Construct validity of two identity status measures: the EIPQ and the EOM-EIS-II

The present study was designed to examine construct validity of two identity status measures, the Ego Identity Process Questionnaire (EIPQ; J. Adolescence 18 (1995) 179) and the Extended Objective Measure of Ego Identity Status II (EOM-EIS-II; J. Adolescent Res. 1 (1986) 183). Construct validity was operationalized in terms of how identity status classifications generated by the EIPQ and EOM-EIS related to a measure of psychological agency, the Multi-Measure Agentic Personality Scale (MAPS; J. Adolescence 20 (1997) 421). Results indicated that, for the most part, the agentic personality scales differentiated the EIPQ diffused and moratorium statuses from the foreclosed and achieved statuses, whereas the agentic personality scales differentiated the EOM-EIS-II achieved status from the other three statuses. The EIPQ is recommended as the preferred instrument for making contrasts between or among identity statuses, whereas the EOM-EIS-II is recommended when the objective is to consider continuous measures of the identity statuses.     

Brief report: the Ego Identity Process Questionnaire: factor structure, reliability, and convergent validity in Dutch-speaking late adolescents

The reliability and validity of a Dutch version of the Ego Identity Process Questionnaire (EIPQ) were evaluated. In Study 1, the instrument was found to exhibit a clear factor structure and acceptable reliability. Using Confirmatory Factor Analysis, both a model with two process factors (Commitment, Exploration) and a model with four content factors (Ideological Commitment, Ideological Exploration, Interpersonal Commitment, Interpersonal Exploration) evidenced a good fit once direction of wording was taken into account. In Study 2, moderate convergence was observed between Commitment and Exploration, and continuous measures of identity statuses and identity styles. The results of both studies combined indicated that the Dutch version of the EIPQ may be recommended as a research tool with college students.     

Child rearing knowledge and practice scales for women with epilepsy

Background:

Comprehensive instruments to evaluate the child rearing knowledge and practice are not readily available for clinical research.

Materials and Methods:

We have designed in two phases a new instrument to evaluate the child rearing knowledge and practice under the four major domains of child rearing. Twenty-five subject experts from the field of Paediatrics, Obstetrics, Neurology and Nursing elicited the content validity of the instrument. The test retest reliability was evaluated by 25 young mothers who completed the CRKS at an interval of two weeks.

Results:

The Content Validity Ratio (CVR) of individual items ranged between 0.6 to 1. The reliability was tested for the 20 individual items of the CRKS using Kappa coefficient. The measurement of agreement Kappa ranged from 0.51 to 1. The total knowledge scores and sub scores data were analysed for correlation using Pearson’s correlation coefficient. A significant Pearson’s correlation indicated that the total scores were consistent over time (r = 0.89). The sub scores on feeding (6 items), Growth and development (4 items), protection (7 items), and infant stimulation (3 items) were found to have reliability of 0.91, 0.76, 0.84, and 0.89 respectively using Pearson’s correlation.

Conclusion:

The instrument is found to be valid and reliable and can be used to measure child rearing knowledge and practice in early infancy.     

Validation of the Caregivers’ Satisfaction with Stroke Care Questionnaire: C-SASC hospital scale

To date, researchers have lacked a validated instrument to measure stroke caregivers’ satisfaction with hospital care. We adjusted a validated patient version of satisfaction with hospital care for stroke caregivers and tested the 11-item caregivers’ satisfaction with hospital care (C-SASC hospital scale) on caregivers of stroke patients admitted to nine stroke service facilities in the Netherlands. Stroke patients were identified through the stroke service facilities; caregivers were identified through the patients. We collected admission demographic data from the caregivers and gave them the C-SASC hospital scale. We tested the instrument by means of structural equation modeling and examined its validity and reliability. After the elimination of three items, the confirmatory factor analyses revealed good indices of fit with the resulting eight-item C-SASC hospital scale. Cronbach’s α was high (0.85) and correlations with general satisfaction items with hospital care ranged from 0.594 to 0.594 (convergent validity). No significant relations were found with health and quality of life (divergent validity). Such results indicate strong construct validity. We conclude that the C-SASC hospital scale is a promising instrument for measuring stroke caregivers’ satisfaction with hospital stroke care.     

