The psychometric properties of Chinese version of SCI Exercise Self-Efficacy Scale in patients with stroke

OBJECTIVE To test the Chinese version of the SCI Exercise Self-Efficacy Scale (C-ESES) in stroke patients and evaluate its validity and reliability. BACKGROUND Physical inactivity is a well established and changeable risk factor for stroke, and regular exercise of 3-7 days per week is essential for stroke survivors and the general population. Though regular exercise is beneficial, it has been proved that duration, frequency, and intensity of exercise are generally low in stroke survivors. METHODS The performance of the instrument was assessed in 350 Chinese stroke survivors and repeated in 50 patients to examine test-retest reliability. Questionnaires included a form on demographic and socioeconomic characteristics, C-ESES, and the Chinese version of the General Self-Efficacy Scale. The AMOS 20.0 and SPSS 17.0 were chosen to evaluate their validity and reliability. RESULTS Even though 350 participants answered the questionnaires in the present study, useful data were obtained from 321 participants (response rate: 91.71%). Correlation between item and the total scale score (Item-Total Correlation) ranged from 0.551 to 0.718, indicating that no item needed to be omitted; two factors, with factor loading 0.620 and 0.806, were obtained from an exploratory principal components analysis, assuming 59.745% of the total variance. The two factors were named internal motivation and external motivation. A confirmatory factor analysis supported the results with a suitable model (χ (5)=291.157; df=185; P<0.001; root mean square error of approximation =0.044; goodness-of-fit index =0.938; adjusted goodness-of-fit index =0.914; comparative fit index =0.858). The C-ESES correlated well with the validated General Self-Efficacy Scale (r=0.827, P<0.01). Good internal consistency (Cronbach's α=0.757 to 0.879) and test-retest reliability (r=0.750, P<0.01) were obtained. CONCLUSION The C-ESES is a short, easy to understand, and psychometrically sound measurement to evaluate exercise self-efficacy in Chinese-speaking stroke survivors.