Cardiovascular Management Self-efficacy: Psychometric Properties of a New Scale and Its Usefulness in a Rehabilitation Context

The effects of nurse-led spiritual care on psychological well-being in the healthcare services of patients with cardiovascular diseases in Iran: a systematic review

BACKGROUND

Cardiovascular disease (CVD) significantly impacts patients' lives, affecting not only their physical health but also their spiritual well-being. While holistic care acknowledges the importance of addressing spiritual needs, the integration of nurse-led spiritual care within CVD management remains understudied.

OBJECTIVES

This systematic review aimed to evaluate the effectiveness of spiritual and psychological interventions in enhancing quality of life and reducing anxiety among CVD patients.

METHODS

Following the PRISMA guidelines, we conducted a comprehensive search across multiple databases (PubMed, Scopus, EMBASE, CINAHL, Cochrane Library, SID, Magiran, and Web of Science) for relevant articles published in English and Persian between 2013 and 2023. The risk of bias in included experimental and quasi-experimental studies was assessed using ROB 2 and ROBINS-I scales.

RESULTS

The initial search yielded 1416 articles. After applying inclusion and exclusion criteria, along with qualitative evaluation, 15 studies with a total of 1035 participants were selected for review. These studies explored the impact of spiritual interventions (e.g., healthy heart model, emotion-oriented approach, communication with a higher power, acceptance, and relationship improvement) on anxiety, stress, life expectancy, depression, blood parameters, spiritual experiences, pain, and negative emotions in CVD patients. All reviewed studies reported positive outcomes with spiritual interventions, demonstrating their effectiveness in reducing anxiety, depression, pain, stress, and negative emotions, while also improving quality of life and possibly life expectancy.

CONCLUSION

Integrating spiritual care into routine care for CVD patients presents a promising approach to improve their overall well-being. This review highlights the effectiveness of spiritual interventions in reducing various negative emotions and enhancing quality of life.

TRIAL REGISTRATION

PROSPERO (CRD42023448687).

Self-efficacy measurement instruments for individuals with coronary artery disease: A systematic review

INTRODUCTION

Over the past decade, there has been a heightened interest in evaluating self-efficacy among patients with coronary artery disease (CAD). A significant number of instruments have been developed and validated, yet the need remains to assess the quality of their studies and their properties.

OBJECTIVES

To evaluate the measurement properties and link the content extracted from self-efficacy instrument items for individuals with CAD to the International Classification of Functioning, Disability, and Health (ICF).

METHODOLOGY

The study was conducted following the Cochrane systematic review guidelines and COnsensus norms for Selection of health Measuring INstruments (COSMIN), registered under CRD42021262613. The search was carried out on MEDLINE (Ovid), Web of Science, EMBASE, and PsycINFO, including studies involving the development and validation of self-efficacy instruments for individuals with CAD, without language or date restrictions. Data extraction was performed in May 2022 and updated in January 2023 and all the steps of this review were carried out by two different collaborators and reviewed by a third when there were divergences. Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommended by COSMIN was used to determine the quality of evidence as high, moderate, low, or very low. Instrument categorization was carried out per COSMIN recommendations, according to the construct of interest and study population into three categories (A, B, or C).

RESULTS

A total of 21 studies from 12 instruments were identified. The best-rated instruments received a recommendation of B, which means, additional validation studies are needed. Barnason Efficacy Expectation Scale (BEES) showed high-quality evidence for structural, construct, criterion, and internal consistency validity; Cardiac Self-Efficacy Scale (CSES) demonstrated high quality for content, structural, cross-cultural validity, and internal consistency; Self-efficacy for Appropriate Medication Use (SEAMS) achieved a high level for structural, criterion, and internal consistency validity; Cardiovascular Management Self-Efficacy Scale exhibited high-level validity for structural, criterion, construct, and internal consistency. The CSES showed content linkage with all domains of the ICF, as well as the highest number of linkages with the categories.

CONCLUSIONS

Instruments with a B-level recommendation hold potential for use. More studies assessing measurement properties are needed to reinforce or improve these recommendations. The CSES stands out as the most comprehensive instrument concerning the ICF.