The multidimensional scale of independent functioning: a new instrument for measuring functional disability in psychiatric populations

The Multidimensional Scale of Independent Functioning (MSIF) is a new instrument for rating functional disability in psychiatric outpatients. The MSIF differs from other disability rating scales by providing discrete ratings of (1) role responsibility, (2) presence and level of support, and (3) performance quality. The MSIF, which consists of a semistructured interview and detailed rating anchors, was validated in 114 psychiatric outpatients. The instrument had good criterion, discriminative, interrater, and construct validity. Correlations between comparable ratings on the Social Adjustment Scale II (SAS II) ranged from 0.78 to 0.86. Nevertheless, redundancy analysis using canonical correlation demonstrated that, although the two instruments overlap, the MSIF contains information that is not contained in the SAS II. Furthermore, there was only modest shared variance with conceptually non-overlapping subscales in the SAS II. Interrater reliability (intraclass correlation coefficients) ranged from 0.74 to 1.00 for global and subscale scores. MSIF subscales performed as expected with respect to external validators such as hours of employment, earned income, supported versus nonsupported employment and housing, and mainstream versus nonmainstream educational status. MSIF global ratings were modestly correlated with IQ and psychopathology ratings, consistent with reports in the literature. Construct validity, estimated using Cronbach's alpha coefficient, was 0.72. The MSIF is a promising new instrument designed to circumvent several limitations with existing functional outcome instruments for longitudinal studies, intervention research, and services research.     

Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events

The authors developed the Japanese-language version of the Impact of Event Scale-Revised (IES-R-J) and investigated its reliability and validity in four different groups: workers with lifetime mixed traumatic events, survivors of an arsenic poisoning case, survivors of the Hanshin-Awaji earthquake, and survivors of the Tokyo Metro sarin attack. Evidence includes retest reliability and internal consistency of the IES-R-J. Posttraumatic stress disorder (PTSD) and partial PTSD cases indicated significantly higher scores than non-PTSD cases. The IES-R-J can be a useful self-rating diagnostic instrument particularly for survivors with PTSD symptoms as a clinical concern (PTSD + partial PTSD) by using a 24/25 cutoff in total score. In analysis of scale structure, the majority of intrusion and hyperarousal items were subsumed under the same cluster, whereas avoidance items made up a separate cluster. Female patients indicated higher scores than male patients. A negative weak correlation between age and the score was found only among female earthquake survivors. The IES-R-J can be used as a validated instrument in future international comparative research.     

A multi-dimensional measure of vocational identity status

Establishing a worker identity is among the most central aspects of the transition from adolescence to adulthood. Despite its importance, few measures with acceptable psychometric and conceptual characteristics exist to assess vocational identity statuses. This study reports the development and evaluation of the Vocational Identity Status Assessment (VISA), which is derived from established conceptual models and includes career exploration, commitment, and reconsideration dimensions. Results show that the VISA exhibited metric invariance across a high school and university sample. Cluster analyses demonstrated that the VISA consistently resolved six identity statuses across the two samples, supporting the previously established achieved, moratorium, foreclosed, and diffused statuses along with two additional statuses termed searching moratorium and undifferentiated. The identity statuses predicted differences in participants’ work valences and well-being with the achieved and diffused statuses respectively exhibiting the most and least favorable characteristics. Implications, limitations, and suggestions for future research based upon these findings are offered.     

The development and initial validation of the narrative foreclosure scale

Objectives: As people grow older, identity development in later life becomes a more and more relevant topic. Studying processes that hinder or promote identity development in later life is of importance. Within this broader field, there has been a growing interest in narrative foreclosure. Our goal was to develop a short, reliable and easy–to-use instrument measuring narrative foreclosure and to validate this instrument in two samples.Methods: The narrative foreclosure scale (NFS) was validated in two studies with a sample of middle-aged adults (n = 319) and a sample with older adults (n = 174). Several analyses were conducted to assess the psychometric properties, the factor-structure and incremental validity of the scale.Results: Confirmatory factor analyses generally showed an acceptable fit of the two-factor (NF-Future and NF-Past) model to the data in both samples. Both factors of the NFS demonstrated adequate to good internal consistency, with alpha coefficients ranging from .79 for NF-Past in study 2 to .88 for NF-Future in study 1. Construct validity was good as shown by moderate to large correlations to related constructs. The scale adds a unique portion of explained variance to positive mental health, thereby showing the incremental validity of the NFS.Conclusion: A reliable scale is now available that allows to study the premature hindering of identity development in older populations. The use of the NFS as a process measure in studies on the effectiveness of interventions aiming at meaning making and identity development, such as life-review therapy and narrative therapy, is also recommended.     

