Translation to Brazilian Portuguese, cultural adaptation and psychometric properties of 8-item ArthritisSelf-Efficacy Scale (ASES-8)

ABSTRACT BACKGROUND: Self-efficacy refers to one’s belief in one’s ability to organize, perform actions and face challenges in order to achieve goals and motivation. High self-efficacy improves disease coping and adherence to treatment among patients with rheumatoid arthritis. The objective of this study was to translate, culturally adapt and test the reproducibility of the 8-item Arthritis Self-Efficacy Scale (ASES-8) questionnaire for use in Brazil. DESIGN AND SETTING: Validation study conducted in university outpatient clinics. METHODS: The questionnaire was translated into Brazilian Portuguese and then back-translated into English. The final version in Portuguese was tested on 30 patients with rheumatoid arthritis and was shown to be understandable and culturally adapted. A further 32 patients with rheumatoid arthritis were evaluated three times using the questionnaire. On the first occasion, two evaluators applied the questionnaire to check inter-evaluator reproducibility. After 15 days, one of the evaluators reassessed the patients to verify intra-evaluator reproducibility. At the first assessment, to test the construct validity of ASES-8, the Numerical Pain Scale, Health Assessment Questionnaire, Beck Depression Inventory and Short Form-36 questionnaire were also applied to all the patients. RESULTS: The inter and intra-evaluator correlation coefficients for ASES-8 were high. Cronbach’s alpha was higher than 0.90 for the questionnaire, indicating excellent internal consistency. There were moderate correlations between ASES-8 and most of the instruments tested, indicating good construct validity. CONCLUSION: ASES-8 was translated and adapted to the Portuguese language for Brazil. This instrument is valid, reproducible and reliable for evaluating self-efficacy among patients with rheumatoid arthritis.

研究背景：自我效能感（self-efficacy）指个体为达成目标、获取动力，对自身组织行动、执行行为及应对挑战的能力所持有的信念。对于类风湿关节炎患者而言，较高的自我效能感有助于提升其疾病应对能力与治疗依从性。本研究旨在针对巴西人群，对8条目关节炎自我效能量表（Arthritis Self-Efficacy Scale, ASES-8）进行翻译、文化调适，并检验其重测信度。研究设计与研究场所：本研究为在大学附属门诊开展的验证性研究。研究方法：该量表先被译为巴西葡萄牙语，随后又被回译为英语。最终确定的葡萄牙语版本在30名类风湿关节炎患者中进行了预测试，结果显示该版本易于理解且完成了文化调适。另有32名类风湿关节炎患者接受了三次该量表的评估。首次评估时，由两名评估者分别施测该量表，以检验评定者间信度；15天后，其中一名评估者对患者进行再次评估，以检验评定者内信度。首次评估时，为检验ASES-8的结构效度，研究团队同时对所有患者施测了数字疼痛评分量表（Numerical Pain Scale）、健康评估问卷（Health Assessment Questionnaire）、贝克抑郁量表（Beck Depression Inventory）以及简明健康调查问卷36（Short Form-36, SF-36）。研究结果：ASES-8的评定者间与评定者内相关系数均较高。该量表的克朗巴赫α系数高于0.90，提示其内部一致性极佳。ASES-8与大部分施测量表间存在中等程度相关，提示其具有良好的结构效度。研究结论：本研究已完成针对巴西人群的葡萄牙语版ASES-8的翻译与文化调适。该量表可有效评估类风湿关节炎患者的自我效能感，且具有良好的效度、重测信度与内部一致性。