Revised Scale for Caregiving Self-Efficacy

Abstract

The Revised Scale for Caregiving Self-Efficacy (RSCSE) is a specialized psychometric instrument designed to measure the confidence levels of individuals performing crucial tasks associated with family caregiving, particularly those caring for patients with chronic conditions like dementia. Developed by Steffen, Bandura, and colleagues, the scale operationalizes the construct of self-efficacy within the demanding care environment. The scale is structured around key domains that often predict caregiver stress and outcome, including the ability to secure social support (respite), manage disruptive patient behaviors, and control negative, upsetting cognitions related to the care role. It utilizes a 0 to 100 confidence rating scale, allowing for nuanced assessment of perceived competence across various challenging situations.

This revision of earlier caregiving scales provides enhanced psychometrics, offering researchers and clinicians a reliable tool for intervention planning and outcome measurement in caregiver support programs. The instrument is valuable for identifying specific areas where a caregiver lacks confidence, thereby guiding targeted interventions aimed at bolstering perceived capabilities and reducing associated distress, such as depressive symptoms.

Keywords

caregiving self-efficacy, Bandura, dementia, family caregivers, psychometric instrument, respite, disruptive behavior management, cognitive control, confidence scale

Authors

Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D., Bandura, A.

Purpose

The primary purpose of the Revised Scale for Caregiving Self-Efficacy (RSCSE) is to quantify the degree of perceived confidence, or self-efficacy, that family caregivers possess across various critical domains of their caregiving role. This assessment is vital because a caregiver’s belief in their ability to handle challenging situations is strongly linked to their mental health outcomes, including the prevention of burnout and depression.

Specifically, the scale aims to provide a detailed profile across four distinct, measurable factors: perceived physical strength, confidence in obtaining respite, ability to manage disruptive patient behaviors, and efficacy in controlling upsetting thoughts. By identifying specific areas of low confidence, the RSCSE serves as a diagnostic tool that informs the development and efficacy testing of tailored psychological interventions for caregiving populations.

Construct

The RSCSE is grounded firmly in Albert Bandura’s Social Cognitive Theory, specifically measuring domain-specific self-efficacy. Self-efficacy is defined as a person’s belief in their capability to execute courses of action required to produce specific attainments. Unlike general self-esteem or global confidence, the RSCSE measures efficacy beliefs related to highly specific, observable, and often stressful caregiving tasks.

The scale measures efficacy across three core psychosocial domains crucial to long-term caregiving success: the efficacy to manage social support (obtaining respite), the efficacy to manage environmental and behavioral challenges (disruptive patient behaviors), and the efficacy to manage internal cognitive processes (controlling upsetting thoughts). The initial items also assess confidence related to physical demands (lifting objects), though the primary focus of the scale revision is often concentrated on the psychosocial factors.

Validity

Studies conducted by Steffen, Bandura, and colleagues (2002) established the validity of the RSCSE. The instrument demonstrates strong construct validity, evidenced by the clear factor structure corresponding to the theoretical domains of caregiving efficacy (respite, behavioral management, and cognitive control). The scale items effectively capture the range of specific challenges encountered by caregivers.

Furthermore, the RSCSE has shown significant predictive validity. Scores on the efficacy subscales are inversely related to negative outcomes such as caregiver distress and depressive symptoms, confirming that higher confidence in specific caregiving domains predicts better psychological adjustment. This strong relationship supports the use of the RSCSE as a reliable measure of the psychological mechanisms targeted by cognitive-behavioral interventions for caregivers.

Reliability

The RSCSE has demonstrated robust internal consistency, indicating high reliability across its subscales. High Cronbach’s alpha coefficients reported in the initial psychometric studies confirm that items within each factor (e.g., Self-Efficacy for Obtaining Respite) consistently measure the same underlying construct. This consistency ensures that the scale provides stable and dependable measurement of the caregiver’s perceived competence.

The reliability of the RSCSE makes it suitable for use in longitudinal research and clinical settings where accurate tracking of changes in self-efficacy over time is required. The established reliability is essential for ensuring that observed changes in scores following an intervention are due to the intervention itself, rather than measurement error.

Factor Analysis

The structure of the Revised Scale for Caregiving Self-Efficacy was confirmed through factor analysis, which typically identifies distinct, yet correlated, factors corresponding to the hypothesized domains of caregiving self-efficacy. The analysis separates the core items into three primary psychosocial factors: Self-Efficacy for Obtaining Respite, Self-Efficacy for Responding to Disruptive Patient Behaviors, and Self-Efficacy for Controlling Upsetting Thoughts about Caregiving.

These factors represent unique aspects of the caregiving challenge. The factor structure supports the theoretical framework that efficacy is domain-specific. While the initial items related to physical strength may be administered, they often form a separate factor or are used primarily for context, while the latter 15 items constitute the core, revised measure of psychosocial caregiving self-efficacy.

