title: Sensitivity to change of the Rheumatoid Arthritis Self-Efficacy scale (RASE) and predictors of change in self-efficacy.
abstract: OBJECTIVE
  Patient education in rheumatoid arthritis (RA) aims to improve health outcomes by prompting people to adopt self-management behaviours. One precursor for initiating behaviour change is self-efficacy (SE), a belief that you can do a task. This study tested the sensitivity to change of a new scale to measure SE for self-management in people with RA, the Rheumatoid Arthritis Self-Efficacy scale (RASE). Exploratory analysis examined potential predictors of change in SE.
  
  
  METHODS
  People with RA at 11 rheumatology centres, who had accepted an education programme as part of clinical care, completed questionnaires at baseline, and two and eight weeks after their programme end. Programmes were not standardized, as this was a pragmatic study in clinical practice.
  
  
  RESULTS
  A total of 128 patients participated. After controlling for baseline scores, the RASE showed small but significant improvements in SE from baseline (RASE 107.57, CI 105.42-109.72) to two weeks after programme end (RASE 110.80, CI 108.60-112.99), and eight weeks (RASE 110.62, CI 108.40-112.85, p<0.001). Standardized response means, calculated both by absolute and percentage change, were 0.339 and 0.371 at two weeks after programme end, and 0.321 and 0.352 at eight weeks. Changes in the RASE were associated with behaviour initiation at two and eight weeks (r=0.419, r=0.342, p<0.001). No substantial predictors of change in SE could be identified.
  
  
  CONCLUSIONS
  The RASE is sensitive to change in a cohort of people with RA in the UK receiving education programmes as routine clinical care. Exploratory analysis did not identify clinical or psychological factors that predict change in SE, suggesting that programmes should not be restricted to particular patients.
authors.affiliation: School of Nursing, University of the West of England, Bristol UK. Sarah.Hewlett@uwe.ac.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Hewlett
authors.forename: Zoë
authors.initials: Z
authors.lastname: Cockshott
authors.forename: Celia
authors.initials: C
authors.lastname: Almeida
authors.forename: Pam
authors.initials: P
authors.lastname: Richards
authors.forename: Rob
authors.initials: R
authors.lastname: Lowe
authors.forename: Rosemary
authors.initials: R
authors.lastname: Greenwood
authors.forename: John
authors.initials: J
authors.lastname: Kirwan
mesh_terms: D000704:Analysis of Variance; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012648:Self Care; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D006113:United Kingdom