Work

Measurement properties of the Swedish version of the Knee Self‐Efficacy Scale: A Rasch analysis

Year: 2025

Type: article

Abstract: Purpose This study aimed to evaluate measurement properties of the Swedish version of the Knee Self‐Efficacy Scale 18 items version (K‐SES 18 ) in patients after anterior cruciate ligament (ACL) reconstruction using Rasch measurement theory (RMT). Method Data were extracted from Project ACL, a rehabilitation registry. Responses to the K‐SES 18 from 1307 patients (aged 15–50 years) at 12 months post‐ACL reconstruction were analyzed. The RMT analysis assessed targeting aspects of reliability, response category thresholds, item hierarchy, overall and individual item fit, local dependency, differential item functioning (DIF) and unidimensionality. Results The use of RMT indicated that the K‐SES 18 present subscale exhibited high reliability (Person separation index = 0.904; Cronbach's α = 0.939) but also a potential ceiling effect (mean person location = 1.440). Disordered thresholds were observed in 11 out of 14 items, which indicates that, according to the RMT, patients might have some difficulties to distinguish between response categories. Item misfit was noted, which suggests multidimensionality. Subgroup analyses partially resolved local dependency but indicated distinct dimensions for daily activities, leisure activities and physical activities. The K‐SES 18 future subscale also demonstrated good reliability (PSI = 0.750; α = 0.783) but showed targeting issues and multidimensionality across items. Conclusion The main finding of this study is that the K‐SES 18 , according to RMT, demonstrates strong reliability but has limitations in terms of measurement properties that possibly limit its clinical utility. The present and future subscales exhibit ceiling effects, disordered thresholds, and item misfit. Therefore, the K‐SES 18 might not be able to capture the full range of patients' knee self‐efficacy after ACL reconstruction. These findings indicate that a scale refinement to enhance targeting, response sensitivity, and dimensionality is needed. Clinicians are therefore advised to interpret the subscale scores cautiously, acknowledging the multidimensional nature of the constructs measured. Level of Evidence Level III.

Source: Journal of Experimental Orthopaedics

DOI: 10.1002/jeo2.70306

Authors: Ramana Piussi, Roland Thomeé, Kristian Samuelsson, Eric Hamrin Senorski

Institutions: Sahlgrenska University Hospital, University of Gothenburg, Swedish Olympic Committee

Language: English

Topic: Psychometric Methodologies and Testing

Subfield: Management Science and Operations Research

Field: Decision Sciences

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,850