Cross-cultural adaptation and validation of the Stroke Self-Efficacy Questionnaire to European Portuguese

Self-efficacy is recognized as a key determinant in post-stroke adjustment. Adapting the Stroke Self-Efficacy Questionnaire (SSEQ) into European Portuguese is needed, due to the lack of reliable and valid measures to assess self-efficacy in post-stroke populations within this context.

To conduct the cross-cultural adaptation of the SSEQ to European Portuguese and investigate its validity, reliability, and interpretability for the European Portuguese stroke population.

A two-phase study was conducted: i) translation and cultural adaptation of the English version of SSEQ to European Portuguese (SSEQ-PT); and ii) psychometric assessment ofSSEQ-PT. The initial phase encompassed the content index validation by an expert committee with seven professionals and verbal probing by nine stroke survivors. The second phase involved 103 participants and assessed construct validity through Confirmatory Factor Analysis (CFA) and concurrent validity, test-retest reliability, and interpretability measures.

The SSEQ-PT demonstrated adequate content validity and comprehensibility. The original two-factor structure was confirmed through CFA where Chi-Square (χ2)(64) = 114.11, Comparative Fix Index (CFI) = 0.93, Standardized Root Mean Square Residual (SRMR) = 0.06, with factor correlation of 0.63. Adequate construct validity was demonstrated with expected correlations between the SSEQ-PT subscales and selected scales. The activity subscale demonstrated a Cronbach's α of 0.91 and the self-management subscale of 0.80. The total instrument demonstrated an Interclass CorrelationCoefficient (ICC) of 0.87.

The SSEQ-PT proved to be a highly relevant and easily comprehensible measure for assessing self-efficacy in stroke survivors. This study demonstrates that the European Portuguese version of the instrument is valid and reliable for assessing self-efficacy in stroke patients.