Bergman S.1,2, Klässbo M.3
1Karolinska Institutet, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden, 2Hela Kroppen Physiotherapy, Stockholm, Sweden, 3Centre for Clinical Research. County Council of Värmland, Karlstad, Sweden
Background: In people with osteoarthritis (OA), self-efficacy (SE) to affect pain and other symptoms can be evaluated with two subscales in the Arthritis Self-Efficacy Scale-Swe (ASES-S). When evaluating the ASES-S for validity and reliability only a few individuals with OA have been tested. Clinical experience has shown that the questions in the ASES-S are difficult to answer for people with OA in their hip and/or knee, but no one has analyzed the reasons systematically.
Purpose: To explore reflections expressed by people with hip and/or knee OA when answering the ASES-S, sub-scales for pain and other symptoms, to identify potential problems.
Methods: In-depth interviews, based on the think-aloud method, were conducted with ten individuals with OA in their hip and/or knee. They were recruited strategically from a physiotherapy clinic in Stockholm, Sweden. All the individuals did consent to participate in the study. Three people with different clinical and scientific background, triangulation, used qualitative content analysis to analyze the data. The interviews were audio recorded, transcribed verbatim, and ordered into meaningful units, codes, and categories. Finally the latent content was merged into themes.
Results: The result culminated in three themes with categories. The first theme "ASES-S validity" described reflections that can affect the ASES-S validity in a negative and/or positive direction. The second theme "Form completions consequences for the informants" described positive and negative thoughts related to the informants´ self-image/symptoms. The third theme "Assessment-scales generally validity described the reflections of factors that may affect the validity of the completion of the assessment-scales generally.
Conclusion(s): ASES-S was shown to have defects in the validity for those with hip and/or knee OA. In addition, the questions in the ASES-S also influenced the individuals confidence in their own knowledge of how to handle the difficulties that arise from OA. SE is a potent concept, but the ASES-S can not be considered a valid tool to measure change in SE to affect pain and other symptoms for people with OA of the hip and/or knee, and should therefore be revised.
Implications: The results from this study could be used in the development and design of a new instrument where the questions are specified based on common problems or situations that people with osteoarthritis of the hip and / or knee must manage. A high-quality instrument would improve the evaluation of OA physiotherapy intervention, which would further support the development of evidence-based methods in physiotherapy.
Funding acknowledgements: Many thanks to the informants and a warm thanks to my supervisor Maria Klässbo, PhD, RPT.
Topic: Orthopaedics
Ethics approval: This master´s thesis followed the Declaration of Helsinki, no ethic review was made with reference to Ethics Act 2003: 460.
All authors, affiliations and abstracts have been published as submitted.
