AbstractOutcome expectations are a multidimensional construct encompassing physical, social, and self-evaluative components, significantly influencing adults’ exercise behaviors. The study aimed to develop and validate a Turkish version of the ‘Multidimensional Outcome Expectations for Exercise Scale’ (MOEES) and assess its reliability in adults with cardiovascular disease (CVD). This cross-sectional validation included 150 participants. The MOEES was translated into Turkish, ensuring cultural and linguistic appropriateness, and reviewed by 15 healthcare professionals. Participants’ demographic data were collected, and they completed the MOEES, International Physical Activity Questionnaire (IPAQ), and Tampa Scale for Kinesiophobia-Heart (TSK-H) twice, 15 days apart. The internal consistency of the MOEES was excellent, with a Cronbach’s Alpha of 0.919. Test-retest reliability showed high intraclass correlation coefficients (ICC) for the physical (0.924), self-evaluative (0.921), and social (0.929) subscales. Confirmatory factor analysis (CFA) indicated an excellent fit (X2/df = 1.782, GFI = 0.908, AGFI = 0.856, CFI = 0.962, RMSEA = 0.072, NFI = 0.918, SRMR = 0.052). Strong correlations were found between MOEES sub-dimensions and IPAQ total and TSK-H scores (p < 0.01), confirming the scale’s validity. The Turkish MOEES is a reliable tool for evaluating physical, social, and self-evaluative outcome expectations regarding exercise in CVD patients, making it suitable for clinical and research applications.
IntroductionCardiovascular diseases (CVD), defined as heart and circulatory disorders, are heterogeneous diseases whose cause is usually atherosclerosis1. CVD, which progresses gradually throughout life and is asymptomatic for long periods, is a leading cause of death worldwide1. In addition to medical treatments, interventions to prevent risk factors are increasingly being used in the management of these diseases2. It is also known that there is an inverse relationship between physical activity level and cardiovascular mortality3,4. Physical activity enhances insulin sensitivity, reduces plasma lipid levels, normalizes high blood pressure, lowers blood viscosity, boosts endothelial nitric oxide production, and improves leptin sensitivity, all contributing to cardiovascular protection. This protective effect of exercise is supported by clinical studies, as highlighted by World Health Organization (WHO) recommendations5. The American Heart Association advises a moderate exercise routine of 30 min, five times a week to prevent cardiovascular disease6. Given individuals’ varying physical fitness levels, a one-size-fits-all exercise regimen may not be effective for everyone7. Therefore, personalized exercise programs are likely to become increasingly important, offering more effective results with less wasted effort4,6,8.Individuals with cardiovascular disease tend to have low participation rates in exercise training9. To understand why some patients maintain regular exercise after a cardiac event while others do not, it is essential to explore their expectations regarding exercise. Patients recovering from short-term heart conditions often aim to regain full exercise capacity, leading to higher expectations from their training10. On the other hand, individuals with ischemic heart disease may fear physical activity, which lowers their participation in cardiac rehabilitation and reduces their overall expectations from exercise9,10. Albert Bandura described “self-efficacy” as an individual’s belief in their ability to accomplish a task and “outcome expectations” as the belief that their actions will lead to the desired outcome11.Individuals may believe in their ability to perform a specific behavior but may not perceive the outcome as valuable12. Accurately assessing outcome expectations is crucial for understanding their influence, and interventions to enhance these expectations could increase engagement in exercise activities13,14.Outcome expectations can evaluated using questionnaires, one of which is the “Outcome Expectations for Exercise Scale,” designed to measure only physical and mental outcome expectations14. The “Multidimensional Outcome Expectations for Exercise Scale (MOEES),” developed by McAuley et al., evaluates a broader range of outcome expectations related to exercise[,14,15,16. The MOEES has undergone validity and reliability testing in different populations, including older adults15, individuals with multiple sclerosis (MS)14, and in a Swedish version for cardiac patients16. It has been consistently reported as a reliable and valid tool for