Parental self-efficacy and the management of childhood atopic eczema: development and testing of a new clinical outcome measure.

Abstract

Effective parental management of childhood eczema requires education and support to reduce disease severity and improve the child's quality of life. Self-efficacy is a key factor influencing effective chronic disease management, yet there are no published scales to measure parental self-efficacy in managing childhood eczema. The Parental Self-Efficacy with Eczema Care Index (PASECI) was designed to measure parental self-efficacy in managing childhood eczema as a pre- and postintervention tool in the evaluation of a structured Eczema Education Programme (EEP). To develop and test the validity, reliability and sensitivity of a new outcome measure (PASECI) designed to assess parental self-efficacy in managing their child's eczema to determine pre- vs. postintervention changes in educational intervention evaluation studies. PASECI was developed from the literature, expert consultation and piloting of a 40-item prototype. The final 29-item scale is arranged in four subscales. Parents of children with eczema aged 0-16 years (n = 242) attending the EEP were assessed at 1 week pre-EEP and 4 weeks postintervention. Cronbach's α and factor analyses were undertaken. PASECI has face, content and construct validity. It is reliable, with high item internal consistency (α > 0·87 in all domains). Factor analysis revealed four viable domains. It was sensitive to change for postintervention measures using sign tests (P < 0·001). PASECI is a useful, valid, reliable and sensitive evaluative outcome measure of self-efficacy in parents managing childhood eczema.