Instrument

Test Type: Self-Report Confidence Inventory

Format: The scale uses a visual analog or numerical rating scale ranging from 0 to 100, where 0 represents “Cannot do at all” and 100 represents “Certain can do.” Respondents rate their degree of confidence for each specific task or situation.

Language Available: English (Original)

Population Group: Family Caregivers

Age Group: Adult (Typically middle-aged and older adults acting as caregivers)

Population Details: Primarily developed and validated among family caregivers of individuals with chronic illnesses, particularly those with dementia or Alzheimer’s disease.

Test Methodology: Administration involves reading a standardized confidence phrase (“How confident are you that you can…”) before each item, prompting the caregiver to rate their perceived competence on the 0-100 scale. Administrators may be instructed to use “N/A” (Not Applicable) if a scenario has absolutely never occurred.

Keywords

caregiver assessment, scale development, dementia care, psychosocial support, psychometrics, Albert Bandura, confidence rating, chronic illness

Authors

Author ORCID Identifier: Not consistently provided in the original source, requires external lookup.

Affiliation Email addresses: Not consistently provided in the original source.

Correspondence Address: Correspondence is typically directed to the lead author, A. M. Steffen (associated with the University of Missouri–St. Louis at the time of publication).

Permissions & Fee and Test Year

Test Year: 2002 (Year of primary publication of the revised scale’s psychometric properties).

Permissions and Fee: As a psychological scale developed by academic researchers, it is often available for non-commercial research and clinical use, especially given the involvement of Albert Bandura, who typically advocates for free access to his scales. Users should consult the lead author or institutional repository for formal permission requirements.

The original PDF can be downloaded here: www.umsl.edu/~steffena/documents/RevisedScale.pdf

Reference’s

• Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D., & Bandura, A. (2002). The revised scale for care giving self-efficacy: reliability and validity studies. Journal of Gerontology: Psychological Sciences, 57(1), 74–86.
• Gilliam, C.M., & Steffen, A. M. (2004). The relationship between caregiving self-efficacy and depressive symptoms in dementia family caregivers. Aging & Mental Health, 10(2), 79–86.
• Steffen et al. (2002). The Revised Scale for Care Giving Self-Efficacy. In: Simmons C. A., Lehmann P. (eds). Tools for strengths-based assessment and evaluation, New York, NY: Springer, pp. 316-319. (2013).

Items of the Revised Scale for Caregiving Self-Efficacy

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

“If you were asked to lift objects of different weights right now‚ how confident are you that you can lift each of the weights described?

Administrator: read the words How confident are you that you can . . .” before each item

PHYSICAL STRENGTH

1. Lift a 10-pound object
2. Lift a 20-pound object
3. Lift a 50-pound object
4. Lift a 100-pound object

How confident are you that you can do the following activities? (If necessary say‚ “If this is absolutely not applicable to your situation‚ let me know.” Then put N/A). Read How confident are you that you . . .” in every item; place this phrase just before the word “can” in the item. (Display Card #1)

Self- Efficacy for Obtaining Respite

1. . . . Can ask a friend/family member to stay with ____ when you need to see the doctor yourself?
2. . . . Can ask a friend/family member to stay with ____ for a day when you have errands to be done?
3. . . .Can ask a friend or family member to do errands for you?
4. . . .Can ask a friend/family member to stay with ____ for the day when you feel the need for a break?
5. . . .Can ask a friend/family member to stay with ____ for a week when you need the time for yourself?

Self-Efficacy for Responding to Disruptive Patient Behaviors

6. When ____ forgets your daily routine and asks when lunch is right after you eaten . . . can you answer him/her without raising your voice? (clarify that “answer” can be direct or a distraction.)
7. When you get angry because ____ repeats the same question over and over . . . can you say things to yourself that calm you down?
8. When ____ complains to you about how you are treating him/her . . . can you respond without arguing back?
9. When ____ asks you 4 times in the first one hour after lunch when lunch is . . . can you answer him/her without raising your voice?
10. When ____ interrupts you for the fourth time while you are making dinner . . . can you respond without raising your voice?

(Administrator: When caregivers state that they have absolutely never had the thoughts in one of the items‚ put “N/A” (not applicable) on the line for rating confidence. Begin each item with the phase‚ How confident are you that you can control . . .” Display Card # 1.)

Self- Efficacy for Controlling Upsetting Thoughts about Caregiving

11. . . .Thinking about unpleasant aspects about taking care of ___?
12. . . .Thinking how unfair it is that you have to put up with this situation (taking care of ) ____?
13. . . .Thinking about what a good life you had before____ ’s illness and how much you’ve lost?
14. . . .Thinking about what you are missing or giving up because of ____?
15. . . .Worrying about future problems that might come up with ____?

Self-efficacy for obtaining respite‚ responding to disruptive patient behaviors‚ and controlling upsetting thoughts about caregiving

Rate your degree of confidence from 0 to 100 using the scale given below:

0= Cannot do at all to 100 = Certain can do