scholarly journals German Translation, Cultural Adaption and Validation of the Unidimensional Self-efficacy Scale for Multiple Sclerosis Using Rasch Analysis

2020 ◽  
Author(s):  
Barbara Seebacher ◽  
Roger Mills ◽  
Markus Reindl ◽  
Laura Zamarian ◽  
Simone Kircher ◽  
...  

Abstract Background Self-efficacy refers to people’s beliefs in their ability to perform relevant activities to achieve personal goals. In people with multiple sclerosis (PwMS), self-efficacy has been shown to significantly impact health-related behaviour. So far, a validated German language self-efficacy scale for PwMS is missing. Therefore, the aims his study were to translate the Unidimensional Self-Efficacy Scale for Multiple Sclerosis (USE-MS) into German, establish face and content validity and cultural adaption of the German version for PwMS in Austria. Further aims were to validate the German USE-MS (USE-MS-G) in PwMS using Rasch analysis. Methods Formal permission to translate and validate the USE-MS was received from the scale developers. Following guidelines for translation and validation of questionnaires and applying Bandura’s concept of self-efficacy, the USE-MS was forward-backward translated, and content and face validity established. Cultural adaption for Austria was performed using cognitive interviews of 30 PwMS. The validation by Rasch analysis, of the final USE-MS-G involved 309 PwMS with minimal to severe disability using scales for resilience, general self-efficacy, anxiety and depression, MS fatigue and health-related quality of life. Re-test was conducted within 14–21 days after the initial test. Data were also pooled with an historic English dataset. Results Using a bi-factor solution, excellent external and construct validity, internal consistency, person separation reliability, test-retest reliability and fit to the Rasch model was demonstrated. The USE-MS-G was shown to be unidimensional, well-targeted and free from differential item functioning. Pooling of the English and German datasets confirmed equivalence of the two language versions. Conclusion The USE-MS-G is a robust, valid and reliable scale to assess self-efficacy in PwMS. Rasch model fit given, an interval scale transformation table is available for clinical settings and research. Trial registration: ISRCTN Registry; ISRCTN14843579; prospectively registered on 02. 01. 2019; http://www.isrctn.com/ISRCTN14843579

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029565
Author(s):  
Barbara Seebacher ◽  
Roger J Mills ◽  
Markus Reindl ◽  
Laura Zamarian ◽  
Raija Kuisma ◽  
...  

IntroductionSelf-efficacy refers to individuals’ confidence in their ability to perform relevant tasks to accomplish desired goals. This is independent of their actual abilities. In people with multiple sclerosis (MS), self-efficacy has been shown to powerfully influence motivation and health-related behaviour, such as adherence to prescribed treatment or physical activity. So far, a rigorously tested German language self-efficacy questionnaire for people with MS is missing.MethodsThe purpose of this study is to translate the original Unidimensional Self-Efficacy Scale for Multiple Sclerosis (USE-MS) into German and to validate the German USE-MS (USE-MS-G). Based on Bandura’s concept of self-efficacy and international guidelines for questionnaire development, the patient-led development of the pre-final German version will involve a forward–backward translation process, synthesis of translations, expert committee review and consensus with the original test developers. At two centres in Tyrol, Austria, content and face validity and cultural adaption for Austria will be established using face-to-face semistructured cognitive interviews of 30 people with MS (PwMS). A further 292 PwMS with minimal to severe disability will be tested at two timepoints to validate the USE-MS-G.ResultsMixed methods analyses will be applied. Interviews will be transcribed and analysed employing qualitative content analysis. External validity will be explored using Spearman’s Rank correlation coefficients of the USE-MS-G with the 13-item Resilience Scale, General Self-Efficacy Scale, Multiple Sclerosis International Quality of Life questionnaire, Hospital Anxiety and Depression Scale and MS-specific Neurological Fatigue Index. Test–retest reliability, internal consistency and floor and ceiling effects will be evaluated. Internal validity will be examined using Rasch analysis.Ethics and disseminationEthical approval was received from the Ethics Committee of the Medical University of Innsbruck, Austria (reference number EK1260/2018; 13.12.2018). Results from this study will be disseminated to the participants and MS Societies, and to clinicians and researchers through peer-reviewed publications and conferences.Study registrationISRCTN Registry; trial ID ISRCTN14843579; prospectively registered on 02. 01. 2019; http://www.isrctn.com/ISRCTN14843579


2020 ◽  
pp. 135245852091397 ◽  
Author(s):  
Gelareh Sadigh ◽  
Neil Lava ◽  
Jeffrey Switchenko ◽  
Richard Duszak ◽  
Elizabeth A Krupinski ◽  
...  

