title: Factorial structure of a scale: Strategies Used by People to Promote Health--Chinese version.
abstract: BACKGROUND
  The Strategies Used by People to Promote Health (SUPPH) is an instrument used to measure self-reported self-efficacy in patient populations. Self-efficacy has a major impact on quality of life and psychological well-being. Previous findings of dimensionality of the SUPPH vary, and cultural differences exist suggesting the need for further investigation and psychometric testing to establish construct validity of the SUPPH in different cultures.
  
  
  OBJECTIVE
  The purpose of this study was to examine the factorial structure of the Chinese version of the SUPPH (C-SUPPH).
  
  
  METHODS
  Using reports from 764 oncology patients in China, the factorial structure of the C-SUPPH was assessed via 2 analytical strategies. First-order confirmatory factor analysis (CFA) models were used to examine the dimensionality of the C-SUPPH; a second-order CFA was used to determine the existence of a factorial structure hierarchy of the C-SUPPH.
  
  
  RESULTS
  Compared with the 2- and 4-factor solutions, the 3-factor CFA of the C-SUPPH had a better fit with the data (comparative fit index = 0.94, Tucker-Lewis index = 0.94, root-mean-square error of approximation = 0.05, the close-fit test P = .565, and standardized root-mean-square residual = 0.04). Our findings confirmed the 3-scale structure: Positive Attitude, Stress Reduction, and Making Decisions; together, the 3 factors represent an underlying higher-order factor, that of general self-care self-efficacy.
  
  
  CONCLUSIONS
  The C-SUPPH has a valid factorial structure and can be readily applied to studying self-efficacy in Chinese patients who are diagnosed with cancers.
  
  
  CONCLUSIONS
  Our findings provide support for a culturally sensitive, reliable, and valid self-efficacy measure (the C-SUPPH) of Chinese adult cancer patients' self-care self-efficacy.
authors.affiliation: Author Affiliations: School of Nursing, Second Military Medical University, Shanghai, China (Dr Yuan); Orthopedics Department, Shanghai Jiaotong University Affiliated Sixth People's Hospital, China (Ms Qian); Department of Nursing Research and Quality Outcomes and the Center for Translational Science, Children's National Medical Center, School of Medicine, the George Washington University, Washington, DC (Drs Wang and Hinds); College of Nursing, Rutgers University, Newark, New Jersey (Dr Lev); and Chemistry and Biochemistry Department, Suffolk University, Boston, Massachusetts (Ms Yuan).
authors.forename: Changrong
authors.initials: C
authors.lastname: Yuan
authors.forename: Huijuan
authors.initials: H
authors.lastname: Qian
authors.forename: Jichuan
authors.initials: J
authors.lastname: Wang
authors.forename: Elise L
authors.initials: EL
authors.lastname: Lev
authors.forename: Avery
authors.initials: A
authors.lastname: Yuan
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Hinds
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires