A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study

Retracted: Reliability and validity of the Chinese version of the mobile Agnew Relationship Measure (mARM-C)

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and the authors. The authors requested post acceptance two new names to be added to the authorship of the article. However, the authors were not able to provide a satisfactory explanation for the requested authorship change and demanded the retraction of the article. Consequently, the Editor no longer has confidence in this article and decided to retract it.

Cross-cultural adaptation and validation of the caregiver self-efficacy in contributing to patient self-care scale in China

BACKGROUND

Caregiver self-efficacy is crucial in improving patient outcomes and caregiver well-being, but there is a lack of suitable scales to assess this concept within the context of Chinese culture. This study aimed to cross-culturally translate the Caregiver Self-Efficacy in Contributing to Patient Self-Care (CSE-CSC) Scale and evaluate its psychometric properties using classical test theory and item response theory.

METHODS

The CSE-CSC scale was adapted using Brislin's translation model after obtaining authorization from the original author. A multicenter, cross-sectional study was conducted to assess the psychometric properties of this scale. Classical test theory was used to evaluate reliability (internal consistency, test-retest reliability), validity (content validity, structural validity, convergent validity), and floor and ceiling effects. Item response theory was employed to assess the fit of the rating scale model, reliability, item difficulties, and measurement invariance.

RESULTS

The translation and cultural adaptation process was completed. Classical test theory demonstrated good internal consistency (Cronbach's α = 0.935) and test-retest reliability (ICC from 0.784 to 0.829, p<0.001). The I-CVI and K* of each item ranged from 0.875 to 1.00 and 0.871 to 1.00. The first-order 2-factor model fit well (χ2/df = 3.71, RMSEA = 0.082, SRMR = 0.032, CFI = 0.973, TLI = 0.60). Convergent validity showed that the CSE-CSC scores had a strong positive correlation with three separate scales of the CC-SC-CII. There was no floor and ceiling effect in this scale. Rasch analysis showed that the CSE-CSC scale demonstrated a good fit to the rating scale model and exhibited excellent reliability (person/item separation index>2, person/item reliability coefficients>0.8). The Wright map showed that item difficulty matched the respondents' measured abilities. The analysis of differential item functioning (DIF) showed that all items were comparable in gender.

CONCLUSIONS

This study indicated that the CSE-CSC scale had good reliability, validity, difficulty degree, and measurement invariance. The CSE-CSC scale can be used to measure caregiver self-efficacy of Chinese patients with multiple chronic conditions.

Measurement properties of the Iranian version of the breast cancer perception scale (BCPS) according to the COSMIN checklist

BACKGROUND

Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran.

METHODS

The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed.

RESULTS

The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response.

CONCLUSIONS

The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.

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.

The physical activity and social support scale: a translation and psychometric validation study in a Chinese college student sample

Objective

This study aims to evaluate the reliability and validity of the Chinese version of the Physical Activity Social Support Scale (PASSS-C) and its measurement invariance across different gender groups in a Chinese college student sample.

Methods

A total of 1,689 Chinese college students participated in the study. We assessed the internal consistency of PASSS-C using Cronbach's alpha and McDonald's omega. A Confirmatory Factor Analysis (CFA) was conducted to test its five-factor model. Multi-group CFA was used to examine measurement equivalence between male and female groups. Convergent and criterion-related validity were assessed using Pearson correlation coefficients.

Results

The overall internal consistency of PASSS-C was good with a Cronbach's alpha of 0.952, and the subscales showed acceptable consistency. The CFA results supported the five-factor structure of PASSS-C in the college student sample, with values of CFI = 0.932, TLI = 0.917, RMSEA = 0.048, 90% CI [0.043 0.053], SRMR = 0.047. Scalar invariance was also supported across different gender groups, with ΔCFI = -0.003, ΔTLI = 0, ΔRMSEA = 0. PASSS-C demonstrated good convergent and criterion-related validity.

Conclusion

PASSS-C exhibits satisfactory psychometric properties and is a valid and reliable tool for assessing the perceived level of social support for physical activity among college students.

A behavioural driving model of adherence to home-based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed-methods study

AIMS AND OBJECTIVES

To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence.

BACKGROUND

Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored.

DESIGN

An exploratory sequential mixed-methods study was conducted in this study.

METHODS

A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1).

RESULTS

Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence.

CONCLUSIONS

This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence.

RELEVANCE TO CLINICAL PRACTICE

To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear.

PATIENT OR PUBLIC CONTRIBUTION

None.