Background: Multiple sclerosis (MS) results in considerable financial burdens due to expensive treatment and high rates of disability, which could both impact care non-adherence. Objective: To measure financial toxicity in MS patients, identify its predictors and association with care non-adherence. Methods: Adult MS patients visiting neurology clinic (June 2018 to February 2019) were consented to complete a survey. Financial toxicity was measured using Comprehensive Score for Financial Toxicity (COST) (range: 0–44, the lower the score, the worse the financial toxicity). Independent predictors of financial toxicity were identified using linear regression. Associations of COST score with patient outcomes were assessed. Results: The mean COST score in 243 recruited patients was 17.4 ± 10.2. In response to financial burdens, 66.7% and 34.7% reported life-style altering behaviors or care non-adherence, respectively. Higher financial self-efficacy was associated with less financial toxicity (coefficient, 1.33 (95% confidence interval (CI), 1.02–1.64); p < 0.001). At least one relapse in the last 3 months was associated with greater financial toxicity (coefficient, −3.34 (95% CI, −6.66 to −0.01); p = 0.049). Greater financial toxicity correlated with life-style-altering coping strategy use ( p < 0.001), care non-adherence ( p = 0.001), and worse health-related quality of life (HRQOL) ( p = 0.03). Conclusion: MS patients with lower financial self-efficacy and prior relapse history are at higher risk for financial toxicity, with associated care non-adherence and lower HRQOL.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jennifer Fortune ◽  
Meriel Norris ◽  
Andrea Stennett ◽  
Cherry Kilbride ◽  
Grace Lavelle ◽  
...  

AbstractHigh levels of sedentary behaviour are associated with poor health outcomes in people with multiple sclerosis (MS). Identifying modifiable correlates of sedentary behaviour for people with MS is essential to design effective intervention strategies to minimise sedentary time. This study aimed to quantify patterns and identify correlates of sedentary behaviour among adults with MS. Fatigue, self-efficacy, walking capability, the physical and psychological impact of MS, health-related quality of life, and participation and autonomy were assessed by questionnaire. Participants wore an activPAL monitor. Total (min/day), prolonged bouts (≥ 30 min) and breaks in sedentary time were calculated. Associations were examined using regression analysis adjusted for demographic and clinical confounders. Fifty-six adults with MS participated (mean ± SD age: 57.0 ± 9.25 years; 66% female). Self-efficacy for control over MS was associated with sedentary time (β = 0.16, 95% CI 0.01, 0.30). Self-efficacy in function maintenance (β = 0.02, 95% CI 0.00, 0.04), health-related quality of life (EuroQol-5D) (β = 31.60, 95% CI 7.25, 55.96), and the autonomy indoors subscale of the Impact on Participation and Autonomy Questionnaire (β = − 5.11, 95% CI − 9.74, − 0.485) were associated with breaks in sedentary time. Future studies should consider self-efficacy, health-related quality of life and participation and autonomy as potential components of interventions to reduce sedentary behaviour.


2019 ◽  
Vol 31 (1) ◽  
pp. 40 ◽  
Author(s):  
Fevronia Adamopoulou ◽  
Victoria Alikari ◽  
Sofia Zyga ◽  
Maria Tsironi ◽  
Fotini Tzavella ◽  
...  

