Development and content validation of the Wheelchair Use Confidence Scale: a mixed-methods study

Area of Science:

• Rehabilitation research
• Occupational therapy
• Assistive technology assessment

Background:

• Confidence significantly impacts task performance, often more than skill.
• Existing measures for manual wheelchair user confidence were lacking.
• The need for a validated scale to assess wheelchair use confidence was identified.

Purpose of the Study:

• To develop the Wheelchair Use Confidence Scale (WheelCon-M).
• To assess the content validity of the newly developed scale.

Main Methods:

• A two-phase mixed-methods approach was employed.
• Qualitative data from semi-structured interviews generated scale items.
• A Delphi survey involving wheelchair users, healthcare professionals, and researchers refined item selection.

Main Results:

• An initial 84-item scale was created from qualitative data.
• The final 62-item Wheelchair Use Confidence Scale (WheelCon-M) was established after the Delphi survey.
• The scale covers six domains: Physical Environment, Activities, Knowledge, Advocacy, Social Situations, and Emotions.

Conclusions:

• The development and content validation of the Wheelchair Use Confidence Scale (WheelCon-M) are reported.
• This provides the first available scale to measure confidence in manual wheelchair use.
• Clinicians can now identify individuals with low wheelchair use confidence, enabling targeted interventions.