assessing exercise-related outcome expectations15.The MOEES has been validated and reliability-tested in different diseases and languages14,15,16. Existing scales primarily focus on physical outcome expectations related to exercise. Developing a Turkish scale that assesses physical, social, and self-assessment outcome expectations could enhance participation and motivation in exercise programs and help design interventions that align with patient expectations. This study aims to evaluate the validity and reliability of the Turkish version of the MOEES, which was developed to measure physical, social, and self-assessment outcomes expected from exercise in CVD patients.MethodsAdaptation processTranslations of MOEES were performed both forward and backward, adhering to international guidelines17,18. The MOEES questionnaire was translated from English to Turkish by a physiotherapist and a specialist in English translation. This translation was adapted considering the characteristics of the Turkish language and culture. In the next phase, to assess the comprehensibility of the scale items, 15 physiotherapists evaluated them using a 5-point Likert scale (1 - Not appropriate, 5 - Very appropriate). In this evaluation, the Content Validity Index (CVI) was calculated as 0.91, indicating that no items in the scale were deemed unclear.ParticipantsThe study was conducted at University Hospital, Cardiology Department, between January 5, 2023, and February 6, 2024. CVD patients who met the inclusion criteria and provided informed consent were included in the study. The study protocol was approved by the The Hatay Mustafa Kemal University Clinical Research Ethics Committee (Approval No: 05.01.2023/01–39). This study carried out according to the Helsinki Declaration (NCT05700968, 2023-01-26) and adhered to CONSORT guidelines. Written and verbal informed consent was obtained from all participants.In Likert-type rating scales, it is accepted that the number of participants should be at least 5 to 10 times the number of survey questions to achieve a normal distribution19. Therefore, at least 150 (15 × 10 = 150) participants were included in the study for the validity and reliability study of the MOEES scale, which is a Likert-type scoring scale consisting of 15 questions.Inclusion criteria Participants aged 18 years or older with a diagnosed heart disease, possess at least one cardiac risk factor (such as hypertension, diabetes mellitus, hyperlipidemia/dyslipidemia, overweight or obesity with a Body Mass Index (BMI) > 25 kg/m2, or physical inactivity defined as engaging in less than 150 min of moderate-intensity exercise per week20, be consent to participate in the study, and be able to read and speak Turkish.Participants with impaired cooperation, mental retardation, or failure to answer all questions were excluded.Outcome measuresDemographic and clinical characteristics such as occupation, age, gender, diagnosis, BMI, education, and, physical activity history, and smoking status were recorded. The data were collected from self-reported questionnaires and medical records by a researcher involved in the study.The Multidimensional Outcome Expectations for Exercise Scale (MOEES), developed by McAuley et al. in 2010, was originally in English and first used with middle-aged/older adults and those with multiple sclerosis14,15. Unlike unidimensional scales, the 15-item MOEES assesses physical (6 items), social (4 items), and self-evaluation (5 items) outcome expectations. Physical outcome expectations (POE) reflect physical experiences from activity, social outcome expectations (SOE) relate to socialization, and self-evaluation outcome expectations (SEOE) pertain to satisfaction and self-esteem from activity. A 5-point scale (1 = strongly disagree to 5 = strongly agree) measures agreement with statements, and scores are combined for each subscale (e.g., POE: 6–30, SOE: 4–20, SEOE: 5–25). This scale aids healthcare professionals in structuring exercise environments to meet individual expectations15. The MOEES has been tested for validity and reliability for use with cardiac patients in its Swedish version16.Kinesiophobia has been defined as the avoidance of movement due to fear of re-injury21. The Tampa Kinesiophobia Scale was developed to evaluate kinesiophobia in individuals with low back pain22. Bäck and colleagues developed the ‘Tampa Kinesiophobia Scale for Heart (TSK-H)’ to assess kinesiophobia in individuals with heart disease23. This scale, includes 17 items. These items are evaluated using a 4-point Likert scale, ranging from “1 - Strongly Disagree” to “4 - Strongly Agree,” and measure fear of injury, avoidance of exercise, perceived danger due to heart issues, and functional impairment. The total score ranges from 17 to 68, with higher scores reflecting greater severity of kinesiophobia23.The short-form International Physical Activity Questionnaire (IPAQ) developed by Craig et al.24 was utilized to evaluate physical activity levels. This questionnaire considers physical activities that last at least 10 minutes at a time. For the past seven days, the study recorded and calculated the duration (in minutes) of vigorous and moderate physical activities, walking, and sitting time per day.”24.Validity and reliability processFor the test-retest evaluation, the MOEES questionnaire was re-administered to all participants 15 days after the initial assessment. It was confirmed that the patients’ clinical characteristics remained stable during this interval. Construct validity of the MOEES questionnaire was assessed through exploratory factor analysis (EFA), which included examining the scree plot, the percentage of variance explained by the factorial model, and the patterns of factor loadings25. Convergent validity was evaluated by analyzing the correlation coefficients between the MOEES questionnaire and the IPAQ and TSK-H scales26,27,28.Statistical analysesData analysis for the study was conducted using SPSS 23.0, AMOS, and MedCalc software. Statistical significance was considered at a p-value of < 0.05. Descriptive statistics for the obtained data were presented as mean, standard deviation, median, and 25th-75th percentiles for numerical variables, and as frequency and percentage for categorical variables. The normality of the total scores and subscale scores obtained from the scales was assessed using the Shapiro-Wilk test. Spearman correlation analysis was used to determine the relationship between the scales. To understand the factor structure of the MOEES scale, exploratory factor analysis (EFA) was initially conducted. Various rotation techniques were tested, and it was determined that the varimax rotation technique was the most suitable. However, items 4, ‘Exercise will enhance my mental alertness,’ and 5, ‘Exercise will provide me with a sense of personal achievement,’ from the Self-Assessment Results Expectations subscale were found to disrupt the factor structure and were therefore removed from the model. In the validation phase of the study, confirmatory factor analysis (CFA) was conducted using AMOS software. The results of the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were presented in detail in the findings section using tables. For the subscales of the MOEES, intraclass reliability coefficients were provided using the test-retest method. To support the test-retest method graphically, Bland-Altman plots for the subscales of the scale were included25,28,29. Correlation coefficients are categorized as weak (-0.29 to -0.10 or 0.10 to 0.29), moderate (-0.49 to -0.30 or 0.30 to 0.49), and strong (-0.50 to -1.00 or 0.50 to 1.00)30.ResultsDescriptive and clinical resultsTo adapt the MOEES to Turkish and evaluate its validity and reliability, researchers included 150 individuals diagnosed with cardiac disease in the study. Table 1 shows the clinical and demographic data of the patients. Among the participants, 46.7% had hypertension (HT). The average age was 57.98 ± 14.01 years, and the average BMI was 29.16 ± 5.48 kg/m2. Of the group, 54.7% were female, 76% were married, 51.3% were housewives, and 41.3% were classified as obese. Among the participants, 24% had additional disease diagnoses, including diabetes (24%), chronic renal failure (2.7%), respiratory diseases (2%), and cerebrovascular accidents (6%). Sixty-five point 3% of participants reported never smoking, 94% stated they did not consume alcohol, and 84% indicated they did not engage in regular exercise. The average scores for the pretest administration MOEES were: POE subscale, 27.13 ± 3.39; SOE subscale, 12.32 ± 2.33.; and SEOE subscale, 20.78 ± 3.45.Table 1 Demographic and clinical characteristics of the CVD disease patients.Full size tableValidity resultsCorrelations between the MOEES scale and IPAQ and TSK-H are presented in Table 2. The POE-test showed a weak positive correlation with the IPAQ vigorous activity test (r = 0.188) and the IPAQ walking test (r = 0.293). A moderate positive correlation was observed between the POE-test the IPAQ moderate activity test (r = 0.322) and the IPAQ total test (r = 0.361).Table 2 Correlation coefficients between test- repeated measurements and sub-dimensions of the scales.Full size tableA weak positive correlation was