Cross-Cultural Adaptation and Psychometric Properties of an Instrument to Measure the Self-efficacy of Older Persons After Hip Surgery

Abstract

Self-efficacy is essential for symptom management and performing physical activities to achieve post-operative goals. Nevertheless, there is not an instrument for assessing postoperative self-efficacy in older persons after hip surgery in the Thai context. Therefore, this cross-cultural adaptation and psychometric properties study aimed to modify and evaluate an instrument to be suitable for measuring post-operative hip self-efficacy of older persons in Thailand. The participants were 116 older persons who underwent hip surgery. The development process included; 1) requesting permission to translate and modify the Self-Efficacy for Managing Chronic Disease Scale; 2) instrument translation, translation review, and verifying cross-cultural equivalence; 3) instrument modification; 4) evaluation of content validity; 5) conducting a pilot study; 6) evaluation of construct validity using exploratory and confirmatory factor analysis; and 7) assessment of the instrument’s reliability using Cronbach’s alpha coefficient. The results found that the modified instrument, the Post-Operative Hip Self-Efficacy Scale (PHOSE), was comprised of six items with a 10-level rating scale and was cross-culturally equivalent. The scale’s content validity (S-CVI/Ave) was 0.97 and the construct validity’s exploratory factor analysis (EFA) revealed two components: 1) symptom and emotional management and 2) physical activity. These components explained 98.65% of the total variance. The confirmatory factor analysis (CFA) demonstrated that the confirmatory model fitted well with the empirical data with a likelihood ratio chi-square (CMIN) = 14.86, CMIN/DF = 1.86, degree of freedom (df) = 8, p = .53, goodness of fit index (GFI) = .98, and root mean residual (RMR) = .045. Additionally, the Cronbach’s alpha of the PHOSE was .96. Healthcare providers can use this scale to assess self-efficacy among orthopedic patients who have has hip surgery.