title: Exercise barriers self-efficacy: development and validation of a subcale for individuals with cancer-related lymphedema.
abstract: BACKGROUND
  No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers.
  
  
  METHODS
  A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale.
  
  
  RESULTS
  The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC = 0.67, p < 0.01).
  
  
  CONCLUSIONS
  A valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.
authors.affiliation: Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. jena.buchan@qut.edu.au.
authors.forename: Jena
authors.initials: J
authors.lastname: Buchan
authors.affiliation: Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. m.janda@qut.edu.au.
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
authors.affiliation: Queensland Lymphoedema and Breast Oncology Physiotherapy, Grange, QLD, 4051, Australia. qlbop@bigpond.com.
authors.forename: Robyn
authors.initials: R
authors.lastname: Box
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA. rogersl@uab.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Rogers
authors.affiliation: Institute of Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. sc.hayes@qut.edu.au.
authors.forename: Sandi
authors.initials: S
authors.lastname: Hayes
mesh_terms: D000368:Aged; D001315:Australia; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000523:psychology*; D008297:Male; D009369:Neoplasms / Q000150:complications; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*