DEVELOPMENT AND PSYCHOMETRIC VALIDATION OF THE SELF-EFFICACY AND PERFORMANCE IN SELF-MANAGEMENT SUPPORT INSTRUMENT FOR PHYSIOTHERAPISTS (SEPSS-PT)

A. Feleus¹, L. Wevers², D. Schiphof³, J. Verhoef⁴, S. van Hooft⁵, A. van Staa⁶

¹Rotterdam University of Applied Sciences (Hogeschool Rotterd, Physical Therapy and Research Center Innovations in Care, Rotterdam, Netherlands, ²Rotterdam University of Applied Sciences (Hogeschool Rotterd, Physiotherapy and Research Center Innovations in Care, Rotterdam, Netherlands, ³Erasmus MC University Medical Center, Department of General Practice, Rotterdam, Netherlands, ⁴University of Applied Sciences Leiden, Department of Physical Therapy & Faculty of Health, Leiden, Netherlands, ⁵Rotterdam University of Applied Sciences (Hogeschool Rotterd, Department of Nursing and Research Center Innovations in Care, Roosendaal, Netherlands, ⁶Rotterdam University of Applied Sciences (Hogeschool Rotterd, Research Center Innovations in Care, Rotterdam, Netherlands

Background: Self-management support to patients is considered increasingly important in healthcare, also for physiotherapists.
However, the competencies that physiotherapists need to deliver self-management support have yet to be described.

Purpose: To develop and psychometrically test the Self-Efficacy and Performance in Self-Management Support instrument for physiotherapists (SEPSS-PT), on the bases of the SEPSS-36, the corresponding instrument for nurses.

Methods: A literature review (n=42 reviews) and consultations with physiotherapists and patients identified the essential competencies for physiotherapists to support patients in self-management and therewith the specific content for the questionnaire for physiotherapy. The Five-A’s model and an overarching category of ‘overall’ competencies was used to structure the items. Psychometric evaluation of the draft questionnaire (40 items) was tested in a sample of 334 physiotherapists and physiotherapy students from the Netherlands, of whom 33 filled out the questionnaire twice to establish the test–retest reliability.

Results: Confirmatory factor analyses revealed satisfactory fit indices for both the six-factor model and the hierarchical model, with best fit for the six-factor model. The questionnaire discriminated between physiotherapists and physicotherapy students, and between physiotherapists who did or did not consider self-management support important. The overall internal consistency (Cronbach’s alpha) was high, both for the self-efficacy and the performance items. In the majority of the subscales, test-retest intra-class correlation coefficients for both overall self-efficacy and performance were good, but in three subscales insufficient for performance.

Conclusions: The SEPSS-PT questionnaire is a 40-item, Likert-scaled instrument with good content and construct validity, good internal consistency and reliability, and sufficient test-retest reliability. Future research in a larger and more diverse sample could confirm stability and discriminating power. Sensitivity to change in competence development can be explored in educational settings or retraining courses.

Implications: The outcome of the SEPSS-PT gives insight into one’s current self-efficacy and performance of self-management support in daily physical therapy practice, and operationalizes that what one can do, and provides insight into areas of focus for training. Incorporating the SEPSS-PT into future training and courses on self-management support gives the opportunity to explore the responsiveness of the instrument and, if found responsive, to evaluate training effects.

Funding acknowledgements: The study was supported by a grant from the Dutch Taskforce for Applied Research SIA (Regieorgaan SIA), (file number: HBOPD.2018.03.016).

Keywords:
self-management support
competencies
measurement

Topics:
Education: continuing professional development
Health promotion & wellbeing/healthy ageing/physical activity
Primary health care

Did this work require ethics approval? Yes

Institution: Erasmus University Medical Center Rotterdam

Committee: Medical Ethics Review Board

Ethics number: MEC-2019-0547