Self-Efficacy for Managing Chronic Disease Scale SSE
Self-Efficacy for Managing Chronic Disease Scale SSE overview
Creator and Context
The Self-Efficacy for Managing Chronic Disease 6-Item Scale, often referred to as the Stanford Self-Efficacy Scale, measures how confident a person is that they can manage their own condition.
It was developed by Kate Lorig, Philip Ritter and colleagues at the Stanford Patient Education Research Center, and is now maintained by the Self-Management Resource Center. It is free to use without permission.
Presenting Conditions
The six items cover confidence in:
Keeping fatigue from interfering with life
Keeping physical discomfort or pain from interfering
Keeping emotional distress from interfering
Keeping other symptoms or health problems from interfering
Doing the tasks needed to manage the condition and reduce the need to see a doctor
Doing things other than taking medication to reduce the impact of the illness
There are no formal subscales, but the items span symptom control, role function, emotional functioning and communication with clinicians.
Administration
Self administered, taking a couple of minutes. Each item is rated from 1 (not at all confident) to 10 (totally confident), at the present time.
Desired Audience
Adults with a chronic disease. Validation samples spanned the USA, England, Canada, Mexico and Australia, from adolescence to over 80.
Self management confidence is the strongest single predictor of whether someone will actually do the things their care plan asks of them. Six items is a very small investment for that information, and it points directly at what to work on.
Considerations
The score is a mean, not a sum. Reporting a total out of 60 is a common and consequential error.
No test retest reliability has been published.
There are no cut offs or clinical bands.
Every item refers to the person's disease or illness, so it is a poor fit for a general wellbeing population and can be awkward for people who do not frame their mental health as a disease.
How to score the Self-Efficacy for Managing Chronic Disease Scale SSE
Conducting the assessment
The person rates each of the six items from 1 to 10. If two consecutive numbers are circled, the lower is used. The scale is not scored if more than two items are missing.
Interpretation
The score is the mean of the six items, giving a range of 1 to 10. Higher scores indicate greater self efficacy.
There are no cut offs or bands. Interpretation is against reference means or based on change.
In the original validation of 605 people with chronic disease, the mean was 5.17 with a standard deviation of 2.22. Across six later studies, means ranged from 4.9 to 6.1.
Clinical Considerations
Score it as a mean. Verify this in any digital implementation.
Look at which item is lowest. That is where the self management support should start.
Track change across a programme rather than reading a single score.
Self-Efficacy for Managing Chronic Disease Scale SSE use cases
Measuring self management confidence in people with long term conditions
Identifying where a person needs support to manage their own care
Tracking change across a self management programme
Research in chronic disease self management
Category
General Well-being
Research Summary
Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. (2001). Effect of a self management program for patients with chronic disease. Effective Clinical Practice, 4(6), 256 to 262.
Ritter, P. L., & Lorig, K. (2014). The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies. Journal of Clinical Epidemiology, 67(11), 1265 to 1273.
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Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