found between the SOE test and the IPAQ vigorous activity test (r = 0.162), the IPAQ walking test (r = 0.235), and the IPAQ total test (r = 0.232). Additionally, the SEOE-test score showed a weak positive relationship with the IPAQ moderate activity test (r = 0.295) and the IPAQ total test (r = 0.230). TSK-H test score was correlated negatively with POE-test (r=-0.434), SOE test (r=-0.398) and SEOE-test (r=-0.385).A moderate positive correlation was found between the POE re-test, the IPAQ walking re-test (r = 0.326), and the IPAQ total re-test (r = 0.331). A weak positive relationship was observed between the POE re-test, the IPAQ moderate activity re-test (r = 0.231), and the IPAQ vigorous activity re-test (r = 0.172).For the SOE re-test, a strong positive correlation was noted (r = 0.740). Additionally, weak positive correlations were found between the SOE re-test and the IPAQ moderate activity re-test (r = 0.237), IPAQ walking re-test (r = 0.244), and IPAQ total re-test (r = 0.274).The SEOE re-test showed weak positive correlations with the IPAQ vigorous activity re-test (r = 0.182), IPAQ moderate activity re-test (r = 0.268), IPAQ walking re-test (r = 0.216), and IPAQ total re-test (r = 0.277). TSK-H was negatively correlated with POE re-test (r=-0.392), SOE re-test (r=-0.370) and SEOE re-test (r=-0.360) scores.Reliability resultsExploratory Factor Analysis (EFA) was conducted on the MOEES scale. During the analysis, the varimax rotation technique was applied, but it disrupted the factor structure. As a result, two items from the Self-Evaluative Outcome Expectations subscale were removed: item 4, “Exercise will increase my mental alertness,” and item 5, “Exercise will give me a sense of personal accomplishment.” The EFA and reliability analysis (Cronbach’s Alpha) results for the revised version of MOEES scale was presented in Table 3.Table 3 Exploratory factor analysis and Cronbach’s alpha results.Full size tableThe Physical Outcome Expectations subscale had factor loadings ranging from 0.589 to 0.829, an eigenvalue of 6.755, an explained variance of 27.903%, and a reliability coefficient of 87.8%. The Self-Evaluative Outcome Expectations subscale had factor loadings between 0.609 and 0.867, an eigenvalue of 1.269, an explained variance of 21.693%, and a reliability coefficient of 83.9%. The Social Outcome Expectations subscale showed factor loadings between 0.752 and 0.868, an eigenvalue of 1.067, an explained variance of 20.337%, and a reliability coefficient of 89%.These three factors together accounted for 69.933% of the total variance. The Bartlett’s test for sample adequacy was statistically significant at a 95% confidence level, indicating that the sample size was sufficient for EFA. The overall reliability of the scale was 91.9%. Results of the Confirmatory Factor Analysis (CFA), which included the subscales of the MOEES, were displayed in Fig. 1.Fig. 1Path diagram for the Turkish version of the ‘Multidimensional Outcome Expectations for Exercise Scale’ (MOEES).Full size imageThe analysis showed that the item explaining the POE subscale the most was POE4, “Exercise will strengthen my bones,” with a coefficient of 0.85. In contrast the least explanatory item was POE5, “Exercise will aid in weight control,” with a coefficient of 0.62. For the SEOE subscale, SEOE2, “Exercise will improve my mood,” had the highest explanatory power with a coefficient of 0.90, and SEOE3, “Exercise will improve my psychological state,” had the lowest with a coefficient of 0.80. In the SOE subscale, SOE1, “Exercise will improve my social status,” had the highest coefficient at 0.79, while SOE4, “Exercise will make me accepted by others,” had the lowest at 0.69 (Fig. 1).Additionally, the correlation between the latent variables revealed a strong positive correlation of 0.68 between POE and SEOE, 0.71 between POE and SOE, and 0.71 between SEOE and SOE. The significance of the coefficients in the Confirmatory Factor Analysis showed that all coefficients were statistically significant at the 95% confidence level (p < 0.001).According to the goodness-of-fit criteria in Table 4, the X2/sd value, one of the key indicators of model fit, was 1.782, indicating an excellent fit. The Root Mean Square Error of Approximation (RMSEA) was calculated as 0.072, Normed Fit Index (NFI) as 0.918, Comparative Fit Index (CFI) as 0.962, Goodness of Fit Index (GFI) as 0.908, Standardized Root Mean Square Residual (SRMR) = 0. 