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Chen TY, Kao CW, Cheng SM, Liu CY. Translation, adaptation, and validation of a Chinese version of the Hypertension Self-Care Activity Level effects (H-SCALE) for patients with hypertension. BMC Nurs 2024; 23:334. [PMID: 38760793 PMCID: PMC11100141 DOI: 10.1186/s12912-024-01993-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Lifestyle modification is an essential component of prevention and management of hypertension. Existing instruments in Taiwan focus on assessing lifestyle modifications by evaluating medication adherence or confidence in controlling blood pressure. However, other self-care activities, such as diet, physical activity, weight management, smoking, and alcohol consumption are also important. The Hypertension Self-Care Activity Level Effects (H-SCALE) is one such instrument, but there are no similar tools available in Taiwan. AIM This study aimed to translate the H-SCALE into Chinese and test its validity, and reliability in a sample of adults with hypertension. METHODS The English version of the 31-item H-SCALE was translated into Chinese using the forward-backward method. The content validity index (CVI) of the translated scale was determined by five experts in hypertension. Item analysis was conducted with a pilot sample of 20 patients with hypertension. Cronbach's α was used to establish the internal consistency reliability for the Chinese version of the H-SCALE (H-SCALE-C). Exploratory factor analysis (EFA) explored the structure of the H-SCALE-C. Additionally, construct validity was examined with confirmatory factor analysis (CFA). Patients with hypertension were recruited by convenience sampling from a cardiovascular outpatient clinic of a medical center in northern Taiwan. A total of 318 patients met the inclusion criteria and participated in factor analysis in the study. RESULTS Pilot testing of the scale items indicated most patients could not accurately estimate the number of days of alcohol consumption for the previous week. Therefore, three alcohol-related items were removed. The adaptation resulted in a 28-item H-SCALE-C. EFA revealed a 4-factor solution with 13 items that explained 63.93% of the total variance. CFA indicated a good fit for a 4-factor model and construct validity was acceptable. Internal consistency reliability was acceptable (Cronbach's alpha for the four subscales ranged from 0.65 to 0.94). Convergent validity was acceptable, and discriminant validity was significant. CONCLUSIONS The H-SCALE-C is a valid, reliable tool for promptly assessing life-style activities for patients with hypertension in Taiwan. The instrument is suitable for assisting healthcare providers in evaluating self-care activities, which could be used to facilitate lifestyle modifications for patients with hypertension.
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Affiliation(s)
- Ting-Yu Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Chi-Wen Kao
- School of Nursing, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd Neihu Dist, Taipei, 11490, Taiwan.
| | - Shu-Meng Cheng
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Zhao Q, Guo Y, Gu L, Yang L. Comparison of two instruments for hypertension self-care assessments among older adults from China. Nurs Open 2023; 10:1672-1683. [PMID: 36548119 PMCID: PMC9912401 DOI: 10.1002/nop2.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/29/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
AIM To test and compare the Self-Care of Hypertension Inventory (SC-HI) and Hypertension Self-Care Profile (HBP SCP) among older patients with hypertension in China. DESIGN A cross-sectional observational study. METHODS A convenience sampling of 220 older adults (120 male patients and 100 female patients) with hypertension and a mean age of 73.74 years was surveyed using the Chinese version of SC-HI, the Chinese version of HBP SCP and the Chinese version of Exercise of Self-Care Agency Scale (ESCA) during July-September 2019. Psychometric analyses and Receiver Operating Characteristic curve analyses were performed on the collected data. RESULTS The Cronbach's α of SC-HI and HBP SCP was 0.858 and 0.953, respectively. The Pearson's coefficients between the SC-HI total score and the ESCA total score, the HBP SCP total score and the ESCA total score were 0.494 and 0.700, respectively. The satisfactory sensitivity, specificity, cut-off point and Area under the curve of SC-HI were 0.8292, 0.5495, 120.5 and 0.754, respectively. As for HBP SCP, the values were 0.7907, 0.7582, 169.5 and 0.838, respectively. There was no significant difference between these two scales. Each has its own characteristics. However, the HBP SCP is more precise and effective for measuring self-care ability in older patients.
