A confiabilidade e validade da The Stroke Self-Efficacy Questionnaire Brazil (SSEQ-B)

Abstract

Importance: Stroke stands out as the second leading cause of death in the world. Its incidence doubles every decade after the age of 55, occupying a prominent position among the elderly population. Considering the possible neurological sequelae, it is necessary to evaluate all its dimensions. Self-efficacy, which is the conviction of a person being able to perform a specific task, is an important mediator in post-stroke. The Stroke Self-Efficacy Questionnaire (SSEQ) measures domain-specific self-efficacy in stroke survivors. Objective: To evaluate the reliability and validity of The Stroke Self-Efficacy Questionnaire Brazil (SSEQ b) in relation to the purposes of the original scale. Material and methods: A cross-sectional study was carried out to assess reliability, structure validation through factor analysis and convergent validation of the SSEQ-B using the Frenchay Activity Index (FAI), the Barthel Index (BI) and The Stroke Specific Quality of Life Scale (SS-QOL) in stroke survivors born in Brazil and residing in the states of Rio Grande do Sul or São Paulo. Results: 115 stroke survivors with a mean age of 66.7±14.2 years were included in the study in the structural validity test. Internal consistency presents a Cronbach's Alpha (αC) of 0.829. The exploratory factor analysis using the scree plot criterion demonstrated a model with two factors, activity (Q2,Q3,Q4,q5,Q6,Q7,Q8) and self-management (Q1,Q9,Q10,Q11,Q12eQ13), compatible with the version original of the questionnaire and with other cross-cultural adaptations of the SSEQ. Confirmatory factor analysis also suggested the three-factor model, with distribution in factor 1 (Q5,Q6,Q7,Q8,Q12), factor 2 (Q1,Q9,Q10,Q11,Q13); and factor 3 (Q2,Q3,Q4). Both models with subscales showed evidence of good construct validity, however, the bifactorial structure demonstrates greater clinical plausibility. In the convergent validation process, 75 stroke survivors aged 66.64 ± 12.97 years were included. The total SSEQ-B scores were significantly correlated with the FAI (ICC = 0.8 / r = 0.72 / 1-ß = 1.0), BI (ICC = 0.68 / r = 0.68 / 1 -ß = 0.99) and SS-QOL (ICC = 0.46 / r = 0.65 / 1-ß = 0.94), which suggests that stroke self-efficacy is associated with instrumental activities and daily living .Conclusion: The bifactorial model is suggested through the validation of the SSEQ-B structure, where the adjustment indices showed acceptable levels. It shows a good convergent validation with the instruments of daily and instrumental activities of living, and seems to be useful in the assessment of self-efficacy in stroke survivors residing in Brazil.