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The development and validation of the Perceived Health Competence Scale

Authors:
  • Peabody College of Vanderbilt University

Abstract

A sense of competence or self-efficacy is associated with many positive outcomes, particularly in the area of health behavior. A measure of a sense of competence in the domain of health behavior has not been developed. Most measures are either general measures of a general sense of self-efficacy or are very specific to a particular health behavior. The Perceived Health Competence Scale (PHCS), a domain-specific measure of the degree to which an individual feels capable of effectively managing his or her health outcomes, was developed to provide a measure of perceived competence at an intermediate level of specificity. Five studies using three different types of samples (students, adults and persons with a chronic illness) provide evidence for the reliability and validity of the PHCS. The eight items of the PHCS combine both outcome and behavioral expectancies. Results from the five studies indicate that the scale has good internal consistency and test–retest reliability. The construct validity of the scale is demonstrated through the support obtained for substantive hypotheses regarding the correlates of perceived health competence, such as health behavior intentions, general sense of competence and health locus of control.
... Because preventive measures are closely related to government policies and strategies, students who are aware of these policies or are often politically concerned may have higher preventive behavior engagements based on public policy (16). Perceived health competence is a measure of selfefficacy in terms of capability of managing own health outcomes (39). Perceived control measures the control beliefs at more community and policy levels as indicated in upper level in the Figure 1, while the perceived health competence measures it at individual levels as indicated in the lower position in the Figure 1. ...
... The third section of the survey measured perceived health competence using the Perceived Health Competence Scale (PHCS) (39). This scale measures the degree of participants' . ...
... Permissions were obtained to use these scales from the developers and translators. The last part of the survey was on the sociodemographic factors, which included nationality, student groups (domestic or international), socio-economic status, religion (Buddhism, Shintoism, Christianity, Islam, Hinduism, and no religious beliefs), biological factors (age and sex), and lifestyle and health related items (alcohol drinking, sleeping hours, and having chronic conditions requiring regular checkups) (39,(43)(44)(45). Socio-economic status included living conditions (living with somebody or not), current work status (working full-time, parttime, or not working), and having medical-related license. ...
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Background Both individual and policy level perceived control are known to be positively related to preventive behavior, and both may differ among healthcare graduate students with different cultural backgrounds. This study compared the preventive health behavior and perceived control among domestic and international healthcare graduate students in Japan and the United States during the COVID-19 pandemic, and analyzed factors associated with preventive health behavior and perceived control. Methods The study used a self-administered online survey, conducted at two universities in Japan and one university in the United States. The survey included sociodemographic data and scales of preventive health behaviors, perceived control (policy level), and perceived health competence (individual level). Association among variables were analyzed using structural equation modeling. Results A total of 610 students (485 domestic and 125 international) in Japan and 231 students (220 domestic and 11 international) in the United States completed the survey. Participants' average age was 31.3 years, and 67.0% were female. Model fit of structural equation modeling was good (χ ² = 9.419, P = 0.151, comparative fit index = 0.995, RMSEA = 0.026). Japanese students had better preventive health behavior than American (β = −0.407, P < 0.001) and international students in both countries (β = −0.112, P < 0.001). However, Japanese students had significantly lower perceived control than American students (β = 0.346, P < 0.001) and international students in both countries (β = 0.188, P < 0.001). Overall higher perceived control (β = 0.175, P < 0.001) and being female (β = 0.141, P < 0.001) were significantly associated with better preventive behavior. Although higher perceived control was related to higher perceived health competence (β = 0.295, P < 0.001), perceived health competence was not associated with preventive behavior (β = 0.025, P = 0.470). Religion was not associated with perceived control or preventive behavior. Conclusion Nationality was identified as the main factor associated with both perceived control and preventive behavior. Policy level perceived control was more strongly associated with preventive health behavior than individual level perceived health competence. Further investigations in the contribution of specific cultural dimensions associated with perceived control and preventive behaviors are recommended.
... Individuals who believe that they have robust control over their behaviours and possess influence over policy decisions impacting their community may achieve more positive health outcomes (Salehi et al. 2016). Perceived health competence was defined as a measure of one's sense of competence in the domain of health behaviours (Smith et al. 1995). In this sense, while perceived control is more closely related to public policy and community (positioning higher level in the figure), perceived health competence is more on the individual level. ...
... This study collected information from the participants, namely, sociodemographic data, the perceived control, self-efficacy scale (Salehi et al. 2016) and perceived health competence (Smith et al. 1995) scores, and responses to the preventive health behaviours and mental health effect questionnaire (Kondo et al. 2021). Sociodemographic data included biological, basic health-related, and socioeconomic factors, besides the country of origin. ...
... every day, 4-5 times a week, 2-3 times a week, once a week, rarely, and never), smoking status, hours of sleep per day, and any chronic conditions requiring regular check-ups. These variables reflect general health behaviours and have been investigated in previous studies (Kondo et al. 2021;Murray 2013;Salehi et al. 2016;Smith et al. 1995). Finally, socioeconomic factors included academic status (i.e. ...
