Background: Appropriate evaluation is important to optimize health care interventions and to understand patient’s experiences of their situation. Self-efficacy has been proven to have impact on pain, fatigue, physical activity and on cardiovascular risk in patients with inflammatory arthritides, and adequate evaluation is important. The arthritis self-efficacy scale (ASES) is one patient reported outcome measure recommended for evaluation of self-efficacy in arthritides. The aim of this study was to start analyzing the content validity of the ASES through linking to the International Classification of Functioning (ICF), and by using the proposed structure for personal factors (PF).
Material and methods: The linking to the ICF was performed through identification of each meaningful concept of heading, introduction and all question including answering options of the ASES subscales for pain and symptoms. Each identified meaningful concept was linked to the third level ICF domain, according to established linking rules. Concepts identified as potential personal factors were sorted into the proposed structure of personal factors (Geyh, 2011) when applicable. The two authors independently identified meaningful concepts and performed the linking to the ICF, and sorted into the structure of personal factors (PF). Disagreements were discussed thoroughly, and reviewed until consensus was reached.
Results: The ASES subscales for pain and symptom comprised 5 and 6 questions respectively. All questions were linked to the ICF domain body functions, at a minimum through each answering option that was linked to the b126 “temperament and personality functions”. Other body function domains covered were b130 (energy and drive functions), b134 (sleep functions), b152 (emotional functions), b160 (thought functions) and b280 (pain).
Seven questions and the introduction of the ASES subscales for pain and symptom were linked to the ICF domain activity and participation (3 and 4 questions respectively). Five questions were linked to d570 (looking after one’s health), while d220 (undertaking multiple tasks) and d230 (carrying out daily routine) were captured by both subscales although somewhat less well represented.
Three questions were linked to the ICF domain environmental factors. Two ASES pain questions were linked to e110 (products and substances for personal consumption) while one ASES symptom question was linked to e425 (individual attitudes of acquaintances, peers, colleagues, neighbors and community members).
Personal factors were identified in both ASES subscales. The answering options for all questions except two could be sorted into the PF concept “feelings”, the headings, introductions and six questions could be sorted into the PF concept “patterns of experience and behavior”, and three questions could be sorted into “thoughts and beliefs”.
Conclusion: The ASES subscales for pain and symptom showed satisfying content validity since important constructs on all ICF domains (except for body structure) were included. Both ASES subscales also covered PF that contribute with important aspects on health, and impact of the disease, further improving the content validity.
Stockholm: Svensk reumatologisk förening , 2017. no 119; 4, p. 59-60, article id 93