Spanish validation of the cardiac self-efficacy scale: a gender invariant measure

The aim is to validate the Spanish version of the Cardiac Self-Efficacy (S-CSE) Scale by examining its psychometric properties and to test the invariance for women and men. Two groups - 722 and 522- of patients completed the S-CSE Scale and other psychosocial measures during a medical revision several months after being diagnosed with cardiovascular disease. Construct validity was psychometrically evaluated using exploratory factor analysis (EFA) with a split of the first sample and confirmatory factor analysis (CFA) with a second split of the same sample. Scale structure was confirmed using the second sample. Convergent, discriminant, and external validity were tested. Results revealed that the S-CSE Scale was represented by three dimensions (control symptoms, control illness, maintain functioning) obtaining excellent reliability indexes and it appeared to be invariant for women and men. The S-CSE scale is a useful tool for monitoring the general well-being of these patients to promote individualized interventions.

The efficacy of phase I cardiac rehabilitation training based on augmented reality on the self-efficacy of patients undergoing coronary artery bypass graft surgery: A randomized clinical trial

BACKGROUND

Open-heart surgery is considered one of the primary treatments for severe coronary artery stenosis, but it comes with its own set of complications. However, these complications can be reduced through the implementation of proper cardiac rehabilitation during phase I. This study aimed to examine the impact of phase I cardiac rehabilitation training, using augmented reality, on the self-efficacy of cardiac management in patients undergoing coronary artery bypass grafting.

METHODOLOGY

This randomized clinical trial study involved 60 patients who were admitted to the Cardiac Surgery Intensive Care Unit at Ghaem Hospital in Mashhad. The software used in this study consisted of various videos and educational images demonstrating physical exercises for cardiac rehabilitation. The software was developed to train the patients in the intervention group on the rehabilitation program, starting from their admission to the Intensive Care Unit until their discharge from the hospital. The collected data were analyzed using statistical tests such as independent t-test, Mann-Whitney test, paired t-test, chi-square test, as well as descriptive indicators. Cohen's d was also used to evaluate the magnitude of the effect size.

RESULTS

The findings of this study revealed that the total mean score for cardiovascular management self-efficacy significantly increased during the transfer to the Intensive Care Unit and at the time of discharge. Notably, the increase observed in the intervention group was significantly greater than that of the control group (P < 0.001).

CONCLUSION

The results of this study indicated that implementing early rehabilitation programs, using innovative educational technology like augmented reality, enhanced the self-efficacy of patients undergoing coronary artery bypass grafting. These findings suggest that such programs can be effectively employed as educational tools throughout different stages of cardiac rehabilitation.

TRIAL REGISTRATION

This study was registered in the Iranian Registry of Clinical Trials (no. IRCT20200203046361N1) on 16/02/2020.

How to Age More Positively? Analyzing Determinants that Shape Attitudes Towards Aging

A considerable amount of research has illustrated that negative attitudes toward one’s own aging can directly hinder mental and physical well-being or lead to maladjustment in later stages of life (Swift et al. in Social Issues Policy Rev 11(1):195–231, https://doi.org/10.1111/sipr.12031, 2017). Research so far has focused on the analysis of individual factors related to attitudes toward aging, often related to personality traits. Our study proposes and tests a model of positive contact with aging (PCA). It analyses both individual and social antecedents of attitudes towards one’s own aging, hypothesizing that individual health self-efficacy directly affects attitudes towards one’s own aging and that the quality and quantity of contact with older adults indirectly impacts on attitudes towards one’s own aging through attitudes towards older adults. The model was tested in a wide sample of the Italian population (N = 753) with a varied age range. The PCA model tested showed excellent fit to the data, explaining a moderate amount of variance in attitudes toward one’s own aging (12%). This model promises to offer implications for active policies that can improve attitudes towards one’s own aging, promoting educational strategies to increase intergenerational exchanges and foster health-related self-efficacy.

Latent change models of lifestyle in acute coronary syndrome patients: Are lifestyle changes associated with resilience changes?

