The Wheelchair Use Confidence Scale: Italian translation, adaptation, and validation of the short form

OBJECTIVE: We developed an Italian version of the Wheelchair Use Confidence Scale for Manual Users-Short Form (WheelCon-M-I-short form) and examined its reliability and validity. METHODS: The original scale was translated from English to Italian using the "Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice" guidelines. The WheelCon-M-I-short form was administered to experienced manual wheelchair users who had a variety of diagnoses. Its internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated using Pearson correlation coefficients with the Italian version of the Wheelchair Outcome Measure (WhOM-I) and the Italian version of the Barthel index (BI). RESULTS: The WheelCon-M-I-short form was administered to 31 subjects. The mean ± SD of the WheelCon-M-I-short form score was 7.5 ± 1.9. All WheelCon-M-I-short form items were either identical or similar in meaning to the WheelCon-M-short form items. Cronbach's α for the WheelCon-M-I-short form was 0.95 (p < 0.01), and the test-retest reliability (ICC) was 0.978 (p < 0.01). The Pearson correlation coefficient of the WheelCon-M-I-short form scores with the WhOM-I scores was 0.7618 (p < 0.01). The Pearson correlation coefficient of the WheelCon-M-I-short form scores with the Italian BI scores was 0.638 (p < 0.01). CONCLUSIONS: The WheelCon-M-I-short form was found to be reliable and a valid outcome measure for assessing manual wheelchair confidence in the Italian population. Implication for Rehabilitation The WheelCon-M-I-short form is a valid outcome measure available for assessing wheelchair confidence, according to Bandura's social cognitive theory, self-efficacy is a better predictor of future behavior than skill itself. Translation of the WheelCon-M-short form into the WheelCon-M-I-short form provides a new tool for Italian professionals. Clinicians now have a method to measure this invisible barrier to wheelchair use, and they will be able to make informed decisions when prescribing the use of manual wheelchairs and when training clients in their use. The WheelCon-M-I-short form also provides researchers with a tool in an important and relevant area of study for future research.