Measurement of confidence: the development and psychometric evaluation of a stroke-specific, measure of confidence.
Jane C Horne, Nadina B Lincoln, Pip A Logan
PMID 28466669WHAT IT FOUND
A 27-item stroke confidence questionnaire covers self-confidence, positive attitude and social confidence, with consistent scores over time in 202 adults, but it is not yet shown to guide treatment or predict recovery.
Key findings
01After item reduction and factor analysis, the final CaSM contained 27 items and grouped into self-confidence, positive attitude and social confidence, explaining 51.98% of the variance.
02The 27-item CaSM showed high internal consistency in stroke participants (α=0.92) and healthy elderly participants (α=0.90).
03The CaSM correlated highly with the Stroke Self-Efficacy Questionnaire (rs=0.77, P=0.001).
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The paper did not collect ethnicity, so it cannot check whether the items are appropriate for different ethnic groups. Only 13 stroke participants self-reported aphasia, and the authors say the level of communication skill needed to complete the measure is unclear. Responsiveness to change over time and the smallest meaningful score change were not established, so the CaSM is not yet an outcome measure for treatment effects. The study tested measurement properties, not whether using the CaSM changes care or improves recovery. The factor analysis used classical test theory, and the authors note Rasch analysis could examine further item redundancy and model fit.
The easy way to misread this
Do not treat the CaSM as a validated outcome measure for therapy. The paper tested whether answers on the questionnaire hang together and stay similar over time, not whether scores change after treatment or predict recovery. Responsiveness and the smallest meaningful score change were not established.