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Affiliation(s)
- Qiao Zhao
- Department of NursingWuxi Higher Health Vocational Technology SchoolWuxiChina
| | - Yujie Guo
- School of Medicine (School of Nursing)Nantong UniversityNantongChina
| | - Lipei Gu
- Department of BurnFirst People's Hospital of NantongNantongChina
| | - Lei Yang
- Nursing DepartmentJiangsu Province HospitalJiangsuNanjingChina
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Lunyera J, Davenport CA, Ephraim P, Mohottige D, Bhavsar NA, Clark-Cutaia MN, Cabacungan A, DePasquale N, Peskoe S, Boulware LE. Association of Perceived Neighborhood Health With Hypertension Self-care. JAMA Netw Open 2023; 6:e2255626. [PMID: 36763360 PMCID: PMC9918870 DOI: 10.1001/jamanetworkopen.2022.55626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/22/2022] [Indexed: 02/11/2023] Open
Abstract
Importance Hypertension self-management is recommended for optimal blood pressure (BP) control, but self-identified residential contextual factors that hinder hypertension self-care are understudied. Objective To quantify perceived neighborhood health and hypertension self-care and assess interactions with the area deprivation index (ADI) and healthy food availability at home. Design, Setting, and Participants A cross-sectional study was conducted in Baltimore, Maryland, including primary care adults enrolled in the Achieving Blood Pressure Control Together trial between September 1, 2013, and June 30, 2014. Participants were Black and had at least 2 BP readings greater than or equal to 140/90 mm Hg in the 6 months before enrollment. Analyses were conducted from August 5, 2021, to January 28, 2022. Exposures Participants' perceived neighborhood health, defined as the mean standardized score across 4 subdomains of aesthetic quality, walkability, safety, and violence, with a higher score signifying better neighborhood health. Main Outcomes and Measures Hypertension self-care behavior and self-efficacy. Multivariable generalized linear models were fit regressing each outcome on perceived neighborhood health (higher scores on each domain signify better perceived neighborhood health), adjusted for confounders, and interaction terms between neighborhood health and potential modifiers (ADI [higher percentiles correspond to more deprivation] and healthy food availability [higher scores indicate greater availability]) of the primary association were included. Results Among 159 participants (median [IQR] age, 57 [49-64] years; mean [SD] age, 57 (11) years; 117 women [74%]), median (IQR) hypertension self-care behavior was 50 (45-56) and self-efficacy was 64 (57-72). Better perceived neighborhood health was associated with greater hypertension self-care behavior (β, 2.48; 95% CI, 0.63-4.33) and self-efficacy (β, 4.42; 95% CI, 2.25-6.59); these associations persisted for all neighborhood health subdomains except aesthetic quality. There were no statistically significant interactions between perceived neighborhood health or its subdomains with ADI on self-care behavior (P = .74 for interaction) or self-efficacy (P = .85 for interaction). However, better perceived neighborhood aesthetic quality had associations with greater self-care behavior specifically at higher healthy food availability at home scores: β at -1 SD, -0.29; 95% CI, -2.89 to 2.30 vs β at 1 SD, 2.97; 95% CI, 0.46-5.47; P = .09 for interaction). Likewise, associations of perceived worse neighborhood violence with lower self-care behavior were attenuated at higher healthy food availability at home scores (β for -1 SD, 3.69; 95% CI, 1.31-6.08 vs β for 1 SD, 0.01; 95% CI, -2.53 to 2.54; P = .04 for interaction). Conclusions and Relevance In this cross-sectional study, better perceived neighborhood health was associated with greater hypertension self-care among Black individuals with hypertension, particularly among those with greater in-home food availability. Thus, optimizing hypertension self-management may require multifaceted interventions targeting both the patients' perceived contextual neighborhood barriers to self-care and availability of healthy food resources in the home.
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Affiliation(s)
- Joseph Lunyera
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Clemontina A. Davenport
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | - Patti Ephraim
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York
| | - Dinushika Mohottige
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Nrupen A. Bhavsar
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | | | - Ashley Cabacungan
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Nicole DePasquale
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Sarah Peskoe
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina
| | - L. Ebony Boulware
- Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
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Suwanno J, Phonphet C, Thiamwong L, Mayurapak C, Ninla-Aesong P. Evaluating the Dimensionality and Reliability of the Thai Self-Care of Hypertension Inventory Version 2.0. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:S1976-1317(22)00039-1. [PMID: 35970337 DOI: 10.1016/j.anr.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Self-care is essential for hypertensive individuals to promote optimal health and illness treatment. We developed the Thai Self-Care of Hypertension Inventory (SC-HI) version 2.0 from the original US version using a multi-stage approach for cross-cultural adaptation. Scales previously studied outside a US context had different dimensions and factor solutions. Therefore, we examined the Thai SC-HI's factorial validity, construct validity, and internal reliability within a Thai context. METHODS We administered a cross-sectional survey with hypertensive patients in 10 primary care settings, and conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on two sets of separate samples from each of five sites to examine the model's factorial validity and construct validity. We estimated scale reliability with Cronbach's alpha and McDonald's omega coefficients. RESULTS Participants were predominantly female, older adults, with mean age 66 years (SD = 11.94; range 36-97 years). The Self-Care Maintenance scale had three factors and demonstrated good fit when the error covariances were respecified. The two-factor Self-Care Management scale had different factorial solutions compared to previous models. The CFA result showed good fit indices for the Thai, original US, and Brazilian models. The Self-Care Confidence scale was unidimensional, with partially supported fit indices that improved after we respecified the error covariances. Reliability coefficients estimated by difference methods were nearly equal: slightly lower than desired for Self-Care Maintenance (.68-.70) and inadequate for Self-Care Management (.62-.65); Self-Care Confidence reliability was adequate (.89-.90). CONCLUSION The Thai SC-HI has good psychometric characteristics and reflects the original instrument's theoretical basis.