052 and Adjusted Goodness of Fit Index (AGFI) as 0.856, all of which fall within the acceptable fit range. The test-retest results, shown in Table 5, revealed that the Intraclass Correlation Coefficients (ICC) for the subscales of the MOEES—POE, SOE, and SEOE—ranged from 0.85 to 0.94, indicating high intra-class reliability. The Bland-Altman method was applied to assess the subscales, and the graphs displaying the deviations of the observed values from the mean are presented in Fig. 2a, b and c.Table 4 Goodness of fit results regarding confirmatory factor analysis.Full size tableTable 5 Test-Retest method results of MOEES.Full size tableFig. 2Bland-Altman plots for the subscales test re-test results of the ‘Multidimensional Outcome Expectations for Exercise Scale’ (MOEES).Full size imageThe differences between the POE test and retest results were systematically distributed around their means, with a clear relationship between the differences and the means (Fig. 2a). Similarly, the differences in the SOE test-retest results were also systematically distributed around their means, and a relationship between the differences and means was observed (Fig. 2b). For the SEOE test-retest results, the differences were again systematically distributed around their means, showing a relationship between the differences and the means (Fig. 2c).DiscussionThe present study aimed to evaluate the validity and reliability of the Turkish version of the Multidimensional outcome Expectations for Exercise Scale (MOEES), which assesses exercise expectations in patients diagnosed with cardiovascular disease. Two items from the Self-Evaluative Outcome Expectations subscale were removed due to their disruption of the factor structure. Analysis of all sub-dimensions of the MOEES revealed high reliability, as evidenced by elevated Cronbach’s Alpha values. The intra-class correlation coefficient also demonstrated high reliability. Furthermore, confirmatory factor analysis indicated a strong positive correlation between the sub-dimensions of the scale.Around 31% of the global population does not meet the recommended levels of physical activity, which poses a significant risk for various serious health conditions, such as obesity, chronic diseases, cancer, and cardiovascular diseases5. Physical inactivity is now recognized as the fourth leading cause of global mortality31. The American Heart Association highlights sedentary behavior and physical inactivity as modifiable risk factors for cardiovascular disease32. In recent years, global efforts to promote physical activity, exercise training, and improved cardiorespiratory fitness have become key strategies in preventing chronic diseases33.There is a strong link between exercise outcome expectations and exercise behavior12. Individuals who are physically active tend to have higher outcome expectations compared to those who are inactive13. Accurately measuring these expectations is crucial for understanding them and developing interventions that effectively enhance them12. Without assessing outcome expectations, it becomes difficult to predict the results an individual may expect from exercise, and appropriate interventions may not be implemented to address potentially low expectations, hindering the customization of exercise programs to meet individual needs12 .Accurately and reliably measuring outcome expectations is essential for creating more dependable and personalized exercise plans12. The “Outcome Expectations for Exercise Scale,” a commonly used tool, includes 9 items that evaluate individuals’ mental and physical outcome expectations12. However, this scale does not fully capture the multidimensional nature of exercise outcome expectations. In contrast, the MOEES, whose validity and reliability have been confirmed in this study, is a comprehensive questionnaire that assesses not only physical outcome expectations but also social outcome expectations—focusing on individuals’ interactions with their environment—and self-evaluative outcome expectations, which reflect personal goals and self-perceptions14. This multidimensional approach supports both individuals participating in exercise and health professionals in designing exercise plans, as it boosts motivation and allows for more tailored exercise planning14.It has been noticed that there is a lack of a tool to measure exercise-related outcome expectations in our country. Through our research on the validity and reliability of the MOEES, we have successfully adapted this scale to the Turkish cultural context, providing a reliable instrument for use in both clinical settings and academic studies. Originally developed in English by McAuley and colleagues14, the MOEES has been previously validated and applied to elderly individuals and those with multiple