Psychometric Evaluation of the Surrogate Decision Making Self-Efficacy Scale

Currently, no instrument exists to assess self-efficacy for surrogate decision making. This study assessed the psychometric properties of the Surrogate Decision Making Self-Efficacy Scale (SDM-SES). Interview data from surrogate decision makers (SDMs) were used to generate the items. Items were assessed for face validity by expert gerontological nurses. Responses from a sample of 155 SDMs for nursing home residents with dementia were analyzed to assess the psychometric properties of the scale scores. Internal consistency was calculated using Cronbach's alpha coefficient, and construct validity was evaluated using confirmatory factor analysis. The Cronbach's alpha coefficient suggested high internal consistency, and results of the confirmatory factor analysis supported the construct validity of the instrument. The SDM-SES may be useful as an assessment instrument, as well as an outcome measure for interventions aimed at increasing the capacity of SDMs. Future validations are suggested to optimize its utility.