Conceptualisation and validation of the "Emotional State Questionnaire (ESQ)": evaluation of an emotional profile

OBJECTIVES: The objective of this study is to evaluate the validity of a new self questionnaire: the "ESQ" (Emotional State Questionnaire). BACKGROUND: This novel instrument possesses a number of original attributes: first of all, it is designed to assess a general emotional profile, in opposition to other similar scales which can only be applied to the emotional reactions provoked by specific stimuli. Secondly, this scale is composed of several emotional dimensions. The ESQ has been constructed according to four components: recognition, expression, internal emotional experience and social context. The first three dimensions were selected because of their wide use through behavioral experiments. Indeed, contrary to most scales used in this field, which only assess the emotional experience, we wanted to propose an instrument also able to assess the subject's impression of his own capacities to encode and decode emotions. We hypothesized that these three dimensions could not be dissociated from a fourth dimension, the social context, which therefore also figures in this scale. The emotions explored were the five fundamental emotions indicated by Izard (fear, happiness, sadness, disgust and surprise) to which we added a neutral feeling that we considered as a basic emotion. STUDY DESIGN: To establish this instrument, a first conceptual phase was conducted by a group of experts. These experts all worked in the psychological field. They proposed the scale on the base of their clinical experience and after study of the literature. The scale was then validated in a population of 218 healthy volunteers, aged between 15 and 88 years. Subjects were not included if they presented depression (score above 16 in the Beck Depression Scale) or pathological anxiety (score above 5 in the Spieberger State Anxiety Inventory). The psychometric characteristics tested were: the item analysis, the item-dimension correlation, the factor analysis and the internal consistency reliability. RESULTS: The population studied was equally distributed according to gender (sex ratio: 0.97), the mean age was of 36.2 2 +/- 16.1 years. Acceptability was good with less than 5% of data missing. The analysis of items revealed no floor or ceiling effect and a low correlation between items. Item-dimension correlation ranged from 0.23 to 0.62, with most scores above 0.4. The items were always better correlated to their dimension than to other dimensions, except for one item. The 4 dimensions (recognition, expression, internal emotional experience and social context of emotions) explained 42% of the total variance. Finally, the scale showed good internal consistency with Cronbach coefficients, equal or above 0.84 for the total score, the recognition and the expression dimensions. This coefficient reached 0.77 for the feeling dimension but only 0.58 for the social context dimension. CONCLUSION: All together, results showed satisfactory characteristics in regard of the complexity of the notion measured. However, an important drawback is the lack of an external instrument to assess convergent validity. This instrument can be of great interest in the emotional characterization of healthy volunteers. More-over, if validated in psychiatric populations, this scale could be most useful in psychopathological assessment and also in comparison with behavioral evaluations of emotion.     

Concurrent validity of the Neurobehavioural Assessment for Pre-term Infants (NAPI) at term age

Background: Accurate measurement of neonatal neurological integrity is critical for early identification of pre-term and full-term infants at-risk for developmental disability. The Neurobehavioural Assessment for Pre-term Infants (NAPI) was developed to measure the progression of neurobehavioural development in pre-term infants born between 32 weeks post-conceptional age (PCA) and term. This instrument has many unique advantages; however, criterion validity is unknown and results are subsequently difficult to interpret. Objectives: This study examined the concurrent validity of the NAPI against a criterion instrument, the Einstein Neonatal Neurobehavioural Assessment Scale (ENNAS), which measures similar constructs and has demonstrated excellent reliability and validity. Methods: A sample of 41 pre-term and full-term infants (40?±?2 weeks) was assessed with the NAPI and ENNAS on the same day. Results: The findings demonstrated that correlations between similar NAPI clusters and ENNAS clusters ranged from 0.35–0.65 and correlations between many similar individual NAPI and ENNAS items ranged from 0.40–0.60. Two NAPI clusters also discriminated between normal, abnormal and suspect performance on the ENNAS. Conclusion: The NAPI has many unique advantages as a tool. It examines neonates serially, has established weekly normative data and requires minimal infant handling. This study provides new validation of the NAPI instrument.     

Validation of the Chinese-version MPSS-R for occupational stress among emergency nurses.

