Development，Reliability and Validity of the Chinese Version of the Return-to-Work Self-Efficacy Questionnaire among Young and Middle-aged Stroke Patients

Abstract

BackgroundThe prevalence of varying degrees of post-stroke dysfunctions commonly found in an increasing number of young and middle-aged stroke patients, has hindered them from returning to work quickly, and caused serious socioeconomic burdens. Return-to-work self-efficacy is an important predictor of returning to work, and the assessment of which may provide guidance for promoting patients to return to work. However, there is no scale measuring the return-to-work self-efficacy of Chinese stroke patients.ObjectiveTo develop a Chinese version of the Return-to-work Self-efficacy Questionnaire (RTW-SE) by translating the English version of the RTW-SE, then assess its reliability and validity in young and middle-aged Chinese stroke patients.MethodsBy use of forward and backward translation of the English version of the RTW-SE, the Chinese version of the scale was developed. Then the scale was tested in a sample of 130 cases, and was analyzed for item analysis and exploratory factor analysis. Then, the scale was retested in another sample (n=255) from November 2020 to April 2021 for confirmatory factor analysis. The Pearson correlation and critical ratio were used as parameters for item analysis, and the Cronbach's α and split-half reliability were used as parameters of the reliability of the scale. Content validity and structural validity were adopted as parameters of the scale validity. Content validity was expressed by scale- and item-level content validity indices. Structural validity was evaluated by factor analysis, including exploratory factor analysis and confirmatory factor analysis.ResultsThe response rates of the test, and retest for the scale were 93.1% (121/130) , and 96.1% (245/255) , respectively. The results of item analysis showed that item-total correlation coefficients ranged from 0.636 to 0.897, with critical ratios greater than 3 for all items (P<0.001) . Reliability analysis showed that the Cronbach's α and split-half reliability of the scale were 0.942, and 0.940, respectively. The scale- and item-level content validity indices were 0.95 and 0.80~1.00, respectively. By exploratory factor analysis, one common factor was extracted, and the factor loadings of items ranged from 0.628 to 0.901, with 63.919% as the percentage of explained total variance. The confirmatory factor analysis showed that the model fit was good.ConclusionThe Chinese version of RTW-SE may be a reliable and valid tool for measuring return-to-work self-efficacy in young and middle-aged Chinese patients with stroke