score (0.80-0.96 for subscales). Results showed small to medium negative correlations between all CSES-N scales and anxiety, depression (HADS), physical activity, psychosocial impact of disease and total health status (SGRQ) (-0.20 to -0.49). Small or negligible negative correlations between different CSES-N scales and respiratory symptoms (SGRQ) (-0.03 to -0.23) were found. Any correlations among exercise capacity, lung function and different socio-demographic variables (age, gender and education) and CSES-N were also small or negligible (0.00 to 0.23). This study shows acceptable feasibility, internal consistency and face and construct validity for the CSES-N in a sample of Norwegian COPD patients.

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