Measurement properties of Chinese-version assessment tools of self-efficacy in patients with rheumatoid arthritis: a...

This study aimed to systematically evaluate the measurement properties and methodological quality of self-efficacy assessment tools for rheumatoid arthritis(RA) patients in China, to provide evidence-based recommendations for clinicians and researchers in selecting appropriate tools.

A comprehensive literature search was conducted in the following databases: CNKI, VIP, Wanfang, SinoMed, PubMed, Embase, Web of Science, Scopus, and CINAHL, to identify studies assessing the measurement properties of Chinese versions of the assessment tools of self-efficacy in patients with RA. The search covered all publications up to April 2025. The reported measurement properties included content validity, structural validity, internal consistency, reliability, and hypotheses testing for construct validity. Studies were eligible if: (1) The study population included patients with RA; (2) was the development, cross-cultural adaptation or validation of a self-efficacy assessment tool for RA; (3) evaluated at least one measurement property of a self-efficacy assessment tool for RA.; (4) The study was published in a peer-reviewed journal; (5) The publication language was English or Chinese. Studies were excluded if: (1) The tool was designed to measure only a single dimension of self-efficacy (e.g., medication adherence, exercise self-efficacy); (2) Studies involving non-Chinese populations; (3) The study was a secondary research article (e.g., review, systematic review, conference abstract); (4) The full text of the article was not available. Two reviewers independently screened the literature and extracted data. The measurement properties and methodological quality of the included tools were assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), and final recommendations were formulated accordingly.

A total of seven studies were included, covering seven Chinese versions of the assessment tools of self-efficacy in patients with RA. Among them, the Chinese version of 8-item Arthritis Self-Efficacy Scale (C-ASES-8) demonstrated "sufficient" content validity, with moderate-quality evidence supporting "sufficient" internal consistency. It was categorized as "A" and is recommended for use. The Chinese version of Joint Protection Self-Efficacy Scale (C-JP-SES) (two-factor structure) showed high-quality evidence indicating insufficient structural validity and was categorized as "C," therefore not recommended. The Chinese versions of JP-SES (single-factor structure), ASES, and Rheumatoid Arthritis Self-Efficacy Scale (RASE) did not meet the criteria for either "A" or "C" and were categorized as "B," indicating they may be temporarily recommended pending further validation.

The Chinese-version assessment tools of self-efficacy in patients with RA are diverse. Although the C-ASES-8 has met the recommended standards for use, comprehensive evaluations of its psychometric properties remain insufficient. Future research should aim to thoroughly validate all Chinese versions of the rheumatoid arthritis self-efficacy scales (including the C-ASES-8) and provide complete reports on their psychometric properties, to offer more reliable evidence to support instrument selection in clinical practice and research.