Abstract
Background and Objective: The Self-Care Self-Efficacy Scale (SCSE) assesses a patient's confidence in managing their self-care in chronic conditions, such as heart failure (HF). Higher levels of self-efficacy are strongly linked to improved self-care behaviors and better clinical outcomes. No culturally adapted instrument is available in Sinhala to assess SCSE in Sri Lanka. This study aimed to translate, culturally adapt, and test the reliability of the SCSE among HF patients in Sri Lanka.
Methods: The cross-cultural adaptation followed a structured process based on established guidelines for self-report measures. In Stage 1, two bilingual experts fluent in Sinhala independently performed forward translations of the SCSE. In Stage 2, the two versions were synthesized into one reconciled translation through discussions to resolve discrepancies. Stage 3 involved two independent native English-speaking experts conducting a backward translation. Semantic and conceptual consistency ensured. In Stage 4, an expert committee comprising health professionals, linguists, and the original translators evaluated the translated version for cultural relevance and accuracy. In Stage 5, the adapted version was pretested with 30 HF patients in a Sri Lankan cardiology clinic to assess clarity and cultural suitability. Psychometric testing assessed internal consistency with Cronbach’s alpha and evaluated the content validity index (CVI) (8 experts).
Results: Minor adjustments were made following feedback from the expert committee to enhance clarity and cultural relevance. For instance, "Monitor your condition routinely" was adapted to "Monitor your condition regularly" for better comprehension. The Cronbach’s alpha was 0.88, demonstrating strong internal consistency across the 10 items. Patients found the translated items culturally relevant and easy to understand. Mean self-efficacy scores ranged from 3.57 to 4.40, with higher scores for medication adherence and routine monitoring behaviors. The CVI indicated strong content validity (0.987). The final version of the SCSE scale was approved, and permission was obtained from the original developers for its use in Sri Lanka.
Conclusion: The cross-cultural adaptation of the SCSE produced a reliable and culturally appropriate tool for assessing self-care self-efficacy for the patients with HF in Sri Lanka. Further validation confirmatory factor analysis with larger samples is recommended to confirm its generalizability.
Notes
References: Chica-Pérez, A., Dobarrio-Sanz, I., Correa-Casado, M., Fernández-Sola, C., Ruiz-Fernández, M. D., & Hernández-Padilla, J. M. (2023). Spanish version of the self-care self-efficacy scale: A validation study in community-dwelling older adults with chronic multimorbidity. Geriatric Nursing, 53, 181-190. https://doi.org/https://doi.org/10.1016/j.gerinurse.2023.07.016
Jaarsma, T., Hill, L., Bayes-Genis, A., La Rocca, H. B., Castiello, T., Čelutkiene, J., Marques-Sule, E., Plymen, C. M., Piper, S. E., Riegel, B., Rutten, F. H., Ben Gal, T., Bauersachs, J., Coats, A. J. S., Chioncel, O., Lopatin, Y., Lund, L. H., Lainscak, M., Moura, B., . . . Strömberg, A. (2021). Self-care of heart failure patients: practical management recommendations from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail, 23(1), 157-174. https://doi.org/10.1002/ejhf.2008
Martinez-Amezcua, P., Haque, W., Khera, R., Kanaya, A. M., Sattar, N., Lam, C. S. P., Harikrishnan, S., Shah, S. J., Kandula, N. R., Jose, P. O., Narayan, K. M. V., Agyemang, C., Misra, A., Jenum, A. K., Bilal, U., Nasir, K., & Cainzos-Achirica, M. (2020). The Upcoming Epidemic of Heart Failure in South Asia. Circulation: Heart Failure, 13(10), e007218. https://doi.org/10.1161/CIRCHEARTFAILURE.120.007218
Riegel, B., Dickson, V. V., & Faulkner, K. M. (2016). The Situation-Specific Theory of Heart Failure Self-Care: Revised and Updated. The Journal of Cardiovascular Nursing, 31, 226–235.
Tovar, E. G., Dekker, R. L., Chung, M. L., Gokun, Y., Moser, D. K., Lennie, T. A., & Rayens, M. K. (2016). Self-efficacy mediates the relationship of depressive symptoms and social support with adherence in patients with heart failure. Journal of Health Psychology, 21, 2673 - 2683.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Instrument or Tool Development, Public and Community Health, Self Care, Sri Lanka
Recommended Citation
Maithreepala, Sujeewa Dilhani; Konara Mudiyanselage, Sriyani Padmalatha; and Shu, Bih-Ching, "Cross-Cultural Adaptation of the Sinhala Version of the Self-Care Self-Efficacy Scale" (2025). International Nursing Research Congress (INRC). 42.
https://www.sigmarepository.org/inrc/2025/presentations_2025/42
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Cross-Cultural Adaptation of the Sinhala Version of the Self-Care Self-Efficacy Scale
Seattle, Washington, USA
Background and Objective: The Self-Care Self-Efficacy Scale (SCSE) assesses a patient's confidence in managing their self-care in chronic conditions, such as heart failure (HF). Higher levels of self-efficacy are strongly linked to improved self-care behaviors and better clinical outcomes. No culturally adapted instrument is available in Sinhala to assess SCSE in Sri Lanka. This study aimed to translate, culturally adapt, and test the reliability of the SCSE among HF patients in Sri Lanka.
Methods: The cross-cultural adaptation followed a structured process based on established guidelines for self-report measures. In Stage 1, two bilingual experts fluent in Sinhala independently performed forward translations of the SCSE. In Stage 2, the two versions were synthesized into one reconciled translation through discussions to resolve discrepancies. Stage 3 involved two independent native English-speaking experts conducting a backward translation. Semantic and conceptual consistency ensured. In Stage 4, an expert committee comprising health professionals, linguists, and the original translators evaluated the translated version for cultural relevance and accuracy. In Stage 5, the adapted version was pretested with 30 HF patients in a Sri Lankan cardiology clinic to assess clarity and cultural suitability. Psychometric testing assessed internal consistency with Cronbach’s alpha and evaluated the content validity index (CVI) (8 experts).
Results: Minor adjustments were made following feedback from the expert committee to enhance clarity and cultural relevance. For instance, "Monitor your condition routinely" was adapted to "Monitor your condition regularly" for better comprehension. The Cronbach’s alpha was 0.88, demonstrating strong internal consistency across the 10 items. Patients found the translated items culturally relevant and easy to understand. Mean self-efficacy scores ranged from 3.57 to 4.40, with higher scores for medication adherence and routine monitoring behaviors. The CVI indicated strong content validity (0.987). The final version of the SCSE scale was approved, and permission was obtained from the original developers for its use in Sri Lanka.
Conclusion: The cross-cultural adaptation of the SCSE produced a reliable and culturally appropriate tool for assessing self-care self-efficacy for the patients with HF in Sri Lanka. Further validation confirmatory factor analysis with larger samples is recommended to confirm its generalizability.
Description
The cross-cultural adaptation of the Self-Care Self-Efficacy Scale resulted a reliable and culturally appropriate tool for assessing self-care self-efficacy for patients with heart failure in Sri Lanka.