This study aimed to examine the role of resilience resources in patients' lifestyle changes after the first Acute Coronary event. 275 Italian patients (84.0% men; mean age = 57.5, SD = 7.9) participated in a longitudinal study. Resilience resources (Self-esteem, Dispositional Optimism, Sense of Coherence – SOC, General and Disease-specific Self-efficacy), and lifestyles (diet, physical activity, and smoking) were assessed twice (at baseline and after 6 months). Path analysis using latent change models was performed to model the combined effect of levels and changes of the resilience resources over lifestyle changes. Patients with strong SOC at baseline were less prone to smoke and more prone to decrease smoking; enhancement in SOC was associated with a smoking decrease. High Disease-specific Self-efficacy at baseline was associated with an improvement in all lifestyles; enhancement in Disease-specific Self-efficacy predicted an increase in physical activity. Findings underline the need to design psychological interventions that promote patients' Disease-specific Self-efficacy and SOC.

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the affective and cognitive states of patients. This research aimed to analyze the effectiveness of two brief psychological interventions-mindfulness and positive strengthening-to promote subjective emotional wellbeing and disease management self-efficacy using mHealth. This was a three-arm intervention and feasibility study, with a pre-post design and three follow-up measures with 105 patients (93 completed all phases) with cardiovascular diseases. Group 1 and 2 received the mindfulness or strengthening intervention, and Group 3 was the control group. The positive-negative affect and management self-efficacy for chronic and cardiovascular diseases were analyzed over time, while anxiety and depression levels were assessed at the beginning of the study. The results showed that mindfulness and positive strengthening interventions both had a positive effect on participants' affective state and management self-efficacy for the disease in comparison with the control group over time, even after controlling for baseline anxiety and depression levels. Positive strengthening seems to be more effective for improving cardiac self-efficacy, while mindfulness practice was significantly more effective at reducing negative affect at the first face-to-face evaluation.

Patient-centered care in Coronary Heart Disease: what do you want to measure? A systematic review of reviews on patient-reported outcome measures

Background

The number of published articles on Patient-Reported Outcomes Measures (PROMs) in Coronary Heart Disease (CHD), a leading cause of disability-adjusted life years lost worldwide, has been growing in the last decades. The aim of this study was to identify all the disease-specific PROMs developed for or used in CHD and summarize their characteristics (regardless of the construct), to facilitate the selection of the most adequate one for each purpose.

Methods

A systematic review of reviews was conducted in MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews. PROQOLID and BiblioPRO libraries were also checked. PROMs were classified by construct and information was extracted from different sources regarding their main characteristics such as aim, number of items, specific dimensions, original language, and metric properties that have been assessed.

Results

After title and abstract screening of 1224 articles, 114 publications were included for full text review. Finally, we identified 56 PROMs: 12 symptoms scales, 3 measuring functional status, 21 measuring Health-Related Quality of Life (HRQL), and 20 focused on other constructs. Three of the symptoms scales were specifically designed for a study (no metric properties evaluated), and only five have been included in a published study in the last decade. Regarding functional status, reliability and validity have been assessed for Duke Activity Index and Seattle Angina Questionnaire, which present multiple language versions. For HRQL, most of the PROMs included physical, emotional, and social domains. Responsiveness has only been evaluated for 10 out the 21 HRQL PROMs identified. Other constructs included psychological aspects, self-efficacy, attitudes, perceptions, threats and expectations about the treatment, knowledge, adjustment, or limitation for work, social support, or self-care.

Conclusions

There is a wide variety of instruments to assess the patients’ perspective in CHD, covering several constructs. This is the first systematic review of specific PROMs for CHD including all constructs. It has practical significance, as it summarizes relevant information that may help clinicians, researchers, and other healthcare stakeholders to choose the most adequate instrument for promoting shared decision making in a trend towards value-based healthcare.

Health Status Stability of Patients in a Medical Rehabilitation Program: What Are the Roles of Time, Physical Fitness Level, and Self-efficacy?

BACKGROUND

Individuals' physical and mental health, as well as their chances of returning to work after their ability to work is damaged, can be addressed by medical rehabilitation.

AIM

This study investigated the developmental trends of mental and physical health among patients in medical rehabilitation and the roles of self-efficacy and physical fitness in the development of mental and physical health.

DESIGN

A longitudinal design that included four time-point measurements across 15 months.

SETTING

A medical rehabilitation center in Germany.

POPULATION

Participants included 201 patients who were recruited from a medical rehabilitation center.

METHODS

To objectively measure physical fitness (lung functioning), oxygen reabsorption at anaerobic threshold (VO2AT) was used, along with several self-report scales.

