title: Self-management and self-efficacy in stroke survivors: validation of the Italian version of the Stroke Self-Efficacy Questionnaire.
abstract: BACKGROUND
  Self-efficacy is an important mediator of the adaptation process after stroke. However, few studies have attempted to measure self-efficacy in a stroke population. The most recently developed scale is the Stroke Self-Efficacy Questionnaire that measures self-efficacy ratings in specific domains of functioning relevant for a stroke survivor.
  
  
  OBJECTIVE
  The aim of this study was to validate the Italian version of Stroke Self-efficacy Questionnaire in stroke survivors.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Three Physical Medicine and Rehabilitation Units located in public hospitals.
  
  
  METHODS
  149 adult patients recruited after their first stroke.
  
  
  METHODS
  Patients were assessed using the Self-efficacy in stroke survivors questionnaire, the Modified Barthel Index, the Geriatric Depression Scale and the Short Form Health Survey.
  
  
  RESULTS
  Patients (38.3% female, mean age 69.3 years) completed the Self-efficacy in stroke survivors questionnaire with the help of an interviewer. Using confirmatory factor analysis two factors were identified (activity and self-management). The factor score 'activity' was significantly associated with the Modified Barthel Index and with the physical component of the Short Form Health Survey, but uncorrelated with the mental component of the Short Form Health Survey and with the Geriatric Depression Scale, supporting the convergent/discriminant validity of the instrument. The 'self-management' factor was weakly associated with the Modified Barthel Index, the physical and mental components of the Short Form Health Survey and uncorrelated with the Geriatric Depression Scale, suggesting that it measures a different construct. When we categorized patients according to their walking status, we found that the walking group had significantly higher scores on the activity factor than the non-walking group, while no significant differences were found concerning the self-management factor.
  
  
  CONCLUSIONS
  The findings supported the validity of the Italian version of the Stroke Self-efficacy questionnaire . It measures two dimensions of self-efficacy, activity and self-management, strongly related to independence and recovery after stroke and therefore it represents a useful tool to assess self-efficacy.
  
  
  CONCLUSIONS
  The Italian version of the Stroke Self-efficacy questionnaire is a valid and reliable measure of self-efficacy. Clinicians can use this instrument to target rehabilitation interventions according to patients' individual confidence in their functional and self-management capacity and in order to set realistic goals.
authors.affiliation: Section of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy - laura.dallolio@unibo.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Dallolio
authors.affiliation: Section of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Messina
authors.affiliation: Section of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Calugi
authors.affiliation: IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Fugazzaro
authors.affiliation: IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Bardelli
authors.affiliation: Section of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Rucci
authors.affiliation: Section of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Fantini
authors.affiliation: University Hospital Policlinico Sant'Orsola Malpighi, Bologna, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Cavalli
authors.affiliation: University Hospital Policlinico Sant'Orsola Malpighi, Bologna, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Taricco
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D020377:Self Efficacy; D000073278:Self-Management; D020521:Stroke / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D016138:Walking