• Mohd Nazir Mohd Nazori School of Health Sciences, Universiti Sains Malaysia
  • Rohani Ismail School of Health Sciences, Universiti Sains Malaysia
  • Nur Syahmina Rasudin School of Health Sciences, Universiti Sains Malaysia
  • Rosminah Mohamed School of Health Sciences, Universiti Sains Malaysia
  • Norhayati Mohd Noor School of Medical Sciences, Universiti Sains Malaysia
  • Zailiza Sulli Hulu Langat Health District Office, Kementerian Kesihatan Malaysia
  • Noor Azliah Ahmad Zainuri Petaling Health District Office, Kementerian Kesihatan Malaysia
  • Masitah Mohamed Klang Health District Office, Kementerian Kesihatan Malaysia
  • Ashvini Jayapalan Gombak Health District Office, Kementerian Kesihatan Malaysia



Health self-efficacy, health assertiveness, questionnaire validation, health efficacy and assertiveness scale, structural equation modelling


Modern medical practice emphasises mutual decision-making between healthcare professionals and patients. This pre-requisites health self-efficacy and health assertiveness in patients. However, lack of general health self-efficacy and health assertiveness measure limits research in the local setting. This study aimed to translate and validate Health Efficacy and Assertiveness Scale (HEAS) into Malay language. Malay version of HEAS was obtained through back-to-back translation process. This was tested for factorial validity via exploratory (EFA) and confirmatory factor analysis (CFA) using structural equation modelling. Reliability was established using Cronbach’s alpha. Five items measured health self-efficacy whereas eight items measured health assertiveness on two subdimensions (assert to be informed and assert opinion). Reliability index was 0.76 for health self-efficacy and 0.73 for health assertiveness. CFA on health efficacy measurement model reporting fit indices: ?2/df 1.28, comparative fit index (CFI) 0.96, Tucker-Lewis’s index (TLI) 0.94, and root mean-square error of approximation (RMSEA) was 0.07. CFA on health assertiveness revealed improved fit indices: ?2/df was 1.52, comparative fit index (CFI) 0.94, Tucker-Lewis’s index (TLI) 0.91, and root mean-square error of approximation (RMSEA) was 0.10. Thus, the Malay HEAS questionnaire established acceptable factorial validity and good reliability on Cronbach’s alpha. Universal nature of the items allowed use in different population and health scenarios.


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How to Cite

Mohd Nazir Mohd Nazori, Rohani Ismail, Nur Syahmina Rasudin, Rosminah Mohamed, Norhayati Mohd Noor, Zailiza Sulli, … Ashvini Jayapalan. (2022). HEALTH EFFICACY AND ASSERTIVENESS SCALE IN MALAY LANGUAGE: A VALIDATION STUDY. Malaysian Journal of Public Health Medicine, 22(1), 227–235.