Development and Validation of a Scale to Measure Self-efficacy and Self-management in People With Coronary Heart Disease

Mediation effect of illness acceptance between perceived social support and self-management behaviors in rural elderly with coronary heart disease

OBJECTIVE

To explore the relationship between perceived social support, acceptance of illness, and self-management behaviors and the mediating role of acceptance of illness in perceived social support and self-management behaviors.

METHODS

Between August 2022 and February 2023, 731 rural older adults with coronary heart disease in Feicheng City participated in this study. Correlation analysis was used to analyze the relationship between variables, and mediating effects were analyzed using AMOS 23.0 software.

RESULTS

Perceived social support and acceptance of illness were positively correlated with self-management behaviors. Acceptance of illness mediated the relationship between the perceived social support and the three dimensions of self-management behavior.

CONCLUSION

These findings contribute to the understanding that increased perceived social support and acceptance of illness are more likely to improve self-management behaviors.

A Practical Tool for Measuring Home-Based Cardiac Rehabilitation Self-Management Behavior: A Multiphase Cross-Sectional Study

BACKGROUND

Optimal self-management is the key to home-based cardiac rehabilitation for patients with heart disease. At present, there is a lack of a specific assessment tool to evaluate the home-based cardiac rehabilitation self-management behavior in patients with heart disease. Therefore, the aim of this study was to develop the Home-Based Cardiac Rehabilitation Self-Management Scale and validate its psychometric properties among patients with coronary heart disease.

METHODS AND RESULTS

A multiphase cross-sectional study was conducted that study covered 3 phases: (1) item generation and revision, (2) item evaluation and preliminary exploration, and (3) assessment of the psychometric properties of the scale. A scale with 21 items was developed to measure the home-based cardiac rehabilitation self-management behavior. The content validity index of the scale was 0.980. In exploratory factor analysis, the 5-factor structure supported by eigenvalues and screen plot explained 74.326% of the total variation. In confirmatory factor analysis, all fitting indicators were acceptable, further supporting the construct validity of the scale. The criterion validity of the scale was 0.783. In the reliability analysis, the Cronbach's α coefficient of the scale was 0.882, with a dimensionality range of 0.780 to 0.936. The split-half reliability coefficient and test-retest reliability coefficient were 0.774 and 0.770, respectively.

CONCLUSIONS

This study is the first to develop and validate a practical tool. This scale can comprehensively and accurately assess the self-management behavior of patients with heart disease in a home-based cardiac rehabilitation environment.

Compilation of a self-management assessment scale for postoperative patients with aortic dissection

Objective

The aim of this research was to compile a self-management assessment scale for patients with aortic dissection (AD). The questionnaire is useful in making the patient aware of the need for post-operative care in order to contribute to improving the outcome and quality of life.

Methods

The initial version of the "postoperative self-management assessment scale for patients with aortic dissection" was developed using the Delphi expert consultation method based on qualitative research results, consultation of self-management-related literature, reference to the existing self-management scale, and self-efficacy theory, combined with the disease characteristics of AD. By using the convenience sampling method, a total of 201 patients with AD who had undergone surgery were selected as the research participants. The initial version of the scale was used for follow-up investigation, and the scale entries were evaluated and exploratory factor analysis carried out to form the formal version of the "postoperative self-management assessment scale for patients with aortic dissection." A total of 214 patients with AD after surgery were selected as the research participants. The formal version of the scale was used for follow-up investigation, and its reliability and validity were evaluated.

Results

The formal version of the scale had 6 dimensions and 35 entries. The Cronbach's α coefficient for the total scale was 0.908, the split-half reliability was 0.790, and the test-retest reliability after 2 weeks was 0.471. The content validity index of the total scale was 0.963. Exploratory factor analysis yielded six common factors, and the cumulative contribution rate of variance was 66.303%. Confirmatory factor analysis showed that except for the incremental fit index, Tucker-Lewis index, and comparative fit index >0.85, slightly lower than 0.90, χ 2/df <3, root mean square of approximation <0.08, parsimonious goodness-of-fit index, and parsimonious normed fit index >0.50; all other model fitting requirements were satisfied, indicating that the model fitting was acceptable.

Conclusion

We compiled the postoperative self-management assessment scale for patients with AD, which has demonstrated excellent reliability and validity and can be used as a tool to evaluate the postoperative self-management level in patients with aortic dissection.

Psychometric evaluation of the Thai version of the Self-Care of Coronary Heart Disease Inventory Version 3 (SC-CHDI-V3)

AIMS

Engaging in self-care is an important aspect of the prevention and management of coronary heart disease (CHD), the leading cause of premature death in Thailand. As no validated tool exists to measure self-care in Thai people with CHD, we translated and examined the psychometric properties of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI) Version 3 (V3) in a Thai population.

METHODS AND RESULTS

The SC-CHDI-V3 was translated into Thai using the standard forward and backward translation procedure for self-care instruments. A cross-sectional design was used to examine the psychometric properties of the Thai version of the SC-CHDI-V3 in 250 patients with confirmed CHD in a tertiary hospital in Southern Thailand. Cronbach's alpha and McDonald's omega coefficients were used to assess internal consistency, and confirmatory factor analysis was performed to assess construct validity. The Thai version of the SC-CHDI-V3 demonstrated acceptable internal consistency (Cronbach's alpha and McDonald's omega coefficients of each scale ranged from 0.821 - 0.910). Reliability estimates were adequate for each scale (range 0.863 - 0.906). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.996 - 1.000; root-mean-square error of approximation = <0.001 - 0.040).

CONCLUSIONS

The Thai version of the SC-CHDI-V3 appears to be a valid and reliable instrument for measuring engagement in self-care maintenance, self-care monitoring and self-care management among Thai people with CHD.