Cross Cultural Exploration of the Perceived Health Competence Scale


The eight-item Perceived Health Competence Scale (PHCS) is a measure of self-efficacy in general health management that is used to predict health outcomes and behaviors. The PHCS has been shown to be a reliable and valid instrument but has been used in primarily white European Americans. The PHCS is positively correlated to health status and coping abilities. Younger, healthier populations score higher on the PHCS compared to elderly who are managing chronic illness. This study examined the PHCS in three Midwestern samples: African American elders which revealed two separate factors in PHCS; Native Americans who evaluated the PHCS as a single construct; and a Spanish speaking sample. In the latter sample, findings suggest health competence may be a multi-dimensional construct. Further evaluation of the Spanish version of the PHCS and population characteristics are needed to measure health competence beliefs.

Share and Cite:

Polchert, M. (2015) Cross Cultural Exploration of the Perceived Health Competence Scale. Open Journal of Nursing, 5, 632-641. doi: 10.4236/ojn.2015.57067.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Carlson, E. and Chamberlain, R. (2003) Social Capital, Health, and Health Disparities. Journal of Nursing Scholarship, 35, 325-331.
[2] Flaskerud, J., Lesser, J., Dixon, E., Anderson, N., Conde, F., Kim, S., et al. (2002) Health Disparities among Vulnerable Populations: Evolution of Knowledge over Five Decades in Nursing Research Publications. Nursing Research, 51, 74-85.
[3] Gelberg, L., Andersen, R. and Leake, D. (2000) Healthcare Access and Utilization: The Behavioral Model for Vulnerable Populations: Application to Medical Care Use and Outcomes for Homeless People. Health Services Research, 34, 1273-1302.
[4] Smith, M., Wallston, K. and Smith, C. (1995) The Development and Validation of the Perceived Health Competence Scale. Health Education Research, 10, 51-64.
[5] Dempster, M. and Donnelly, M. (2008) Validity of the Perceived Health Competence Scale in a UK Primary Care Setting. Psychology, Health, and Medicine, 13, 123-127.
[6] Lee, S. and McCleary, K. (2012) The Relationship between Perceived Health, Health Attitude, and Healthy Offerings for Seniors at Family Restaurants. Cornell Hospital Quarterly, XX, 1-12.
[7] Rueda, B. and Perez-Garcia, A. (2006) A Prospective Study of the Effects of Psychological Resources and Depression in Essential Hypertension. Journal of Health Psychology, 11, 129-140.
[8] Lorig, K., Ritter, P. and Gonzalez, V. (2003) Hispanic Chronic Disease Self-Management: A Randomized Community-Based Outcome Trial. Nursing Research, 52, 361-369.
[9] Bandura, A. (1990) Conclusion: Reflections on Non-Ability Determinants of Competence. In Sternberg, R. and Kolligian, J., Eds., Competence Considered, Yale University Press, New Haven, 315-362.
[10] Zulkosky, K. (2009) Self-Efficacy: A Concept Analysis. Nursing Forum, 44, 93-102.
[11] Gonzalez-Calvo, J., Gonzalez, V.M. and Lorig, K. (1997) Cultural Diversity Issues in the Development of Valid and Reliable Measures of Health Status. Arthritis Care and Research, 10, 448-456.
[12] Condon, B.B. (2008) Feeling Misunderstood: A Concept Analysis. Nursing Forum, 43, 177-190.
[13] Aday, L. (2001) At Risk in America: The Health and Health Care Needs of Vulnerable Populations in the United States. 2nd Edition, Jossey-Bass, San Francis-co.
[14] Smedley, B., Stith, A. and Nelson, A. (2002) Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. The National Academies Press, Washington DC.
[15] Hartweg, D.L. and Isabelli-Garcia, C. (2007) Health Perceptions of Low-Income, Immigrant Spanish-Speaking Latinas in the United States. Hispanic Health Care International, 5, 53-63.
[16] Skaff, M.M., Mullan, J.T., Fisher, L. and Chesla, C.A. (2003) A Contextual Model of Control Beliefs, Behavior, and Health: Latino and European Americans with Type 2 Diabetes. Psychology and Health, 18, 295-312.
