Ginoza Lori M, Sigman Erica, Michener Lori A, Straub Rachel K, Sahai-Srivastava Soma, Pozzi Federico
Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA.
Department of Neurology, University of Southern California, Los Angeles, California, USA.
Headache. 2025 Mar;65(3):460-472. doi: 10.1111/head.14888. Epub 2024 Dec 27.
To develop and assess the psychometrics of the Chronic Headache Self-Efficacy Scale (CHASE).
Existing scales assess self-efficacy in coping strategies and management of symptoms and triggers but do not measure other important self-efficacy domains, such as performing daily activities and socializing in patients with chronic daily headache (CDH).
The study had two phases: (i) Development of the 14-item CHASE, with items derived from patients with CDH and a multidisciplinary healthcare team; (ii) longitudinal observational study for psychometric evaluation. Participants with CDH (N = 79) completed the CHASE, Headache Management Self-Efficacy Scale (HMSE), six-item Headache Impact Test-6 (HIT-6), and 12-item Short Form Health Survey (SF-12) at baseline, 24-72 h after baseline, and 12 weeks after baseline. The Global Rating of Change (GROC) assessed perceived change in symptoms. We assessed internal consistency, day-to-day reliability, convergent and known group discriminant validity, dimensionality, and responsiveness via minimal clinical important difference (MCID).
For day-to-day reliability, the CHASE intraclass correlation coefficient was 0.68 (95% confidence interval 0.49-0.81), with standard error of measurement and minimal detectable change of 10.3% and 24%, respectively. The CHASE had two independent factors (total R = 54.5%) that can be combined into a single score (Cronbach's alpha internal consistency 0.88). For convergent validity, the CHASE score was related to the HIT-6, HMSE, and SF-12 (R: 0.17-0.29, all p < 0.001). For known group discriminant validity, individuals with an active headache had a lower CHASE score than those without (mean [standard deviation] 47.7 [17.3]% vs. 57.2 [19.8]%, p < 0.001). Classification and regression tree analysis showed the MCID for meaningful positive symptom change on the GROC was a CHASE change of >8% or CHASE change of 8% with baseline CHASE >67%.
The CHASE is a reliable and valid questionnaire for assessing self-efficacy in performing daily activities, socializing, managing headache symptoms and triggers, and guiding treatment plans for patients with CDH.
开发并评估慢性头痛自我效能量表（CHASE）的心理测量学特性。
现有的量表评估应对策略以及症状和诱发因素管理方面的自我效能，但未测量其他重要的自我效能领域，如慢性每日头痛（CDH）患者的日常活动执行情况和社交能力。
该研究分为两个阶段：（i）开发包含14个条目的CHASE，条目源自CDH患者和多学科医疗团队；（ii）进行心理测量学评估的纵向观察性研究。CDH患者（N = 79）在基线、基线后24 - 72小时以及基线后12周完成CHASE、头痛管理自我效能量表（HMSE）、6条目头痛影响测试-6（HIT-6）和12条目简短健康调查问卷（SF-12）。总体变化评分（GROC）评估症状的感知变化。我们通过最小临床重要差异（MCID）评估内部一致性、每日可靠性、收敛效度和已知组判别效度、维度以及反应性。
对于每日可靠性，CHASE组内相关系数为0.68（95%置信区间0.49 - 0.81），测量标准误差和最小可检测变化分别为10.3%和24%。CHASE有两个独立因素（总R = 54.5%），可合并为一个分数（Cronbach's alpha内部一致性为0.88）。对于收敛效度，CHASE评分与HIT-6、HMSE和SF-12相关（R：0.17 - 0.29，均p < 0.001）。对于已知组判别效度，有活动性头痛的个体CHASE评分低于无头痛个体（均值[标准差]47.7[17.3]%对57.2[19.8]%，p < 0.001）。分类与回归树分析显示，GROC上有意义的积极症状变化的MCID为CHASE变化>8%或基线CHASE>67%时CHASE变化8%。
CHASE是一个可靠且有效的问卷，用于评估CDH患者在日常活动执行情况、社交、头痛症状和诱发因素管理方面的自我效能，并指导治疗计划。
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