Stroke self-efficacy questionnaire (SSEQ), a reliable measure of disease burden: psychometric validation of the Romanian version

Abstract

Self-efficacy is a relevant outcome measure of functional status in stroke research. It can be measured with various patient-reported outcome (PRO) tools, which can be generic or disease (stroke) related. However, in Romania, there is a limited availability of such measures. The Stroke Self-Efficacy Questionnaire(SSEQ) is a specific PRO scale that measures the impact of stroke on self-management and on performance of daily activities. We conducted a two-stage study: (1) translation and cross-cultural adaptation of the SSEQ-Romanian version (SSEQ-RO) and (2) a prospective cohort clinical study designed for psychometric validation of the SSEQ-RO. For the enrolled stroke patients, Barthel index, quality of life and indexes of disease severity, such as NIHSS, MRC and mRS, were measured at baseline and ten days. For psychometric validation we assessed construct validity, reliability and repeatability. In a sample of fifty stroke patients, SSEQ-RO was found to have an excellent construct validity, excellent reliability (Cronbach's alpha = 0.92), and repeatability (ICC = 0.91). SSEQ-RO was also a good measure of disease burden in mild versus moderate to severe stroke as assessed with NIHSS (p = 0.002). In conclusion, for stroke patients, SSEQ-RO is a reliable PRO able to assess the impact of stroke on the ability to perform daily activities and, therefore can reliably be used to monitor functional status dynamics during the disease course.