The aim of this study was to examine the reliability and validity of a Chinese-version stress instrument among emergency nurses. The study sample comprised of 113 nurses whose age ranged from 21 to 47 years old. The Chinese version of Medical Personnel Stress Survey (MPSS-R) was answered in 1996 through self-administered questionnaires. The instrument demonstrated excellent convergent and discriminant validity. Cronbach's alpha (reliability) coefficients ranged from.57 to.77. Factorial analysis yielded four principal components, corresponding to job dissatisfaction, team relationship, organization support, and somatic distress. Validation by independent variable was also consistent with theory. Thus, the Chinese-version MPSS-R retained excellent psychometric properties when used in an emergency nurses group.     

Clinimetric evaluation of a Satisfaction-with-Stroke-Care questionnaire

There is a lack of sound instruments for measuring patient satisfaction with stroke care. One self-report instrument comprising two subscales, satisfaction with inpatient care and satisfaction with care after discharge, has been validated, but only in the United Kingdom. In later studies, items have been added without further validation. Therefore, we tested this extended questionnaire (Satisfaction with Stroke Care questionnaire; SASC-19) for feasibility, reliability (homogeneity and test-retest agreement), and construct validity (convergent and divergent validity and factor analysis) in the Netherlands in 166 prospectively collected stroke patients living at home 6 months after discharge. To determine the test-retest reliability, 51 patients completed the SASC-19 again two weeks after they first completed it. The response rate was 90 %; the mean time needed to complete the SASC-19 was less than 10 minutes. Six items were omitted by more than 10 % of the patients. Both subscales showed good homogeneity and almost perfect test-retest reliability (Cronbach's α's > 0.80; Intraclass Correlation Coefficients > 0.80). The correlations with the General Satisfaction questionnaire (convergent validity) ranged between 0.33 and 0.55; those with the Barthel Index, the Hospital Anxiety and Depression Scale (HADS), and the Short Form 36 (SF-36) health survey questionnaire (divergent validity) ranged between 0.12 and 0.47. Factor analysis showed a total explained variance of 49 %, which supports the subscale structure. We conclude that the SASC-19 is a reliable and valid instrument for measuring patient satisfaction with stroke care and it is easy to complete. The feasibility in terms of missing values is moderate. Received: 29 July 2002, Received in revised form: 6 November 2002, Accepted: 21 November 2002     

Development of the Quality of Life in Epilepsy Inventory for Adolescents: The QOLIE-AD-48

PURPOSE: We report the development of an instrument to assess health-related quality of life (HRQOL) in adolescents with epilepsy. METHODS: A sample of 197 English-speaking adolescents (aged 11-17 years) with epilepsy completed a test questionnaire of 88 items. Also included were mastery and self-esteem scales to assess external validity. A parent simultaneously completed an 11-item questionnaire to evaluate the child's HRQOL. Both adolescent and parent questionnaires were repeated in 2-4 weeks. Demographic information and information pertaining to seizures were collected at baseline along with assessment of systemic and neurologic toxicity. RESULTS: The QOLIE-AD-48 contains 48 items in eight subscales: epilepsy impact (12 items), memory/concentration (10), attitudes toward epilepsy (four), physical functioning (five), stigma (six), social support (four), school behavior (four), health perceptions (three), and a total summary score, with higher scores indicating better HRQOL. Internal construct validity was demonstrated in a single-factor solution for the eight dimensions. All correlations were statistically significant at p < 0.05 level. Internal consistency reliability estimated by Cronbach's alpha coefficient was 0.74 for the summary score and ranged from a low of 0.52 (three-item Health Perceptions Scale) to 0.73-0.94 for the other individual scales. Good test-retest reliability was found for the overall measure (0.83). Summary score correlations with the two external validity scales, self-efficacy and self-esteem were 0.65 and 0.54, respectively. Statistically significant differences in summary scores indicating that HRQOL was increasingly better for adolescents as seizure severity decreases (no seizures = 77+/-13, low = 70+/-17, high = 63+/-17) were found among seizure-severity groups. CONCLUSIONS: These data describe the development of a robust instrument to evaluate HRQOL in adolescents with epilepsy. Empiric analyses provide strong evidence that the QOLIE-AD-48 is both a reliable and valid measure for adolescents with epilepsy.     

