Developing and testing a measure of dyadic efficacy for married women with rheumatoid arthritis and their spouses

Abstract

OBJECTIVE: Interpersonal relationships and self-efficacy have each been independently studied in the context of coping with chronic illness. To examine a new type of interpersonal efficacy in couples coping with rheumatoid arthritis (RA), we developed and tested new measures of perceptions of arthritis dyadic efficacy. We assessed both partners' perceptions of confidence about working together as a team to manage women's illness-related challenges. METHODS: First, a 3-phase pilot study was conducted with interviews, expert review, and pretesting to develop items. Next, the psychometric properties of new measures were tested in 190 women with RA and their husbands. Exploratory analyses were conducted, Cronbach's alphas were calculated for each factor, and construct validity was examined with Pearson's correlations at baseline, 4-month, and 8-month followup. RESULTS: Factor analyses yielded 3 factors in the wife and husband versions, assessing dyadic behaviors concerning arthritis problem solving and emotions, arthritis symptom management, and arthritis-related couple outcomes. All items loaded >0.60, Cronbach's alphas for all subscales were >0.88, and initial evidence of construct validity was demonstrated. Finally, the initial factor structure was replicated with additional exploratory factor analyses in the same sample at 4-month and 8-month followup. CONCLUSION: Three short, reliable subscales resulted for couples coping with RA for use in interpersonal health research. These instruments facilitate viewing illness adaptation processes in a dyadic manner.