Self-Efficacy The Sherer and Adams Self-Efficacy Scale was included to assess self-efficacy. The Self-Efficacy Scale comprises 23 items scored on a 5-point scale measuring expectation of personal ability to initiate and persist in behavior. Of its various scales, we selected the General Self-Efficacy Scale which has demonstrated reliability and validity.Scores range from 23 to 115, with higher scores indicating greater self-efficacy.