A study of the reliability and validity of the Chinese version of the Dementia Rating Scale

BACKGROUND: The present study aims to develop and validate a Chinese version of the Dementia Rating Scale (DRS) for use with Chinese populations in psychogeriatric settings. METHODS: The DRS was translated into Chinese and its content validity was evaluated by an 11-member expert panel. To assess reliability and concurrent validity, 52 subjects with dementia were recruited from medical and psychogeriatric settings using purposive sampling. RESULTS: With percentage of agreement as an indicator, 28 out of 36 items (78%) had satisfactory content validity. Items with a percentage of agreement below 70% were reviewed and modified, based on the comments of the experts. The CDRS had excellent test-retest and inter-rater reliability, with intraclass correlation coefficient (ICC) at 0.94 and 0.93 respectively. Intraclass correlation coefficients ranged between 0.75 and 0.89 for the subscales. The internal consistency of the CDRS subscale, as measured by Cronbach's a, ranged from 0.57 to 0.82. The CDRS had high correlations with the Chinese Mini-mental State Examination (r = 0.80 for total score, r = 0.58 to 0.84 for subscales. CONCLUSIONS: The CDRS is a valid instrument for the assessment of dementia in Chinese-speaking subjects.     

Development of the Quality of Life in Epilepsy Inventory

Summary: We developed an instrument to measure health-related quality of life (HRQOL) in epilepsy. A 99-item inventory was constructed from the RAND 36-Item Health Survey (generic core), with 9 additional generic items, 48 epilepsy-targeted items, and 6 other items concerning attitudes toward epilepsy and self-esteem. We administered the 99-item inventory to 304 adults with epilepsy at 25 epilepsy centers. Patients and patient-designated proxies completed the inventory and were retested 1–91 days later. A multitrait scaling analysis of these data led to retention of 86 items distributed in 17 multiitem scales (Cronbach's alpha ranged from 0.78 to 0.92). Factor analysis of the 17 multiitem scales yielded four underlying dimensions of health: an epilepsy-targeted dimension, a cognitive factor, mental health, and physical health. Construct validity was supported by significant patient-proxy correlations for all scales and correlations between neuropsychologic tests and self-reported emotional and cognitive function (all p values < 0.05). There were significant negative correlations between the four factor scores derived from the HRQOL scales and neurotoxicity, systemic toxicity, and health care utilization (except for the correlation between mental health factor and health care utilization; all p values < 0.05). Patients who were seizure-free in the preceding year reported better HRQOL for the overall score, three of the four factor scores, and 8 of the 17 scale scores than did patients with a high frequency of seizures. Relative validity analysis showed that the epilepsy-targeted factor and three of its four component scales were more sensitive to categorization of patients by severity of seizure frequency and type than scales tapping physical health, mental health, or cognitive function. These cross-sectional data support the reliability and validity of this measure of HRQOL in epilepsy. The addition of an epilepsy-targeted supplement to the generic core improved the sensitivity to severity of epilepsy. The 86 items included in the field testing were supplemented by three additional items to form the Quality of Life in Epilepsy (QOLIE-89) inventory.     

Reliability and validity of the Canadian Neurological Scale in retrospective assessment of initial stroke severity

BACKGROUND: Stroke severity is an important determinant of outcome, however, quantitative data on the initial neurological status might be lacking in retrospective studies. We wanted to assess the reliability and validity of the retrospective use of the Canadian Neurological Scale (CNS). METHODS: In 181 patients with validated stroke, two raters scored the CNS based on medical record review. We assessed interrater reliability and construct validity of the CNS. Predictive validity was assessed by the ability of the CNS to predict 30-day and 1-year mortality. RESULTS: Interrater reliability was high (kappa or weighted kappa 0.76-0.96). Correlations between similar items of prospective Scandinavian Stroke Scale scores and retrospective CNS scores ranged from 0.54 to 0.85. CNS total score was a strong predictor of death within 30 days and 1 year in multivariate models. CONCLUSIONS: The retrospective algorithm for the CNS had a high to substantial interrater reliability and predictive validity. Accordingly, in retrospective stroke studies using medical record information, the CNS can be a feasible instrument to adjust for differences in stroke severity.     

