Evidence of structural validity and reliability of the General Self-Efficacy Scale through confirmatory factor analysis in patients with hypertension

Authors

DOI:

https://doi.org/10.18050/psiquemag.v15i1.4064

Keywords:

Self-Efficacy, validity, reliability, hypertension

Abstract

This study aimed to evaluate the psychometric properties of the General Self-Efficacy Scale developed by Baessler and Schwarzer in hypertensive patients undergoing treatment at a healthcare facility in Lima. An instrumental study was conducted with a sample of 178 patients. Structural validity was examined through confirmatory factor analysis using the diagonally weighted least squares (DWLS) estimator based on polychoric correlation matrices, which is appropriate for ordinal Likert-type variables. Two measurement models were evaluated: a 10-item model and an 8-item model. The results showed good fit for both models (10-item model: CFI = .99, TLI = .99, RMSEA = .05 [90% CI: .01–.08], SRMR = .06; 8-item model: CFI = .99, TLI = .99, RMSEA = .05 [90% CI: .00–.09], SRMR = .04). Internal consistency was high in both cases (α and ω ranging from .91 to .93). These estimates are interpreted based on the adequate fit of the measurement model, in line with current psychometric approaches. In addition, evidence of convergent validity was observed, with average variance extracted values above .50 in both models. Overall, the findings support the scale's unidimensional structure and provide evidence of its internal consistency and convergent validity in a clinical population.

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References

Ato, M., López, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038–1059. https://doi.org/10.6018/analesps.29.3.178511

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191

Charchar, F. J., Prestes, P. R., Mills, C., Ching, S. M., Neupane, D., Marques, F. Z., Sharman, J. E., Vogt, L., Burrell, L. M., Korostovtseva, L., Zec, M., Patil, M., Schultz, M. G., Wallen, M. P., Renna, N. F., Islam, S. M. S., Hiremath, S., Gyeltshen, T., Chia, Y.-C., & Tomaszewski, M. (2024). Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. Journal of Hypertension, 42(1), 23–49. https://doi.org/10.1097/HJH.0000000000003563

Detrinidad, E. (2016). Análisis Factorial Exploratorio y Confirmatorio aplicado al modelo de secularización propuesto por Inglehart-Norris. Periodo 2010-2014 (Estudio de caso España, Estados Unidos, Alemania, Holanda) WSV. [Tesis de Maestría] Universidad De Granada).

Flora, D. B. (2020). Your coefficient alpha is probably wrong, but which coefficient omega is right? A tutorial on using R to obtain better reliability estimates. Advances in Methods and Practices in Psychological Science, 3(4), 484–501. https://doi.org/10.1177/2515245920951747

Forero, C., Maydeu-Olivares, A., & Gallardo-Pujol, D. (2009). Factor analysis with ordinal indicators: A Monte Carlo study comparing DWLS and ULS estimation. Structural Equation Modeling, 16(4), 625–641. https://doi.org/10.1080/10705510903203573

García-Álvarez, D., Cobo Rendón, R., & Hernández Lalinde, J. D. (2022). Validez, fiabilidad e invarianza factorial de las escalas de autoeficacia general y autoeficacia académica en estudiantes universitarios. Retos, 46, e94281. https://doi.org/10.47197/retos.v46.94281

Ghadiri, R., Alimohammadi, M., & Majdabadi, H. A. (2018). Determination of the psychometric properties of the patients’ self-efficacy scale in blood pressure patients. Interventional Medicine & Applied Science, 10(2), 87–94. https://doi.org/10.1556/1646.10.2018.05

Grimaldo Muchotrigo, M., Correa Rojas, J., & Calderón-De la Cruz, G. (2021). Evidencias psicométricas de la Escala de Autoeficacia General (EAG) en universitarios peruanos. Ansiedad y Estrés, 27(2–3), 132–139. https://doi.org/10.5093/anyes2021a18

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2019). Multivariate data analysis (8th ed.). Cengage Learning.

Kalehoff, J. P., & Oparil, S. (2020). The story of the silent killer: A history of hypertension—Its discovery, diagnosis, treatment, and debates. Current Hypertension Reports, 22(9), 72. https://doi.org/10.1007/s11906-020-01077-7

Kara, S. (2022). General self-efficacy and hypertension treatment adherence in Algerian private clinical settings. Journal of Public Health in Africa, 13(3), 2121. https://doi.org/10.4081/jphia.2022.2121

Kim, J. E., Jiang, Y.-H., & Dee, V. (2023). Psychometric Properties of General Self-Efficacy (GSE) Scale Korean Version for Older Korean Immigrants with Diabetes: A Cross-Sectional Study in the United States. Nursing Reports, 13(2), 844-854. https://doi.org/10.3390/nursrep13020074

