Instrumentos de medida de autoeficácia para indivíduos com doença coronariana: uma revisão sistemática e validação da Cardiac Self-Efficacy Scale para população brasileira

Abstract

Study 1: Self-efficacy measurement instruments for individuals with coronary disease: a systematic review. Objectives: To evaluate the measurement properties, methodological quality and link the content extracted from the items of the cardiac selfefficacy instruments for individuals with CAD with the International Classification of Functioning, Disability and Health (ICF). Methods: The study was developed in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA) and the Consensus Norms for Selection of Health Measuring INstruments (COSMIN). Using the following databases: MEDLINE (Ovid), Web of Science, EMBASE and PsycINFO. Development and validation studies that evaluated the measurement properties of self-efficacy instruments for individuals with CAD were included. No date or language restrictions were applied to the search. Two independent authors were responsible for assessing the eligibility of the studies. The methodological quality of the studies was assessed using the COSMIN RoB Checklist, and the Recommendations Rating, Evaluation, Development was used to assess the quality of each study. In addition, the Modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) recommended by COSMIN was used to determine the quality of the evidence. Two other authors linked the content of the extracted items with the components of the ICF. Results: A total of 21 studies were included, representing and being grouped into 12 instruments to measure self-efficacy for individuals with CAD. None of the instruments had an A recommendation level, as both presented information deficiency in the assessment of psychometric properties. The best evaluated instruments with B recommendation quality of evidence were the Barnason Efficacy Expectation Scale (BEES), which presented a moderate level of content validity, and a high level for structural validity, construct validity, criteria and internal consistency; Cardiac Self-Efficacy Scale (CSES), which presented a moderate level for construct validity, and a high level for content, structural, cross-cultural validity and internal consistency; Self-efficacy for Appropriate Medication Use (SEAMS), with a low level for content validity, and a high level for structural validity, criteria and internal consistency. In addition, the CSES instrument was the one with the highest number of connections with the ICF components in its original version and adaptations. Conclusion: The instruments classified as recommendation level B have potential for use, but require further psychometric studies to strengthen information about measurement properties. With regard to the ICF, the CSES proves to be the most complete instrument, taking into account the standardization of the clinical language.