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In the context of mental health, university students have been considered a vulnerable population. However, limited studies have underscored the association between preventive health behaviour levels and mental health effects among nursing students. The current cross‐sectional study provides a comparative analysis of the impact of mental health factors on nursing students in Japan and the United States (US) in the context of the coronavirus disease 2019 (COVID‐19) pandemic. The study consisted of 878 participants, comprising both undergraduate and graduate nursing students from four universities in Japan, and one from the US. Hierarchical logistic regression was used to analyse the participant data in this study. In contrast to the American students, the Japanese students demonstrated significantly lower levels of perceived control and significantly higher levels of preventive health behaviours. Furthermore, Japanese students exhibited significantly higher levels of stress and/or symptoms of depression induced by the social distancing orders compared to the American students (z = −4.218, P < 0.001). However, no difference was observed after adjusting for perceived control, individual factors, socio‐economic factors, and preventive behaviours. During the pandemic, risk factors that can worsen mental health among the nursing students included younger age [odds ratio (95%CI) = 0.62 (0.48–0.81)], women [OR = 2.17 (1.02–4.61)], higher preventive health behaviour [OR = 1.05 (1.02–1.08)], lower perceived control [OR = 0.97 (0.94–0.99)], and lower perceived health competence [OR = 0.93 (0.90–0.96)]. Thus, this study recommends establishing training programmes that enhance perceived control and perceived health competence while encouraging preventive behaviour to support the mental health of nursing students, particularly young female students.
... The patient's impression of dental-associated social and psychological effects in areas, including confidence in dental procedures, social implications, psychological implications, and aesthetic worry, improves after the fixed orthodontic therapy. Patient personality traits, most of which have been extensively researched in well-being dynamics, such as internal self-discipline and self-competency, may affect the progress of psychological and social effects [43]. The extent to which a person feels capable of successfully regulating one's health outcomes is known as health awareness. ...
... Participants' answers to the questions were reversely coded and averaged into a composite score. Health competence was measured by asking participants to indicate the extent to which they are confident about their ability to take good care of their health (Smith et al., 1995). Responses were scored on a five-point scale (1 = completely confident, 5 = not confident at all). ...
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Research has demonstrated links between patient-centered communication (PCC) and patients’ health outcomes. However, little is known about the underlying processes that may mediate the relationship. This study is one of the first to examine the influence of PCC on older adults’ health outcomes, as well as the mediation role of health competence, from a longitudinal perspective. With a general basis of Street et al.’s pathway model, we proposed and tested mediation pathways linking patient-centered communication to the older population’s general and mental health, mediated by health competence. Data from 2011, 2017 and 2020 iterations of the Health Information National Trends Survey (HINTS) were used for this study. This study focused on older adults aged 60 and above. Results indicated that after controlling participants’ age, gender, education, income and race, PCC is related to the older people’s health outcomes either directly or indirectly, irrespective of time series. Specifically, health competence was found to significantly mediate the associations between PCC and the older adults’ general health or mental health over the three iterations. Noteworthily, findings from this study also revealed that different dimensions of PCC might exert different influences on older patients’ health competence and health outcomes.
... Self-efficacy influences health behaviour choices and effort and relates to health outcomes (Schwarzer and Luszczynska, 2015). One measure of health self-efficacy assessesthe perceived competence for general health across situations (Smith et al, 1995), while others assess the competence for a particular health behaviour such as exercise in the context of specific potential barriers (Dzewaltowski et al, 1990). ...
... Perceived Health Competence Scale (PHCS) measures an individual's capacity to effectively manage their own health outcomes. The eight items assess an individual's sense of competence and control over health-related outcomes and behaviors (e.g., "I'm generally able to accomplish my goals with respect to my health") on a 5-point scale (1 = Strongly Disagree; 5 = Strongly Agree), with higher scores reflecting a greater sense of perceived health competence (Shelton Smith et al., 1995). Connor-Davidson Resilience Scale (CD-RISC-10 © ) was used to measure resilience in the sample. ...
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Objective Enhancing cancer patients’ sense of control can positively impact psychological well-being. We developed and assessed the psychometric properties of Valued Outcomes in the Cancer Experience (VOICE) TM , a measure of patients’ perceived control over key personal priorities within their cancer experience. Methods VOICE construction and testing were completed in three phases with separate participant samples: (1) item generation and initial item pool testing ( N = 459), (2) scale refinement ( N = 623), and (3) confirmatory validation ( N = 515). Results A 21-item measure was developed that captures cancer patients’ sense of control in seven key domains: (1) Purpose and Meaning, (2) Functional Capacity, (3) Longevity, (4) Quality Care, (5) Illness Knowledge, (6) Social Support, and (7) Financial Capability. VOICE demonstrated adequate internal consistency (full-scale α = 0.93; factor α = 0.67–0.89) and adequate to strong convergent and discriminatory validity. Significance of results VOICE measures cancer patients’ perceived control across a diverse range of personal priorities, creating a platform for elevating patient perspectives and identifying pathways to enhance patient well-being. VOICE is positioned to guide understanding of the patient experience and aid the development and evaluation of supportive care interventions to enhance well-being.
... A higher score indicated that the individual had a higher ability to control the results and outcomes of health-related programs. The Cronbach's α-coefficient reported by Smith et al., 17 for this instrument, was 0.84. In Iran, in the study of Bayat et al., 18 Cronbach's α-coefficient of 0.73 has been obtained. ...
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