Kline, P. (2015). A handbook of test construction: Introduction to psychometric design. Routledge. https://doi.org/10.4324/9781315695990

Li, C.-H. (2016). Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares. Behavior Research Methods, 48(3), 936–949. https://doi.org/10.3758/s13428-015-0619-7

Macena, M., & Faro, A. (2025). Adaptación y validación de la Escala de Autoeficacia para el Manejo de Enfermedades Crónicas y su asociación con ansiedad y depresión en población brasileña. Ciencias Psicológicas, 19(2), e4594. https://doi.org/10.22235/cp.v19i2.4594

McNeish, D. (2018). Thanks coefficient alpha, we’ll take it from here. Psychological Methods, 23(3), 412–433. https://doi.org/10.1037/met0000144

Pal, B., Dutta, A., Chaudhary, V., Kumari, S., Meenakshi, S., & Murti, K. (2024). Prevalence of antihypertensive medication adherence and associated factors in India: A systematic review and meta-analysis. Hipertensión y Riesgo Vascular, 42(3), 156–164. https://doi.org/10.1016/j.hipert.2024.11.005

Pérez, A., Tecuapacho-Tzompantzi, M. I., Saldaña-Barrientos, S., Pazarán-Zamora, S. F., & López-Mejía, R. (2023). Relación entre autoeficacia y adherencia terapéutica en el adulto mayor con hipertensión arterial. Innovación y Desarrollo Tecnológico Revista Digital, 15(1), 121–130. https://iydt.wordpress.com/wp-content/uploads/2022/11/1_18_relacioin-entre-autoeficacia-y-adherencia-terapeiutica-en-el-adulto-mayor-con-hipertensioin-arterial.pdf

Ruiz-Alejos, A., Carrillo-Larco, R. M., & Bernabé-Ortiz, A. (2021). Prevalencia e incidencia de hipertensión arterial en Perú: Revisión sistemática y metaanálisis. Revista Peruana de Medicina Experimental y Salud Pública, 38(4), 521–529. https://doi.org/10.17843/rpmesp.2021.384.8502

Savalei, V. (2021). Improving fit indices in structural equation modeling with categorical data. Multivariate Behavioral Research, 56(3), 390–407. https://doi.org/10.1080/00273171.2020.1717922

Schmidt, B.-M., Durao, S., Toews, I., Bavuma, C. M., Hohlfeld, A., Nury, E., Meerpohl, J. J., & Kredo, T. (2020). Screening strategies for hypertension. Cochrane Database of Systematic Reviews, 2020(5), CD013212. https://doi.org/10.1002/14651858.CD013212.pub2

Schwarzer, R. (2016). Health action process approach (HAPA) as a theoretical framework to understand behavior change. Actualidades en Psicología, 30(121), 119–130. https://doi.org/10.15517/ap.v30i121.23458

Schwarzer, R., & Jerusalem, M. (2012). The general self-efficacy scale. In M. Johnston, S. Wright, & J. Weinman (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). NFER-NELSON.

Shi, D., Maydeu-Olivares, A., & Rosseel, Y. (2020). Assessing fit in ordinal factor analysis models: SRMR vs. RMSEA. Structural Equation Modeling: A Multidisciplinary Journal, 27(1), 1–15. https://doi.org/10.1080/10705511.2019.1611434

Tajeu, G. S., Kent, S. T., Huang, L., Bress, A. P., Cuffee, Y., Halpern, M. T., Kronish, I. M., Krousel-Wood, M., Mefford, M. T., Shimbo, D., & Muntner, P. (2019). Antihypertensive medication nonpersistence and low adherence for adults <65 years initiating treatment in 2007–2014. Hypertension, 74(1), 35–46. https://doi.org/10.1161/HYPERTENSIONAHA.118.12495

World Health Organization. (2023). Hypertension. https://www.who.int/news-room/fact-sheets/detail/hypertension

World Health Organization. (2024). Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

Viladrich, C., Angulo-Brunet, A., & Doval, E. (2017). A journey around alpha and omega to estimate internal consistency reliability. Anales de Psicología, 33(3), 755–782. https://doi.org/10.6018/analesps.33.3.268401

Ziegler, M., Kemper, C. J., & Kruyen, P. (2014). Short scales—Five misunderstandings and ways to overcome them. Journal of Individual Differences, 35(4), 185–189. https://doi.org/10.1027/1614-0001/a000148

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Published

2026-06-30

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Artículos psicométricos

How to Cite

Sánchez-Ramírez, J. C., Ucedo Silva, V. H., & López Villavicencio, C. A. (2026). Evidence of structural validity and reliability of the General Self-Efficacy Scale through confirmatory factor analysis in patients with hypertension. PsiqueMag, 15(1), 139-149. https://doi.org/10.18050/psiquemag.v15i1.4064