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Affiliation(s)
- Jom Suwanno
- School of Nursing, and the Excellent Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand.
| | - Chennet Phonphet
- School of Nursing, and the Excellent Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, Florida, USA
| | - Chidchanog Mayurapak
- School of Nursing, and the Excellent Center of Community Health Promotion, Walailak University, Nakhon Si Thammarat, Thailand
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Zeng D, Yang C, Chien WT. Testing the psychometric properties of a Chinese version of Dyadic Relationship Scale for families of people with hypertension in China. BMC Psychol 2022; 10:34. [PMID: 35189971 PMCID: PMC8862279 DOI: 10.1186/s40359-022-00747-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background Interventions for people with chronic illness have increasingly got involvement and partnership with family members in China and worldwide. The patient-family interactions in chronic illness care can greatly influence not only family dyadic relationship or collaboration in caregiving but also both patient’s and caregiver’s health and well-being. To date, very few instruments have been developed to measure the family dyadic relationship; and none has been found in Chinese language. This study aimed to translate the original English Dyadic Relationship Scales (DRS), including DRS-patient and DRS-caregiver, into simplified Chinese language (DRS-C) and examine their psychometric properties in Chinese people with hypertension in a rural community. Methods The Brislin’s model of translation was adopted for translation. Face and content validity and semantic equivalence of the translated Chinese version of the two DRS-patient and DRS-caregiver scales were examined. A sample of 132 adults with hypertension and their family caregivers were recruited to test the psychometric properties of the DRS-C scales. Results The DRS-C scales indicated very satisfactory face validity with 10 family dyads in hypertension care, content validity rated by five experts (Item CVI = 0.8–1.0; Scale CVI = 0.98) and semantic equivalence rated by 22 panel members (i.e., all items were rated as 3 = relevant or 4 = very relevant by > 18 members). A well-fitting model of DRS-C-patient was identified with χ2/df = 1.47, p = 0.04, RMSEA = 0.06, GFI = 0.941, CFI = 0.961, TLI = 0.947, and SRMR = 0.019. A well-fitting model of DRS-C-caregiver was identified with χ2/df = 1.340, p = 0.092, RMSEA = 0.039, GFI = 0.940, CFI = 0.975, TLI = 0.965, and SRMR = 0.014. The Chinese DRS-patient and DRS-caregiver had satisfactory internal consistency with Cronbach’s α coefficients of 0.82 and 0.83, respectively, and test–retest reliabilities with intra-correlation coefficients of 0.97 and 0.96, respectively. The convergent validities of the Chinese versions of the DRS-patient and DRS-caregiver were very satisfactory with the self-efficacy subscale of Hypertension Self-Care Profile, and Zarit Burden Interview, respectively (Pearson’s r = − 0.70 and 0.79; both p < 0.001). Significant differences on mean scores of the Chinese versions of the DRS-patient (t = − 8.10, p < 0.001) and the DRS-caregiver (t = − 9.15, p < 0.001), between the groups of adults with hypertension and normal blood pressure counterparts. Conclusion Both Chinese versions of the DRS-patient and DRS-caregiver have sound psychometric properties and similar factor structure to the original English version. The Chinese versions can be valid measures of family dyadic relationship among Chinese adults with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00747-2.
