Date Presented 04/03/2025
The Self-Management Assessment Scale (SMAS) has acceptable internal consistency for older adults with multimorbidity; OTs may want to use this scale to identify self-management barriers with a few caveats discussed here.
Primary Author and Speaker: Grace Keese
Additional Authors and Speakers: Tara C. Klinedinst, Nicholas Hollman
PURPOSE: The Self-Management Assessment Scale (SMAS) is a screening tool with five subscales assessing constructs of interest to occupational therapists: knowledge, social support, future goals, daily routines, and emotional support. Validity and reliability were established in type 2 diabetes (Oberg et al., 2018), however, a reliable tool for barrier identification in multiple chronic conditions (MCC) self-management is needed. We compared the internal consistency of the SMAS to a gold standard, the PROMIS-Self-Efficacy for Managing Chronic Conditions (PROMIS-SE) in older adults with MCC.
DESIGN: This data was collected as part of the baseline battery for a randomized controlled trial of a health behavior change intervention for older adults with MCC (ActiveOT). Participants (n = 41) were recruited from community outreach and primary care clinics.
METHOD: We used Cronbach’s alpha to calculate the internal consistency of the total scale and subscales of both tools. Sufficient internal consistency was discerned by an alpha value of ≥ 0.70 (Oosterveer et al., 2022).
RESULTS: The SMAS had sufficient internal consistency for the overall scale (α=0.88), and 3/5 subscales: knowledge (α = 0.87), social support (α = 0.81), and future goals (α = 0.77); daily routines (α = 0.58) and emotional support (α = 0.56) did not meet the threshold. PROMIS-SE results were similar: overall scale (α = 0.85) and 4/5 subscales (emotions (α = 0.83), symptoms (α = 0.86), medications (α = 0.72), and daily activities (α = 0.81)) met the threshold, but social interaction (α = 0.67) did not.
CONCLUSION: The study suggests both the PROMIS-SE and SMAS may be useful to screen for barriers in self-managing MCC.
IMPACT STATEMENT: The SMAS screens for important aspects of the occupational therapy domain (i.e., future goals and daily routines). Occupational therapists may wish to use the SMAS as a screening tool in MCC but should use caution when interpreting the individual subscales.
References
Öberg, U., Hörnsten, Å., & Isaksson, U. (2019). The Self-Management Assessment Scale: Development and psychometric testing of a screening instrument for person-centred guidance and self-management support. Nursing Open, 6(2), 504–513.
Oosterveer, D. M., Arwert, H., Terwee, C. B., Schoones, J. W., & Vlieland, T. P. V. (2022). Measurement properties and interpretability of the PROMIS item banks in stroke patients: a systematic review. Quality of Life Research, 31(12), 3305–3315.