The Need of Support and Service Questionnaire (NSSQ): a brief scale to assess needs in clients with long-term mental disabilities

We present the Need of Support and Service Questionnaire (NSSQ), a new instrument developed to provide professionals in psychiatric care and community social services with a tool to assess needs of support and service in mentally disabled clients. The final version of the instrument was designed after comments from professionals in psychiatric care, community social services, and the clients and their relatives. A reliability study (test-retest, n=77), inter-rater (n=69) and a validity study (n=529) were performed. In the validity study, comparisons were done with the Camberwell Assessment of Need (CAN) scale, the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS). The test-retest and inter-rater reliability were 0.86 and 0.76, respectively. The percentage of agreement on the individual items ranged from 83.1% to 100.0% (test-retest) and 76.8% to 100.0% (inter-rater reliability). The corresponding kappa coefficients ranged from 0.63 to 1.00 (test-retest) and 0.33 to 1.00 (inter-rater reliability). The comparison between NSSQ and CAN items demonstrated high sensitivity and specificity as well as satisfactory likelihood ratios (LRs). The correlations between GAF and SOFAS scores and the number of needs of support, number of needs of service and the total number of needs of support and service were -0.49, -0.32 and -0.47, and -0.48, -0.26 and -0.45, respectively. All correlations were statistically significant (P<0.01). The results demonstrated that the psychometric characteristics of the NSSQ were satisfactory. Moreover, professionals without any formal training easily used it.     

Measuring fatigue severity in primary care patients

Objective: We developed a new instrument to measure fatigue that synthesized information from existing instruments. Methods: 35 candidate items and 4 formats for a new fatigue scale were obtained from 15 previously developed instruments. A new scale was developed using factor analysis on a data set of 409 primary care patients and validated on a sample of 816 additional subjects. Results: Different formats for obtaining information about a given fatigue item gave similar results. The new 11 item scale contained four subscales: cognitive, fatigue, energy and productivity. Correlations between the four subscales ranged from .49 to .66. Patients with a higher fatigue score were much more likely to have lower health status, greater depression and more somatic symptoms. Conclusion: This new instrument may be useful in primary care and epidemiological studies to screen and monitor patients for fatigue severity and type.     

Exploring the use of the Dementia Management Strategies Scale in caregivers of persons with dementia in Singapore

Background: Well-being in persons with dementia (PWD) depends much on the quality and type of care received. The Dementia Management Strategies Scale (DMSS) is a useful instrument to appraise care styles of caregivers. The present study expanded on previous research by refining and establishing the scale's content validity and psychometric properties in the Singapore context. Method: Five family caregivers and four dementia care professionals (nurse, occupational therapist, social worker and doctor) reviewed the DMSS for content validity. Two hundred and forty-six family caregivers completed questionnaires which assessed caregiver and patient characteristics, and dementia management strategies with DMSS. Internal consistency reliability was assessed and construct validity was evaluated through Pearson's correlation with extant instruments. Results: Eight items from the 28-item DMSS were omitted after content review as they were deemed inappropriate in our socio-cultural setting. A factor analysis with Varimax rotation confirmed a two-factor structure (positive and negative dimensions) for the revised DMSS (rDMSS). The two subscales showed good internal consistency (Cronbach's alpha .89 and .87). Moderate to strong correlations (.35–.53) with the scales, Zarit Burden Instrument, Revised Memory and Behavioural Problems Checklist, General Health Questionnaire, Short Sense of Competence Scale, Gains in Alzheimer's Care Instrument and Positive Aspects of Caregiving established convergent and divergent construct validity of rDMSS. Conclusion: The shortened 20-item rDMSS is a psychometrically valid instrument which can serve as a measure of dementia care strategy from the perspective of the caregiver in Singapore.     

Factor analyses of an Adult Epilepsy Self-Management Measurement Instrument (AESMMI)

The purpose of this study was to test the psychometric properties of an enhanced Adult Epilepsy Self-Management Measurement Instrument (AESMMI). An instrument of 113 items, covering 10 a priori self-management domains, was generated through a multiphase process, based on a review of the literature, validated epilepsy and other chronic condition self-management scales and expert input. Reliability and exploratory factor analyses were conducted on data collected from 422 adults with epilepsy. The instrument was reduced to 65 items, converging on 11 factors: Health-care Communication, Coping, Treatment Management, Seizure Tracking, Social Support, Seizure Response, Wellness, Medication Adherence, Safety, Stress Management, and Proactivity. Exploratory factors supported the construct validity for 6 a priori domains, albeit with significant changes in the retained items or in their scope and 3 new factors. One a priori domain was split in 2 subscales pertaining to treatment. The configuration of the 11 factors provides additional insight into epilepsy self-management behaviors. Internal consistency reliability of the 65-item instrument was high (α = .935). Correlations with independent measures of health status, quality of life, depression, seizure severity, and life impact of epilepsy further validated the instrument. This instrument shows potential for use in research and clinical settings and for assessing intervention outcomes and self-management behaviors in adults with epilepsy.