“If you were asked to lift objects of different weights right now‚ how confident are you that you can lift each of the weights described?
Administrator: read the words How confident are you that you can . . .” before each item
PHYSICAL STRENGTH
1.    Lift a 10-pound object
2.    Lift a 20-pound object
3.    Lift a 50-pound object
4.    Lift a 100-pound object
How confident are you that you can do the following activities? (If necessary say‚ “If this is absolutely not applicable to your situation‚ let me know.” Then put N/A). Read How confident are you that you . . .” in every item; place this phrase just before the word “can” in the item. (Display Card #1)
Self- Efficacy for Obtaining Respite
1.    . . . Can ask a friend/family member to stay with ____ when you need to see the doctor yourself?
2.    . . . Can ask a friend/family member to stay with ____ for a day when you have errands to be done?
3.    . . .Can ask a friend or family member to do errands for you?
4.    . . .Can ask a friend/family member to stay with ____ for the day when you feel the need for a break?
5.    . . .Can ask a friend/family member to stay with ____ for a week when you need the time for yourself?
Self-Efficacy for Responding to Disruptive Patient Behaviors
6.    When ____ forgets your daily routine and asks when lunch is right after you eaten . . . can you answer him/her without raising your voice? (clarify that “answer” can be direct or a distraction.)
7.    When you get angry because ____ repeats the same question over and over . . . can you say things to yourself that calm you down?
8.    When ____ complains to you about how you are treating him/her . . . can you respond without arguing back?
9.    When ____ asks you 4 times in the first one hour after lunch when lunch is . . . can you answer him/her without raising your voice?
10.When ____ interrupts you for the fourth time while you are making dinner . . . can you respond without raising your voice?
(Administrator: When caregivers state that they have absolutely never had the thoughts in one of the items‚ put “N/A” (not applicable) on the line for rating confidence. Begin each item with the phase‚ How confident are you that you can control . . .” Display Card # 1.)
Self- Efficacy for Controlling Upsetting Thoughts about Caregiving
11.. . .Thinking about unpleasant aspects about taking care of ___?
12.. . .Thinking how unfair it is that you have to put up with this situation (taking care of ) ____?
13.. . .Thinking about what a good life you had before____ ’s illness and how much you’ve lost?
14.. . .Thinking about what you are missing or giving up because of ____?
15.. . .Worrying about future problems that might come up with ____?
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Self-efficacy for obtaining respite‚ responding to disruptive patient behaviors‚ and controlling upsetting thoughts about caregiving
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Rate your degree of confidence from 0 to 100 using the scale given below:
0= Cannot do at all to 100 = Certain can do
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Steffen‚ A. M.‚ McKibbin‚ C.‚ Zeiss‚ A. M.‚ Gallagher-Thompson‚ D.‚ & Bandura‚ A. (2002). The revised scale for care giving self-efficacy: reliability and validity studies. Journal of Gerontology: Psychological Sciences‚ 57(1)‚ 74–86.
Gilliam‚ C.M.‚ & Steffen‚ A. M. (20024). The relationship between caregiving self-efficacy and depressive symptoms in dementia family caregivers. Aging & Mental Health‚ 10(2)‚ 79–86.
Steffen et al.‚ (2002). The Revised Scale for Care Giving Self-Efficacy. In: Simmons C. A.‚ Lehmann P. (eds). Tools for strengths-based assessment and evaluation‚ New York‚ NY: Springer‚ pp. 316-319. (2013). Google Scholar