sclerosis14,15. In 2022, Urell and colleagues translated the MOEES into Swedish and applied it to individuals with cardiac disease, further confirming its validity and reliability16.In the factor analysis conducted by McAuley and colleagues, the social outcome expectations items “Exercise will improve my social status” and “Exercise will make me feel accepted by others” disrupted the factor structure. To resolve this, the model was adjusted by allowing a correlation between these two items14. Similarly, in our study, we encountered issues with the factor structure, prompting the removal of two items from the self-evaluation subscale: item 4, “Exercise will increase my mental alertness,” and item 5, “Exercise will give me a sense of personal accomplishment.” These adjustments were necessary to enhance the scale’s overall fit and reliability within the Turkish context.To achieve a normal distribution in a Likert-type scale, it is recommended to include a sample size that is at least 5 to 10 times the number of items on the survey19. Given that the MOEES consists of 15 items, in our study, we ensured an adequate sample size by including a minimum of 150 participants, reflecting the recommended 10:1 participant-to-item ratio for the 15-item scale19 In comparison, Urell and colleagues included 74 participants aged 18 and over in their study16 while Wójcicki and colleagues conducted their research with 320 individuals aged over 5015. The high intraclass correlation coefficient (ICC) observed in our study may be attributed to the robust sample size.The reliability of the MOEES was evaluated in several studies. Wójcicki et al. reported internal consistency values of α = 0.82 for the physical outcome expectations subscale, α = 0.81 for the social outcome expectations subscale, and α = 0.84 for the self-assessment subscale15. McAuley et al. found slightly lower internal consistency values, with α = 0.76 for physical, α = 0.77 for social, and α = 0.83 for self-assessment outcome expectations14. In Urell et al.‘s study, the internal consistency was α = 0.73 for physical, α = 0.84 for social, and α = 0.76 for self-assessment outcome expectations16. In current study, the internal consistency of the three MOEES subscales was α = 0.87 for physical outcome expectations, α = 0.83 for social outcome expectations, and α = 0.89 for self-assessment outcome expectations, with an overall Cronbach’s Alpha of 0.919 for the entire scale. These results suggest the scale has high reliability. Additionally, when comparing Cronbach’s Alpha values across studies, our findings show higher reliability, indicating that the Turkish adaptation of the MOEES is robust and consistent.Present study also assessed the reliability of the MOEES using the test-retest method, which yielded high intraclass correlation coefficient (ICC) values: 0.924 for physical outcome expectations, 0.921 for social outcome expectations, and 0.929 for self-assessment outcome expectations. These results demonstrate greater reliability compared to the ICC values reported by Urell et al.16.Confirmatory factor analysis (CFA) was conducted to assess the factor structure of the scale. The goodness-of-fit indices in our study, including X2/sd = 1.782, RMSEA = 0.072, NFI = 0.918, CFI = 0.962, GFI = 0.908, SRMR = 0.052 and AGFI = 0.856, all met acceptable thresholds, indicating a good model fit. These results are consistent with the findings reported by Wójcicki15 and McAuley14, though they differ from the less favorable outcomes observed by Urell16 and colleagues. Additionally, we identified strong positive correlations between the latent variables: 0.68 between physical and self-assessment outcome expectations, 0.71 between physical and social outcome expectations, and 0.71 between self-assessment and social outcome expectations. All correlations were statistically significant at the 95% confidence level, aligning with the findings from Wójcicki and colleagues15. The Turkish version of the MOEES is a reliable scale, and it is recommended that future research evaluate its reliability in populations, such as those with respiratory and neurological diseases.To establish the structural validity of a scale, it is important to demonstrate its relationships with similar measures34. Wójcicki et al. validated the MOEES using the SF-12 scale, finding a strong correlation between physical outcome expectations and physical health status15. They also identified a statistically significant relationship between self-assessment outcome expectations and the SF-12, although the relationship between social outcome expectations and the SF-12 