[17] Burns, N. and Grove, S. (2009) The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. 6th Edition, Saunders, St. Louis.
[18] Waltz, C., Strickland, O. and Lenz, E. (1991) Measurement in Nursing Research. 2nd Edition, F.A. Davis Company, Philadelphia.
[19] Agazio, J.G., Ephraim, P.M., Flaherty, N.B. and Gurney, C.A. (2002) Health Promotion in Active-Duty Military Women with Children. Women & Health, 35, 65-82.
[20] Arora, N.K., Johnson, P., Gustafson, D.H., McTavish, F., Hawkins, R.P. and Pingree, S. (2002) Barriers to Information Access, Perceived Health Competence, and Psychosocial Health Outcomes: Test of a Mediation Model in a Breast Cancer Sample. Patient Education and Counseling, 47, 37-46.
[21] Marks, G.R. and Lutgendorf, S.K. (1999) Perceived Health Competence and Personality Factors Differentially Predict Health Behaviors in Older Adults. Journal of Aging and Health, 11, 221-239.
[22] Salyer, J., Flattery, M.P., Joyner, P.L. and Elswick, R.K. (2003) Lifestyle and Quality of Life in Long-Term Cardiac Transplant Recipients. The Journal of Heart and Lung Transplantation, 22, 309-321.
[23] Hendrickson, S.G. (2003) Beyond Translation…Cultural Fit. Western Journal of Nursing Research, 25, 593-608.
[24] Buscemi, C. (2011) Acculturation: State of the Science in Nursing. Journal of Cultural Diversity, 18, 39-42.
[25] Purnell, L. (2013) Transcultural Health Care: A Culturally Competent Approach. 4th Edition, F. A. Davis, Philadelphia.
[26] Siatkowski, A.A. (2007) Hispanic Acculturation: A Concept Analysis. Journal of Transcultural Nursing, 18, 316-323.
[27] Red Cliff Band of Lake Superior Chippewa (2006) Official Home Page.
[28] Shortridge-Baggett, L. (2001) Self-Efficacy: Measurement and Intervention in Nursing. Scholarly Inquiry for Nursing Practice: An International Journal, 15, 183-188.
[29] Bonetti, D., Johnston, M., Rodriguez-Marin, J., Pastor, M., Martin-Aragon, M., Doherty, E. and Sheehan, K. (2001) Dimensions of Perceived Control: A Factor Analysis of Three Measures and Examination of Their Relation to Activity Level and Mood in a Student and Cross-Cultural Patient Sample. Psychology and Health, 16, 655-674.
[30] Boyer, A., Mira, M., Calatayud, N., Roig, S., Marin, J. and Bruehl, S. (2010) Control Beliefs, Coping, and Emotions: Exploring Relationships to Explain Fibromyalgia Health Outcomes. International Journal of Clinical and Health Psychology, 10, 450-476.
[31] Rasin, J. (1997) Measurement Issues with the Elderly. In: Frank-Stromborg, M. and Olsen, S., Eds., Instruments for Clinical Health-Care Research, 2nd Edition, Jones and Bartlett Publishers, Sudbury, 44-53.
[32] Weinrich, S., Boyd, M. and Powe, B. (1997) Tool Adaptation for Socioeconomically Disadvantaged Populations. In: Frank-Stromborg, M. and Olsen, S., Eds., Instruments for Clinical Health-Care Research, 2nd Edition, Jones and Bartlett Publishers, Sudbury, 20-28.
[33] Sinclair, V.G. (2001) Predictors of Pain Catastrophizing in Women with Rheumatoid Arthritis. Archives of Psychiatric Nursing, 15, 279-288.
[34] Flaskerud, J.H. and Nyamathi, A.M. (2000) Attaining Gender and Ethnic Diversity in Health Intervention Research: Cultural Responsiveness versus Resource Provision. Advances in Nursing Science, 22, 1-15.
[35] Pastor, M., Martin-Aragon, M., Lopez-Roig, S., Terol, M., Pons, N., Lledo, A., et al. (2009) The Perceived Health Competence Scale: Psychometric Properties in a Spanish Sample. Ansiedad y Estres, 15, 85-96.
[36] Holman, H. and Lorig, K. (1992) Perceived Self-Efficacy in Self-Management of Chronic Disease. In: Schwartzer, R., Ed., Self-Efficacy: Thought Control of Action, Hemisphere Publishing, Washington DC, 305-323.
[37] Shipley, S.D. (2010) Listening: A Concept Analysis. Nursing Forum, 45, 125-134.
[38] Armstrong, T.S. (2003) Symptoms Experience: A Concept Analysis. Oncology Nursing Forum, 30, 601-606.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.