Development of a Self-Efficacy Questionnaire for Walking in Patients with Mild Ischemic Stroke

J Stroke Cerebrovasc Dis. 2019 Feb;28(2):317-324. doi: 10.1016/j.jstrokecerebrovasdis.2018.09.055. Epub 2018 Oct 30.

Abstract

Purpose: This study aimed to develop a self-efficacy questionnaire, which particularly focuses on walking in patients with mild ischemic stroke and transient ischemic attack.

Methods: We enrolled patients with acute ischemic stroke and transient ischemic attack who scored 0-2 on the modified Rankin Scale. The process of development of questionnaire on self-efficacy for walking with 7 items (SEW-7) was composed of 3 steps: (1) item generation; (2) item reduction; and (3) testing the final version. The measurement properties were assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

Results: A total of 168 patients (mean age 69.4 ± 10.1 years) were enrolled for testing the questionnaire on SEW-7. The total score of the SEW-7 ranged from 7 to 35 points. Internal consistency was acceptable with the Cronbach's alpha coefficient of .93. Test-retest reliability was good with intraclass correlation coefficient of .83 (95% confidence interval: .67-.91). The smallest detectable changes at individual and group levels were 8.0 and 1.5, respectively. The results of principal component analysis showed a single factor explaining 71.8% of the total variance. The SEW-7 questionnaire showed moderate to strong correlation with physical activity parameters (step counts: r = .596, P < .001; physical activity-related energy expenditure: r = .615, P < .001; low-intensity physical activity: r = .449, P < .001; moderate- to vigorous-intensity physical activity: r = .581, P < .001).

Conclusions: We propose a simple self-report questionnaire for walking, with 7 items. The SEW-7 has adequate measurement properties and may serve as a time-saving tool for promoting physical activity in mild ischemic stroke patients.

Keywords: Self-efficacy; physical activity; rehabilitation; stroke; walking.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Brain Ischemia / diagnosis
  • Brain Ischemia / physiopathology
  • Brain Ischemia / psychology
  • Brain Ischemia / rehabilitation*
  • Exercise
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / physiopathology
  • Ischemic Attack, Transient / psychology
  • Ischemic Attack, Transient / rehabilitation*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Psychometrics
  • Reproducibility of Results
  • Self Efficacy*
  • Severity of Illness Index
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Surveys and Questionnaires*
  • Time Factors
  • Walking*