RESULTS

We found a nonlinear change in mental health among medical rehabilitation patients. The results underscored the importance of medical rehabilitation for patients' mental health over time. In addition, patients' physical health was stable over time. The initial level of physical fitness (VO2AT) positively predicted their mental health and kept the trend more stable. Self-efficacy appeared to have a positive relationship with mental health after rehabilitation treatment.

CONCLUSIONS

This study revealed a nonlinear change in mental health among medical rehabilitation patients. Self-efficacy was positively related to mental health, and the initial level of physical fitness positively predicted the level of mental health after rehabilitation treatment.

CLINICAL REHABILITATION

More attention could be given to physical capacity and self-efficacy for improving and maintaining rehabilitants' mental health.

A Brief mHealth-Based Psychological Intervention in Emotion Regulation to Promote Positive Subjective Well-Being in Cardiovascular Disease Patients: A Non-Randomized Controlled Trial

The emotional impact that a cardiovascular disease may have on a person’s life can affect the prognosis and comorbidity of the disease. Therefore, emotion regulation is most important for the management of the disease. The aim of this study was to analyze the effectiveness of a brief mHealth psychological intervention in emotion regulation to promote positive subjective well-being in cardiovascular disease patients. The study sample (N = 69, 63.7 ± 11.5 years) was allocated to either the experimental group (n = 34) or control group (n = 35). The intervention consisted of a psychoeducational session in emotion regulation and an mHealth-based intervention for 2 weeks. Positive subjective well-being as a primary outcome and self-efficacy to manage the disease as a secondary outcome were assessed at five time points evaluated over a period of 6 weeks. The experimental group showed higher improvement in positive subjective well-being and self-efficacy for managing the disease compared to the control group over time. The experimental group also improved after the intervention on all outcome measures. Brief mHealth interventions in emotion regulation might be effective for improving positive subjective well-being and self-efficacy to manage the disease in cardiovascular patients.

Self-Efficacy Beliefs of University Students: Examining Factor Validity and Measurement Invariance of the New Academic Self-Efficacy Scale

Academic self-efficacy beliefs influence students' academic and career choices, as well as motivational factors and learning strategies promoting effective academic success. Nevertheless, few studies have focused on the academic self-efficacy of university students in comparison to students at other levels. Furthermore, extant measures present several limitations. The first aim of this study was to develop a reliable and valid scale assessing university students' self-efficacy beliefs in managing academic tasks. The second aim was to investigate differences in academic self-efficacy due to gender, years of enrollment, and student status. The study involved 831 students (age M = 21.09 years; SD = 1.34 years; 66.3% women) enrolled in undergraduate programs. Indicators of academic experiences and performance (i.e., number of exams passed and average exam rating) were collected. A new scale measuring students' academic self-efficacy beliefs was administered. Results from a preliminary Exploratory Factor Analysis were consistently supported by findings from a Confirmatory Factor Analysis. Multigroup CFA supported the presence of measurement invariance. Analyses revealed that the new scale has eight factors: "Planning Academic Activities," "Learning Strategies," "Information Retrieval," "Working in Groups," "Management of Relationships with Teachers," "Managing Lessons," "Stress Management," and "Thesis Work." Self-efficacy dimensions showed significant relations with academic experiences and students' performance indicators, as well as differences due to gender, years of enrollment, and student status. Findings are discussed in terms of practical implications for the implementation of intervention programs aimed at fostering self-efficacy beliefs and academic success.

Validity and reliability of a short self-efficacy instrument for hypertension treatment adherence among adults with uncontrolled hypertension

OBJECTIVE

To establish the reliability and validity of a self-report measure designed to assess self-efficacy for hypertension treatment adherence.

METHODS

This investigation was embedded within a six-month randomized clinical trial (RCT), which demonstrated that a tailored, stage-matched intervention was more effective at improving hypertension control than usual care among individuals (n = 533) with repeated uncontrolled hypertension. The instrument used to assess self-efficacy for hypertension treatment adherence (SE-HTA) comprised three subscales that assessed diet self-efficacy (DSE), exercise self-efficacy (ESE), and medication self-efficacy (MSE). To determine SE-HTA validity and reliability, we assessed internal consistency using Cronbach's α coefficients, conducted exploratory factor analysis, and evaluated convergent and discriminant validity, as well as test-retest reliability using Spearman's ρ correlation coefficients.

