Psychometric properties of the client activation self-efficacy and outcome expectation scales for nurses (CA-SE-n and CA-OE-n) and domestic support workers (CA-SE-d and CA-OE-d): A cross-sectional study

Silke F. Metzelthin*, Anne Classen, G. A. Rixt Zijlstra, Erik van Rossum, Janneke M. de Man-van Ginkel, Teuni H. Rooijackers, Gertrudis I. J. M. Kempen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Self-efficacy and outcome expectations regarding client activation determine professionals' level of actively engaging clients during daily activities. The Client Activation Self-Efficacy and Outcome Expectation Scales for nurses and domestic support workers (DSWs) were developed to measure these concepts. This study aimed to assess their psychometric properties. Cross-sectional data from a sample of Dutch nurses (n=150) and DSWs (n=155) were analysed. Descriptive statistics were used to examine floor and ceiling effects. Con-struct validity was assessed by testing research-based hypotheses. Internal consistency was determined with Cronbach's alpha. The scales for nurses showed a ceiling effect. There were no floor or ceiling effects in the scales for domestic support workers. Three out of five hypotheses could be confirmed (construct validity). For all scales, Cronbach's alpha coefficients exceeded 0.70. In conclusion, all scales had moderate construct validity and high internal consistency. Further research is needed concerning their construct validity, test-retest reliability and sensitivity to change.

(c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (

Original languageEnglish
Pages (from-to)309-316
Number of pages8
JournalGeriatric Nursing
Issue number2
Publication statusPublished - 2021


  • Function focused care
  • Reablement
  • Self-efficacy
  • Outcome expectations
  • Validation

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