Thomeé P, Währborg P, Börjesson M, Thomeé R, Eriksson B I, Karlsson J
Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden.
Scand J Med Sci Sports. 2006 Jun;16(3):181-7. doi: 10.1111/j.1600-0838.2005.00472.x.
It has been suggested that self-efficacy belief is of major importance for rehabilitation outcome after sports-related injuries. No instruments are, however, available to evaluate perceived self-efficacy for prognostic and outcome expectations in patients with an anterior cruciate ligament (ACL) injury. Perceived self-efficacy is defined as a judgment of one's potential ability to carry out a task, rather than a measure of whether or not one actually can or does perform the task. The purpose of this study was to develop a reliable and valid instrument for measuring perceived self-efficacy in patients with an ACL injury. A total of 210 male and female patients with an ACL injury were included in this study. The items were generated by health professionals with long clinical experience of patients with an ACL injury and by discussions with patients. After item analysis and item reduction, based on the results from 88 patients, the final 22-item version of the Knee Self-Efficacy Scale (K-SES) was evaluated in 18 patients for test-retest reliability and in 104 patients for internal consistency and validity. The K-SES was compared with the Multidimensional Health Locus of Control (MHLC), Coping Strategies Questionnaire (CSQ), SF-36 and Knee Injury and Osteoarthritis Outcome Score (KOOS) instruments. A factor analysis was also performed on the K-SES. The test-retest revealed a correlation of r(s)=0.73 between test-days and an intraclass correlation coefficient of 0.75. No significant difference between test-days was found. The internal consistency was 0.94, as calculated with Cronbach's alpha. There were low correlations between the K-SES and MHLC and the K-SES and CSQ, respectively. A strong correlation was found between the K-SES and physical functioning, as measured by the SF-36 (r(s)=0.8). All the sub-scales in the KOOS correlated moderately to strongly (r(s)=0.4-0.7) to the K-SES. The factor analysis produced two factors of importance. Factor one was related to how patients perceived their present physical performance/function, while factor two was related to how patients perceived the future physical performance/prognosis of their knee. Good reliability and good face, content, construct and convergent validity were demonstrated for this new instrument (K-SES) for measuring perceived self-efficacy in patients with an ACL injury. The K-SES is recommended for studies designed to evaluate prognostic and outcome expectations of perceived self-efficacy in patients with an ACL-insufficient knee.
有人认为自我效能信念对运动相关损伤后的康复结果至关重要。然而，目前尚无工具可用于评估前交叉韧带（ACL）损伤患者对预后和结果预期的自我效能感。自我效能感被定义为对个人执行某项任务潜在能力的判断，而非对一个人是否实际能够或确实执行该任务的衡量。本研究的目的是开发一种可靠且有效的工具，用于测量ACL损伤患者的自我效能感。本研究共纳入210例ACL损伤的男性和女性患者。这些条目由对ACL损伤患者有长期临床经验的卫生专业人员以及与患者讨论后生成。经过项目分析和条目缩减，基于88例患者的结果，最终的22条目版膝关节自我效能量表（K-SES）在18例患者中进行了重测信度评估，在104例患者中进行了内部一致性和效度评估。将K-SES与多维健康控制点（MHLC）、应对策略问卷（CSQ）、SF-36以及膝关节损伤和骨关节炎结局评分（KOOS）工具进行了比较。还对K-SES进行了因子分析。重测显示测试日之间的斯皮尔曼相关系数r(s)=0.73，组内相关系数为0.75。未发现测试日之间存在显著差异。用克朗巴赫α系数计算的内部一致性为0.94。K-SES与MHLC以及K-SES与CSQ之间的相关性分别较低。发现K-SES与SF-36测量的身体功能之间存在强相关性（r(s)=0.8）。KOOS的所有子量表与K-SES的相关性为中度至高度（r(s)=0.4 - 0.7）。因子分析产生了两个重要因子。因子一与患者对其当前身体表现/功能的感知方式有关，而因子二与患者对其膝关节未来身体表现/预后的感知方式有关。这种用于测量ACL损伤患者自我效能感的新工具（K-SES）具有良好的信度以及良好的表面效度、内容效度、结构效度和收敛效度。推荐将K-SES用于旨在评估ACL功能不全膝关节患者自我效能感的预后和结果预期的研究。
