Volume 29, Issue 3-4 pp. 645-652
ORIGINAL ARTICLE

The Self-Care of Heart Failure Index: A psychometric study

Binu Koirala PhD, MGS, RN

Corresponding Author

Binu Koirala PhD, MGS, RN

Faculty/Research Associate

School of Nursing, Johns Hopkins University, Baltimore, MD, USA

Center for Innovative Care in Aging, Baltimore, MD, USA

Correspondence

Binu Koirala, Principal Faculty, Center for Innovative Care in Aging, Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Room 521, Baltimore, MD 21205, USA.

Email: [email protected]

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Chakra Budhathoki PhD

Chakra Budhathoki PhD

Associate Professor

School of Nursing, Johns Hopkins University, Baltimore, MD, USA

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Cheryl R. Dennison-Himmelfarb PHD, RN, ANP, FAAN, FAHA, FPCNA

Cheryl R. Dennison-Himmelfarb PHD, RN, ANP, FAAN, FAHA, FPCNA

Associate Dean for Research and Professor

School of Nursing, Johns Hopkins University, Baltimore, MD, USA

Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD, USA

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Priyanka Bhattarai BN Hons

Priyanka Bhattarai BN Hons

PhD Candidate

School of Nursing, The University of Notre Dame, Fremantle, WA, Australia

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Patricia M. Davidson PHD, MED, RN, FAAN

Patricia M. Davidson PHD, MED, RN, FAAN

Dean and Professor

School of Nursing, Johns Hopkins University, Baltimore, MD, USA

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First published: 26 November 2019
Citations: 8

Funding information

This study was supported by 2018 NLN Foundation for Nursing Education Scholarship Award, Southern Nursing Research Society 2018 Dissertation Award, Sigma Theta Tau Nu Beta 2018 Nursing Research Award, Dr. Scholl Foundation, and Deans Travel Fund.

What does this paper contribute to the wider global clinical community?

Like other low- and middle-income countries, Nepal is facing unique challenges associated with the increasing burden of noncommunicable diseases. Yet, there is limited data regarding heart failure and self-care among patients living with heart failure.The paper provides a development and cultural validation process of the Nepali SCHFI, a culturally appropriate self-care measure, to use among patients living with heart failure.Access to a reliable, valid and culturally appropriate Nepali SCHFI will be crucial in describing the state of the problem as well as in developing/evaluating tailored and targeted interventions.

Abstract

Background

The Self-Care of Heart Failure Index is an empirically tested instrument to measure self-care of heart failure patients across different populations and cultures.

Aims

To develop and evaluate the psychometric properties of the Nepali Self-Care of Heart Failure Index.

Design

This psychometric study used a cross-sectional, observational, study design to collect data. The study was guided and reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

Methods

To develop and culturally validate Nepali Self-Care of Heart Failure Index, a combination of the recommended methods for cross-cultural validation studies were applied such as translation, back translation, expert committee review of the translated version and validity/reliability testing. Face and content validity were ensured using expert review. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. Composite reliability scores were calculated for each sub-scale of the Nepali Self-Care of Heart Failure Index.

Results

A total of 221 heart failure patients in Nepal were enrolled in the study. Adequate face and content validity were ensured through expert review. Exploratory factor analysis and confirmatory factor analysis supported the original three-factor model. Although the three factors explained only 41% of the variance, confirmatory factor analysis fit indexes and error measures were found reasonable. The composite reliability coefficients for self-care maintenance, management and confidence scale were 0.6, 0.7 and 0.8, respectively.

Conclusions

The Nepali Self-Care of Heart Failure Index is a theoretically based, culturally acceptable and appropriate instrument for use among Nepali heart failure patients. However, further studies are needed to refine its psychometric properties.

Relevance to clinical practice

Access to reliable, valid and culturally appropriate instruments is crucial in describing the state of the problem as well as for developing and evaluating tailored and targeted self-care practice interventions for Nepali patients living with heart failure.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest.

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