2019 ◽  
Vol 9 (12) ◽  
pp. 121 ◽  
Author(s):  
Marco Guicciardi ◽  
Maria Carta ◽  
Massimiliano Pau ◽  
Eleonora Cocco

Regular physical activity (PA) can enhance the physical and mental health of people with Multiple Sclerosis (MS) because of its impact on muscular strength, mobility, balance, walking, fatigue, pain and health-related quality of life (HRQoL). Previous studies have hypothesized that the relationship between PA and HRQoL is mediated by self-efficacy. The aim of this research is to evaluate whether self-efficacy in goal setting and self-efficacy in the management of symptoms, mediate the relationship between PA and HRQoL, in a similar way to exercise self-efficacy. A sample of 28 participants with MS (18 females) and different levels of physical activity have been recruited and completed the following measures: (a) physical activity (GLTEQ); (b) health-related quality of life (SF-12); (c) self-efficacy in the management of Multiple Sclerosis (SEMS) and, (d) exercise self-efficacy (EXSE). The statistical analysis highlighted that self-efficacy in goal setting mediated the relationship between PA and mental health better than exercise self-efficacy. Our findings suggest that self-efficacy in goal setting can contribute to the adoption and maintenance of regular physical activity for long-lasting times, supporting and increasing the mental quality of life of people suffering from MS.


Author(s):  
Joanna Dymecka ◽  
Rafał Gerymski ◽  
Rafał Tataruch ◽  
Mariola Bidzan

Multiple sclerosis (MS) is a chronic progressive demyelinating disease of the central nervous system that leads to permanent disability and many neurological symptoms, making everyday functioning difficult. The predictors of the acceptance of illness and the health-related quality of life in people with MS include the degree of disability, neurological symptoms and psychosocial factors, such as personal resources. The aim of our study is to determine the relationships among disability, fatigue, self-efficacy, acceptance of illness and quality of life. The study group consisted of 137 people diagnosed with multiple sclerosis—73 women and 64 men. EDSS, GNDS, LSES, AIS and MSIS-29 were used in the present study. The results show that all tested variables were significantly correlated with each other. Disability and fatigue were significant predictors of both the physical and psychological aspects of patients’ quality of life. Self-efficacy was a significant predictor of both the acceptance of illness and the psychological aspect of patients’ quality of life. Based on the current research study, it can be concluded that factors of a biomedical nature explain other aspects of struggling with the disease, rather than psychological resources.


2018 ◽  
Vol 34 (5) ◽  
pp. 352-360 ◽  
Author(s):  
Silvia Bonino ◽  
Federica Graziano ◽  
Martina Borghi ◽  
Davide Marengo ◽  
Giorgia Molinengo ◽  
...  

Abstract. This research developed a new scale to evaluate Self-Efficacy in Multiple Sclerosis (SEMS). The aim of this study was to investigate dimensionality, item functioning, measurement invariance, and concurrent validity of the SEMS scale. Data were collected from 203 multiple sclerosis (MS) patients (mean age, 39.5 years; 66% women; 95% having a relapsing remitting form of MS). Fifteen items of the SEMS scale were submitted to patients along with measures of psychological well-being, sense of coherence, depression, and coping strategies. Data underwent Rasch analysis and correlation analysis. Rasch analysis indicates the SEMS as a multidimensional construct characterized by two correlated dimensions: goal setting and symptom management, with satisfactory reliability coefficients. Overall, the 15 items reported acceptable fit statistics; the scale demonstrated measurement invariance (with respect to gender and disease duration) and good concurrent validity (positive correlations with psychological well-being, sense of coherence, and coping strategies and negative correlations with depression). Preliminary evidence suggests that SEMS is a psychometrically sound measure to evaluate perceived self-efficacy of MS patients with moderate disability, and it would be a valuable instrument for both research and clinical applications.


2021 ◽  
pp. 1-6
Author(s):  
Cihat Uzunköprü ◽  
Yesim Beckmann ◽  
Sabiha Türe

<b><i>Introduction:</i></b> The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life. <b><i>Methods:</i></b> We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years. <b><i>Results:</i></b> One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (<i>p</i> &#x3c; 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (<i>p</i> &#x3c; 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (<i>p</i> &#x3c; 0.001). No serious adverse events occurred. <b><i>Conclusion:</i></b> In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.


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