Academic journal article Journal of Nursing Measurement

Reliability and Validity of the Chinese Versions of Self-Efficacy and Outcome Expectations for Osteoporosis Medication Adherence Scales in Chinese Immigrants

Academic journal article Journal of Nursing Measurement

Reliability and Validity of the Chinese Versions of Self-Efficacy and Outcome Expectations for Osteoporosis Medication Adherence Scales in Chinese Immigrants

Article excerpt

Background and Purpose: To assess the psychometric properties of Chinese versions self- efficacy and outcome expectations on osteoporosis medication adherence (SEOMA-C and OEOMA-C) scales. Methods: Back-translated tools were assessed by internal consistency and R^sup 2^ by structured equation modeling, confirmatory factor analyses, hypothesis testing, and criterion-related validity among 110 (81 females, 29 males) Mandarin-speaking immigrants (mean age = 63.44, SD = 9.63). Results: The Cronbach's alpha for SEOMA-C and OEOMA-C is .904 and .937, respectively. There was fair and good fit of the measurement model to the data. Previous bone mineral density (BMD) testing, calcaneus BMD, self-efficacy for exercise, and osteoporosis medication adherence were positively related to SEOMA-C scores. Conclusion: These scales constitute some preliminary validity and reliability. Further refined and cultural sensitive items could be explored and added.

Keywords: Chinese immigrants; reliability; validity; osteoporosis medication adherence; self-efficacy; outcome expectations

Osteoporosis is a chronic metabolic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to increased bone fragility and susceptibility to fracture (Harvey, Dennison, & Cooper, 2010). According to the World Health Organization (WHO, 2012), osteoporosis is a global health care problem second only to cardiovascular disease. Studies show that a 50-year-old woman's lifetime risk of death from a hip fracture is similar to that of breast cancer. In addition, a woman's risk of a hip fracture because of osteoporosis is equal to her risk of breast, ovarian, and uterine cancer combined; a man age 50 years or older is more likely to break a bone because of osteoporosis than he is to get prostate cancer (National Osteoporosis Foundation [NOF], 2013). Osteoporosis rarely demonstrates early warning signs or outward indicators until a fracture occurs. These fractures are associated with loss of height, chronic back pain, disfigurement, disability, as well as significant impairments in physical and psychological function, and even increased mortality in older individuals (Adachi et al., 2010; B line et al., 2009; Ioannidis et al., 2009; Voigt et al., 2012). The worldwide cost burden of osteoporosis (for all ages) is forecasted to increase to $131.5 billion by 2050. Direct care expenditures for osteoporotic fracture are estimated at $19- $30 billion in the United States (Burge et ah, 2007).

Because of its prevalence worldwide, osteoporosis is considered a serious public health concern. It is estimated that more than 200 million people worldwide suffer from this disease (International Osteoporosis Foundation [IOF], 2013). Epidemiological studies have consistently reported that Asians have as high a rate of osteoporosis as Whites even after controlling for body mass index (BMI; Mithal & Kaur, 2012; Morrison, Fan, Den, & Weisenfluh, 2013). With socioeconomic development in many Asian countries and aging of a large Asian population, osteoporosis has become one of the most prevalent and costly health problems in Asian countries (IOF, 2013). Unsurprisingly, Asia expects the most dramatic increase in hip fractures in the coming decades; recent studies suggest that as many as 88 million Chinese individuals living in China may have osteoporosis (Liu et ah, 2002). Osteoporosis in China has become an epidemic, with a 300% increase in prevalence over the last 30 years (IOF, 2013). The number of osteoporotic fractures in the world is estimated to increase to 6.26 million cases by the year 2050, with more than half of them occurring in the Asian population (Dhanwal, Dennison, Harvey, & Cooper, 2011). Chinese iimnigrants are also a growing population at a higher risk for osteoporosis, making this a significant coimnunity health issue (Tan et al., 2009). Literature shows that among 300 iimnigrant Chinese women living in New York City, aged 40-90 years, more than half of them had osteoporosis and more than a third had osteopenia at the lumbar spine or hip region (Babbar et ah, 2006), putting them at high risk for fractures. …

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