This scale is free to use without permission 1 Self-Efficacy for Managing Chronic Disease 6-item Scale We would like to know how confident you are in doing certain activities. For each of the following questions, please choose the number that corresponds to your confidence that you can do the tasks regularly at the present time. 1. How confident do you feel that you can keep the fatigue caused by your disease from interfering with the things you want to do? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident 2. How confident do you feel that you can keep the physical discomfort or pain of your disease from interfering with the things you want to do? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident 3. How confident do you feel that you can keep the emotional distress caused by your disease from interfering with the things you want to do? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident 4. How confident do you feel that you can keep any other symptoms or health problems you have from interfering with the things you want to do? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident 5. How confident do you feel that you can the different tasks and activities needed to manage your health condition so as to reduce your need to see a doctor? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident 6. How confident do you feel that you can do things other than just taking medication to reduce how much your illness affects your everyday life? ______________________________ not at all | | | | | | | | | | totally confident 1 2 3 4 5 6 7 8 9 10 confident Scoring The score for each item is the number circled. If two consecutive numbers are circled, code the lower number (less self-efficacy). If the numbers are not consecutive, do not score the item. The score for the scale is the mean of the six items. If more than two items are missing, do not score the scale. Higher number indicates higher self-efficacy.