Abstracts

Rationale: Recent efforts have focused on increasing awareness of women’s issues in female PWE. While knowledge is crucial, a women’s ability to engage in self help behavior requires more than awareness. Studies assessing self efficacy behavior in chronic conditions support a strong correlation between efficacy and self-care. While there are scales to evaluate knowledge of women issues in epilepsy, there are no instruments evaluating self efficacy in female patients with the condition. The purpose of this study was to initiate item development and establish content validity for the Self Efficacy Scale in Women with Epilepsy (SESWE). Methods: The original SESWE was developed based on items from the Knowledge of Women’s Issues and Epilepsy (KOWIE) questionnaire. The KOWIE is both valid and reliable. While the content is similar, items in the SESWE emphasize the ability to engage in a particular behavior vs knowledge. Prior self efficacy scales were reviewed to ensure appropriate wording and format. Experts specializing in self efficacy were invited to review the tool for item relevance. Based on feedback, a 10-item electronic content validity inventory (CVI) was created and distributed via Zoomerang. Participants rated each item on an ordinal scale of 1 to 4 with 1 denoting an irrelevant item and 4 supporting an item that is extremely relevant. Items rated a 3 or 4 were considered relevant. Item agreement was established at 80%. Results: Fourteen of 33 experts completed the CVI, a response rate of 42%. The mean number of years in epilepsy practice was 28.50, with a range of 16 to 43yrs. Sixty-four percent were medical doctors, 14% were Nps, 7% were epilepsy social workers and the remaining were listed as "other". Nine out of 10 items were found to be relevant with item agreement ranging from 92-100%. One of the questions on sexual dysfunction was found to be irrelevant (78%). Most related comments focused on the practitioners discomfort with discussing sexual dysfunction, and a lack of resources and treatment for this item. While both comments are valid, including a similar question may increase awareness and reduce patient’s perception of self blame. Also, including this item may generate discussions for appropriate referrals and perhaps expand the interest for related research. Additional comments supported the need to reword this item. One physician rated the question on folate as a "2" out of "4", referencing recent literature suggesting that folate may be unhelpful in reducing teratogenesis in WWE. There are no well controlled studies confirming this. Additionally, current guidelines for WWE support the relevance of preconception folate for risk reduction. Based on comments, the question on birth control was modified to include all forms of contraception. Several items were reworded for clarity. Conclusions: This study supports content validity for 9 of 10 items included in the SESWE. Evaluating self efficacy in WWE is a challenging but crucial concept for engaging in self help behavior. Future studies are underway to further develop this tool and to utilize it in clinical practice and research.