RESULTS

Cronbach's α (internal consistency) values for DSE, ESE, and MSE were 0.81, 0.82 and 0.74. Factor analysis and the scree plot demonstrated three distinct factors, which correspond to the three subscales contained in the SE-HTA instrument. SE-HTA possessed good convergent and discriminant validity, and moderate test-retest reliability.

CONCLUSION

The SE-HTA instrument containing diet, exercise, and medication adherence subscales is valid and reliable in adults with uncontrolled hypertension.

PRACTICE IMPLICATIONS

This SE-HTA instrument measures self-efficacy and could help facilitate behavior change in hypertension.

Instruments to assess self-efficacy among people with cardiovascular disease: A COSMIN systematic review

BACKGROUND

Self-efficacy plays an important role in recovery. There is a need for valid tools that can assess self-efficacy in cardiovascular diseases to provide evidence-based practices.

OBJECTIVE

To perform a psychometric review of self-efficacy instruments in cardiovascular disease according to the COSMIN checklist in order to facilitate the selection of the most suitable measuring instruments.

DESIGN

Psychometric systematic review.

DATA SOURCES

A systematic literature search was conducted on the Web of Science, EBSCOHOST CINAHL COMPLETE, PUBMED, ScienceDirect, Scopus, Cochrane Library, OVID and PROQUEST databases from their time of inception to January 2019.

METHODS

We used COSMIN systematic review guideline to evaluate the quality of the Patient-Reported Outcome Measures (PROMs) and to facilitate the selection of the most suitable measuring instruments.

RESULTS

After the search process, a total of nine studies conducted between 1998 and 2018 were included in the systematic review, representing five instruments. The Cardiac Self-Efficacy Scale demonstrated high quality for content validity and low quality for internal consistency. The Cardiovascular Management Self-Efficacy Scale demonstrated high quality for structural validity and low quality for reliability and content validity. The General Perceived Self-Efficacy Scale demonstrated high quality for both structural validity and internal consistency. Content validity was not assessed for this scale. The Hypertension Self-Care Profile Self-Efficacy Scale demonstrated a moderate quality for structural validity, internal consistency and reliability and also high quality for content validity. The Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale demonstrated high quality for structural validity, internal consistency and responsiveness. None of the studies determined measurement error, cross-cultural validity or criterion validity.

CONCLUSIONS

The Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale is categorised as A and is recommended as the most suitable instrument. All other the four instruments categorised as B with potential to be recommended should be evaluated with further psychometric studies.

Psychometric Properties of the Persian Version of Cardiovascular Management Self-efficacy Scale

BACKGROUND

Self-efficacy plays a major role in the management of cardiovascular disease (CVD). The original Cardiovascular Management Self-efficacy Scale (CMSS) was developed in 2016 in Italian patients with CVD; however, no such scale exists for Iranian patients with CVD.

OBJECTIVE

We translated the CMSS into Persian and assessed its validity, reliability, and psychometric properties in Iranian patients with CVD.

METHODS

This study was conducted for 4 months in 2017 on a group of consenting patients with CVD (N = 363) recruited from a cardiovascular hospital in Kermanshah, Iran. The reliability of the Persian CMSS was evaluated. We assessed validity, including face, content, construct, convergent, divergent, and discriminate validity, using the General Self-efficacy Scale, the Hospital Anxiety and Depression Scale, and the 36-item Short Form Health Survey Scale. Known-group validity was assessed among patients with high blood pressure.

RESULTS

The Persian CMSS had acceptable face and content validity. No floor or ceiling effects were found for the total scale. Cronbach α was calculated as .68. Test-retest reliability was confirmed by intraclass correlation coefficient (ICC1,3 = 0.98, P < .001). Using exploratory factor analysis, 3 subscales were identified, similar to the original version. Significant correlations were found between the Persian CMSS and both the General Self-efficacy Scale (r = 0.94, P < .001) and Hospital Anxiety and Depression Scale (r = -0.35, P < .05). Self-efficacy measured using the Persian CMSS was statistically different between 2 levels of patients' health status (P < .05). Patients with hypertension had a lower level of self-efficacy than those in the healthy group (P < .05).

