Development and content validation of the Wheelchair Use Confidence Scale: a mixed-methods study

Abstract

Background. Confidence in one's ability to perform a given task can be a stronger predictor of performance than skill itself. There are currently no measures to assess confidence with manual wheelchair use. The objective of this study was to develop and assess the content validity of the Wheelchair Use Confidence Scale (WheelCon-M).

Method. A two-phase mixed-methods design was used. Semi-structured interviews were conducted to generate items, followed by a Delphi survey for item selection. Persons who use a wheelchair, health care professionals, and researchers participated in both phases of the study.

Results. An 84-item WheelCon-M was developed based on the qualitative data. After the Delphi survey, a final 62-item WheelCon-M was composed of the following six areas (number of items per area): Negotiating the Physical Environment (33 items), Activities Performed using a Manual Wheelchair (11 items), Knowledge and Problem Solving (6 items), Advocacy (4 items), Managing Social Situations (5 items) and Managing Emotions (3 items).

Conclusion. This article reports the development and content validation of the WheelCon-M. As a scale to measure confidence with wheelchair use was not available prior to this work, clinicians now have a method of identifying individuals who have low confidence with wheelchair use.

Keywords:

• Wheelchair
• self-efficacy
• confidence
• outcome measure
• instrument development

Acknowledgements

PWR and WCM conceptualised the study and developed the design; PWR performed the qualitative interviews, conducted the Delphi survey, analysed the data, and drafted the manuscript. WCM supervised the project, participated in interpretation of the results and editing of the manuscript; RLK provided feedback and recommendations for study design, site support for conducting interviews in Halifax, NS and editing of the manuscript; JJE provided feedback and recommendations for study design, and editing of the manuscript; JY provided assistance with recruitment and editing of the manuscript. All authors read and approved the final manuscript. This study was funded by the Canadian Institutes of Health Research (CGA 86803), the BC Rehab Foundation, and the British Columbia Network for Aging Research. Salary/scholarship funds were provided by: the Canadian Institutes of Health Research (PWR, WCM) and the Michael Smith Foundation for Health Research (PWR, JJE). The authors would also like to express their gratitude to the persons who use a wheelchair, health care professionals, and researchers who participated in this study and contributed to the development of the WheelCon-M.