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Zeng D, Yang C, Chien WT. Effects of a family dyadic partnership program for people with hypertension in a rural community: A pilot randomised controlled trial. Aust J Rural Health 2021; 29:435-448. [PMID: 34218485 DOI: 10.1111/ajr.12712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/19/2020] [Accepted: 12/09/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate the feasibility, acceptability and preliminary effectiveness of a theory-based patient-family carer partnership intervention for people with hypertension in a Chinese rural community. DESIGN A pilot randomised controlled trial using pretest and post-test design. SETTING Rural China PARTICIPANTS: Forty-four hypertensive patients and their family carers (family dyads) were randomly recruited from a village clinic located in China between November 2019 and January 2020. INTERVENTIONS Participants were randomised to either an intervention group receiving a five-session patient-family carer partnership intervention over 10 weeks or a control group receiving usual care. MAIN OUTCOME MEASURES The feasibility and acceptability of patient-family carer partnership intervention and the changes in patients' systolic blood pressure, diastolic blood pressure and percentage of normal controlled blood pressure. RESULTS The patient-family carer partnership intervention was a feasible and acceptable program with high recruitment (81.5%) and completion rates (95.5%) and positive feedback from participants. Greater improvement in the percentage of normal controlled blood pressure was identified in the intervention group tested by the χ2 tests, with P = .03. Two-way ANOVA results indicated its interaction (Group × Time) effects on patients' systolic blood pressure (P < .001), diastolic blood pressure (P < .001), dyadic partnership quality (P = .002), self-care (P < .001), self-efficacy (P = .02), antihypertensive drug treatment rate (P = .02), prescription adjustment (P = .03), perceived anxiety (P < .001) and health-related quality of life (EuroQol five-dimensional five-level: P = .02; EuroQol visual analogue scale: P < .001); family carers' dyadic partnership quality (P = .002), perceived depression (P = .04) and health-related quality of life (P = .02) were significant. CONCLUSION Our findings support the feasibility and acceptability of the patient-family carer partnership intervention and indicate benefits in improving patients' blood pressure control, dyadic relationship and psychological well-being of family dyads in rural area. Further research to test the longer-term effect in a large-sized population is recommended.
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Affiliation(s)
- Dejian Zeng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Gurbuz A, Cil AP, Karakis LS, Abali R, Ceyhan M, Aksakal E, Kilic A, Bahceci M, Urman B. Decision regret and associated factors following oocyte cryopreservation in patients with diminished ovarian reserve and/or age-related fertility decline. J Assist Reprod Genet 2021; 38:1469-1479. [PMID: 33797008 PMCID: PMC8266947 DOI: 10.1007/s10815-021-02164-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/21/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To evaluate the prevalence and factors associated with decision regret following oocyte cryopreservation (OC) in women with diminished ovarian reserve (DOR) and/or age-related fertility decline (ARFD). METHODS A cross-sectional survey study was conducted to five hundred fifty-two women with DOR and/or ARFD who underwent OC between 2014 and 2019 in two private-assisted reproductive units in Istanbul, Turkey. Decision regret was measured using the validated Decision Regret Scale (DRS). RESULTS The median and mean DRS scores were 10 (interquartile range: 25) and 13.4 (SD: 13.2, range 0-70), respectively. Eighty-five (52.5%) women reported mild regret and 26 (16%) had moderate to severe regret. Decision regret was inversely associated with the belief in fate regarding childbearing and trust in the efficacy of OC. CONCLUSIONS The prevalence of severe decision regret among patients with DOR and/or ARFD undergoing OC is low. Women who had belief in fate and trusted in the efficacy of oocyte cryopreservation had significantly lower decisional regret.
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Affiliation(s)
- Aysen Gurbuz
- Women's Health Center, Assisted Reproduction Unit, American Hospital, Guzelbahce Sokak, No: 20 Nisantasi, 34365, Istanbul, Turkey
| | - Aylin Pelin Cil
- Women's Health Center, Assisted Reproduction Unit, American Hospital, Guzelbahce Sokak, No: 20 Nisantasi, 34365, Istanbul, Turkey.
| | | | - Remzi Abali
- Fulya IVF Center, Bahçeci Health Group, 34394, Istanbul, Turkey
| | - Mehmet Ceyhan
- Women's Health Center, Assisted Reproduction Unit, American Hospital, Guzelbahce Sokak, No: 20 Nisantasi, 34365, Istanbul, Turkey
| | - Ece Aksakal
- Women's Health Center, Assisted Reproduction Unit, American Hospital, Guzelbahce Sokak, No: 20 Nisantasi, 34365, Istanbul, Turkey
| | - Azer Kilic
- Department of Sociology, Istanbul Bilgi University, 34060, Istanbul, Turkey
| | - Mustafa Bahceci
- Fulya IVF Center, Bahçeci Health Group, 34394, Istanbul, Turkey
| | - Bulent Urman
- Women's Health Center, Assisted Reproduction Unit, American Hospital, Guzelbahce Sokak, No: 20 Nisantasi, 34365, Istanbul, Turkey
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