CONCLUSIONS

The Persian version of CMSS provides a practical, reliable, and valid scale for evaluating self-efficacy in the clinical management of Persian Iranian patients with CVD.

Sexism Interacts with Patient-Physician Gender Concordance in Influencing Patient Control Preferences: Findings from a Vignette Experimental Design

BACKGROUND

Patient preferences regarding their involvement in shared treatments decisions is fundamental in clinical practice. Previous evidences demonstrated a large heterogeneity in these preferences. However, only few studies have analysed the influence of patients' individual differences, contextual and situational qualities, and their complex interaction in explaining this variability.

METHODS

We assessed the role of the interaction of patient's sociodemographic and psychological factors with a physician's gender. Specifically, we focused on patient gender and attitudes toward male or female physicians. One hundred fifty-three people participated in this randomised controlled study and were randomly assigned to one of two experimental conditions in which they were asked to imagine discussing their treatment with a male and a female doctor.

RESULTS

Analyses showed an interplay between attitude towards women and the gender of patients and doctors, explaining interindividual variability in patient preferences.

CONCLUSIONS

In conclusion, patients' attitudes toward the physicians' gender constitutes a relevant characteristic that may influence the degree of control patients want to have and the overall patient-physician relationship.

French validation of the Arthritis Self-Efficacy Scale and further psychometric properties exploration among 168 people with osteoarthritis

Objective:

To validate the Arthritis Self-Efficacy Scale—French version (ASES-F) of the ASES questionnaire designed to evaluate self-efficacy in arthritis population and to confirm its psychometric properties.

Design:

The translation/back-translation procedure was done in line with cross-cultural adaptation international guidelines. Prospective multicenter validation was performed on 168 patients with osteoarthritis who filled out the ASES-F. Function subscale of the Western Ontario and McMaster Universities Arthritis Index, Hospital Anxiety and Depression (HAD), Knee Osteoarthritis Fears and Beliefs Questionnaire, and pain on visual analog scale were collected. Acceptability, internal consistency, reproducibility, internal and external structure validity, and sensitivity following a self-management program focused on physical activity were analyzed. The retest was performed 15 days later.

Results:

A culturally adapted version was obtained following the validation procedure. The final translated questionnaire is available within the full article. Cronbach’s alpha coefficient was at 0.95 for the overall ASES-F. Regarding the test–retest reproducibility, Lin’s concordance coefficient was at 0.84. The internal and external validity was also explored with correlations at −0.50 between ASES-F and (WOMAC), and significant correlations between ASES-F and HAD. Sensitivity shown significant improvement at three months for the subscale function only (+2.65, P < 0.01).

Conclusion:

The ASES-F, French version of the ASES, available in supplemental data, was validated in knee osteoarthritis patients and could be used in clinical practice and research for French-speaking patients. Sensitivity needs to be more explored.

Assessment of Self-Efficacy and its Relationship with Frailty in the Elderly

Objective It has been increasingly recognized in various clinical areas that self-efficacy promotes the level of competence in patients. The validity, applicability and potential usefulness of a new, simple model for assessing self-efficacy in the elderly with special reference to frailty were investigated for improving elderly patients' accomplishments. Methods The subjects of the present study comprised 257 elderly people who were members of the New Elder Citizen Movement in Japan and their mean age was 82.3±3.8 years. Interview materials including self-efficacy questionnaires were sent to all participants in advance and all other physical examinations were performed at the Life Planning Center Clinic. Results The internal consistency and close relation among a set of items used as a measure of self-efficacy were evaluated by Cronbach's alpha index, which was 0.79. Although no age-dependent difference was identified in either sex, gender-related differences in some factors were noted. Regarding several parametric parameters, Beck's inventory alone revealed a significant relationship to self-efficacy in both sexes. Additionally, non-parametric items such as stamina, power and memory were strongly correlated with self-efficacy in both sexes. Frailty showed a significant independent relationship with self-efficacy in a multiple linear regression model analysis and using Beck's inventory, stamina, power and memory were identified to be independent factors for self-efficacy. Conclusion The simple assessment of self-efficacy described in this study may be a useful tool for successful aging of elderly people.