Translation to Brazilian Portuguese, cultural adaptation and psychometric properties of 8-item ArthritisSelf-Efficacy Scale (ASES-8)

Abstract

Self-efficacy refers to a person's beliefs in their ability to organize, perform actions and face challenges in order to achieve aims and motivation. 1,2 It is not a matter of possessing certain capacities but is a belief that one has them or that one can acquire them through personal efforts (outcome expectancy). The strength of individuals' self-efficacy has an effect on how much effort and perseverance they will apply to achieve an aim. 3 Rheumatoid arthritis is a chronic autoimmune inflammatory disease characterized by pain and destruction of synovial joints that may lead to disability. 4 Epidemiological studies have estimated that the prevalence of rheumatoid arthritis in the adult population is 1%. It affects women three times as much as men and its incidence is highest among people aged between 35 and 65 years. 5 Several studies have found that among patients with rheumatoid arthritis, greater self-efficacy is a predictor for healthy behaviors, such as physical activity, healthy eating and strategies for dealing with pain. 6-9 Greater self-efficacy has also been correlated with lower daily pain, better emotional states, less stiffness, better functional capacity, better physical and mental wellbeing, less depression and better adherence to medication and other health recommendations. 10 It has also been associated with better health outcomes, including physical activity recommendations for rheumatoid arthritis patients. 6,7,11 In a recent review of the literature, negative correlations were found between self-efficacy and disability, pain, fatigue and duration of disease. 12 Studies have also suggested that self-efficacy is associated with the health outcomes of people with rheumatoid arthritis. In these studies, it was observed that the higher the self-efficacy was (which can be changed through educational programs), the higher the association that the patients had with better health status.

Measures of Patient Activation and Self‐Efficacy

“…A German version published in 2003 was developed from the Spanish version for people with arthritis and fibromyalgia (50). An Arabic version published in 2020, a Brazilian Portuguese version published in 2019, a Chinese version published in 2017, and a Yoruba (Nigerian indigenous language) version published in 2016 were each translated from the English version (47,49–52). A modified English version (ASES‐AS) was developed in 2011 for ankylosing spondylitis in a UK population by making minor changes in phraseology, including changing “rheumatoid arthritis and fibromyalgia” to “ankylosing spondylitis” (48).…”

“…The Arabic ASES‐8 had Cronbach’s α that varied slightly between 0.86 and 0.88 when any single items were deleted (49). The Brazilian ASES‐8 had Cronbach’s α of 0.985 among 30 patients with rheumatoid arthritis for at least 1 year (47). The Chinese ASES‐8 had Cronbach’s α of 0.942 among 136 patients with rheumatoid arthritis and varied slightly (range of 0.929‐0.940) when any single item was deleted (51).…”

“…The German version was developed from the Spanish ASES‐8, but details of the content validation process were not published (50). The Arabic, Brazilian Portuguese, Chinese, and Yoruba language versions of ASES‐8 all used a forward and back translation from the English version (47,49–52). The Brazilian Portuguese version was tested for cultural equivalence on 30 patients with rheumatoid arthritis and was shown to be understandable and culturally adapted (47).…”

“…The Arabic, Brazilian Portuguese, Chinese, and Yoruba language versions of ASES‐8 all used a forward and back translation from the English version (47,49–52). The Brazilian Portuguese version was tested for cultural equivalence on 30 patients with rheumatoid arthritis and was shown to be understandable and culturally adapted (47). After cognitive interviews with five patient research partners, the Arabic ASES‐8 required no changes because it was easy to understand and administer and had no conceptual and cultural difference to the English version (49).…”

“…The Brazilian ASES‐8 scores of 32 people aged 18 to 60 year with rheumatoid arthritis were significantly negatively correlated with pain ( r = −0.278), functional capacity ( r = −0.437), and depression ( r = −0.562) and were positively correlated with domains of quality of life ( r = 0.321‐0.558) (47).…”