was not significant15. McAuley et al. used the Godin Leisure Time Exercise Questionnaire (GLTEQ), an accelerometer, and the SF-12 for validation. They found strong, significant relationships between higher activity levels (measured by GLTEQ and accelerometer) and physical, self-assessed, and social outcome expectations. Additionally, McAuley et al. reported significant associations between physical health status and physical, social, and self-assessment outcome expectations as measured by the SF-1214.In our study, the validity of the MOEES was assessed by comparing it with the IPAQ and TSK-H scales. Statistically significant correlations were found between the MOEES sub-dimensions and both the total IPAQ score and the TSK-H, supporting the scale’s validity. A key strength of this study is the MOEES’s multidimensional structure, which differentiates it from most other scales by measuring not only physical but also social and self-assessment outcome expectations. This comprehensive approach allows for more detailed data collection and more precise interventions. Additionally, the MOEES aids in assessing individuals’ readiness for exercise prior to program development, offering valuable insights into their overall perspective on exercise14. The study’s methodological strength was bolstered by the use of highly reliable databases.However, a limitation is the scarcity of validity and reliability studies on the MOEES in other languages, which limited available literature for comparison. Additionally, the study included a broad cardiac population rather than focusing on specific cardiac conditions, and did not account for participants’ BMI or physical activity levels, suggesting that future research could benefit from a more targeted and nuanced approach. Moreover, a potential limitation of this study is the Hawthorne effect, which may have influenced participants’ responses. As data collection relied on self-reported measures, participants might have provided socially desirable answers rather than reflecting their true experiences or opinions.ConclusionIn conclusion, the MOEES, designed to measure exercise outcome expectations, has been shown to be a valid and reliable tool for use in clinical settings and research among Turkish-speaking individuals. This study, conducted with patients who had CVD, confirms its validity and reliability following its translation and cultural adaptation into Turkish, consistent with previous literature. Future research is encouraged to evaluate the MOEES across diverse pathological conditions to further establish its applicability and reliability.
Data availability
The data supporting the findings of this study are available from the corresponding author, (İH), upon reasonable request.
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Download referencesAcknowledgementsWe want to thank all participants for engaging in the study.FundingNone.Author informationAuthors and AffiliationsInstutue of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, TurkeyYusuf Ziya ArslanFaculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkeyİrem Hüzmeli & Nihan KatayıfçıTayfur Ata Sökmen Faculty of Medicine, Department of Cardiology, Hatay Mustafa Kemal University, Hatay, TurkeyAlparslan KurtulFaculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, TurkeyNihan KatayıfçıAuthorsYusuf Ziya ArslanView author publicationsYou can also search for this author in
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PubMed Google ScholarContributionsİH, YZA conceived and designed the study. İH and YZA collected the data. İH, YZA and NK performed the data analysis. İH, NK, and AK wrote and revised the manuscript. All authors approved the submitted version.Corresponding authorCorrespondence to
İrem Hüzmeli.Ethics declarations
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The authors declare no competing interests.
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Reprints and permissionsAbout this articleCite this articleArslan, Y.Z., Hüzmeli, İ., Katayıfçı, N. et al. Validity and reliability study of the Turkish version of the multidimensional outcome expectations for exercise scale (MOEES) in patients with cardiovascular diseases.
Sci Rep 15, 8464 (2025). https://doi.org/10.1038/s41598-025-92222-2Download citationReceived: 13 September 2024Accepted: 26 February 2025Published: 12 March 2025DOI: https://doi.org/10.1038/s41598-025-92222-2Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard
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KeywordsCardiovascular diseaseMotivationExerciseKinesiophobiaPhysical activityValidityReliability