Psychometric properties of the Malay version of the Illness Cognition Questionnaire among cancer patients in Malaysia

OBJECTIVE

The Illness Cognition Questionnaire (ICQ) was translated from its original English version to the Malay version for this research, adapted the Malay language version of the ICQ (ICQ-M) for use in cancer patients, and assessed the internal consistency, content, face, construct, convergent, discriminant and concurrent validity of the ICQ-M among a cohort of cancer patients with mixed cancer types in Malaysia.

METHOD

Initially, the ICQ was translated into Malay and back-translated, and its content and face validity were evaluated. Then, 346 cancer patients with various cancer types received the ICQ-M, and its internal consistency, convergent, discriminant, construct, and concurrent validity were evaluated.

RESULTS

The ICQ-M and its domains had acceptable internal consistency with Cronbach's α ranging from 0.742 to 0.927. Construct validity assessment demonstrated that the ICQ-M consists of 17 items designated in two domains with good convergent and discriminant validity. The ICQ-M and its domains also had moderate correlations with the Acceptance and Action Questionnaire II, which denotes that the ICQ-M had acceptable concurrent validity.

CONCLUSION

The ICQ-M had good psychometric properties and is now available to measure the illness cognition of cancer patients in Malaysia.

Predictors of home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure: a theory-driven cross-sectional study

BACKGROUND

The factors influencing home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure remain unclear. This study aimed to explore predictors of home-based cardiac rehabilitation exercise adherence in these patients, based on the theory of planned behavior.

METHODS

This theory-driven, cross-sectional study used convenience sampling to recruit patients with chronic heart failure undergoing home-based cardiac rehabilitation. Instruments used included the Home-Based Cardiac Rehabilitation Exercise Adherence Scale, the Multidimensional Self-Efficacy for Exercise Scale, the Perceived Social Support Scale, and the Tampa Scale for Kinesiophobia Heart. Multivariate linear hierarchical regression analysis was employed to examine the factors influencing exercise adherence.

RESULTS

A total of 215 patients with chronic heart failure undergoing home-based cardiac rehabilitation participated in the study. The overall score for home cardiac rehabilitation exercise adherence was (48.73 ± 3.92). Multivariate linear hierarchical regression analysis revealed that age (β=-0.087, p = 0.012), education level (β = 0.080, p = 0.020), fear of movement (β=-0.254, p < 0.001), perceived social support (β = 0.451, p < 0.001), and exercise self-efficacy (β = 0.289, p < 0.001) influenced home-based cardiac rehabilitation exercise adherence. In the second model, fear of exercise explained 23.60% of the total variance, while perceived social support and exercise self-efficacy explained 26.60% of the total variance in the third model.

CONCLUSION

This study found that home-based cardiac rehabilitation exercise adherence in patients with chronic heart failure was suboptimal, and identified its influencing factors. Targeted interventions addressing these factors, such as tailored education, support, and addressing fear of exercise, may help improve exercise adherence.

Development and psychometric properties of Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors (HPLS-CRCS): a mixed-method study

BACKGROUND

Detecting a health-promoting lifestyle in colorectal cancer (CRC) survivors is of paramount importance to manage disease complications, prevent their recurrence, and enhance survival; however, no specialized tool has yet been provided to measure the lifestyle of these patients. Accordingly, this study aimed to develop and determine the psychometric properties of the Health-Promoting Lifestyle Scale in CRC Survivors (HPLS-CRCS).

METHODS

This study was a mixed study with an exploratory sequential design in two phases. Concept analysis was performed in the first phase according to Schwartz-Barcott and Kim's (2000) hybrid model to explain the concept, identify dimensions, and generate items. In the second phase, psychometrics including validity (face, content, and construct) and reliability (internal consistency and stability) were determined. Responsiveness, interpretability, ease of use, item weighting, and scale scoring were also determined.

RESULTS

After explaining the concept, an initial scale encompassing 211 items was developed, content and item analyses were conducted, and the items decreased to 89 items after the face validity assessment. For construct validity, confirmatory factor analysis (CFA) was conducted with a sample size of 500 survivors, and convergent validity was performed for the Persian version of the Health-Promoting Lifestyle Profile II (HPLP-II). Accordingly, 80 items were classified into six factors: activity and rest, spiritual growth, health responsibility, nutrition, interpersonal relationships, and psychological management, with RMSEA = 0.055, χ2/df = 2.484, and χ2 = 6816.516. The reliability of the scale was confirmed, Cronbach's alpha was between 0.865 and 0.928, and the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal important change (MIC), and the smallest detectable change (SDC) were 0.896, 3.36, 13.86, and 19.87, respectively.

CONCLUSION

The HPLS-CRCS consists of 80 items in six dimensions and is a valid and reliable scale for evaluating the health-promoting lifestyle in CRC survivors. Using this scale to evaluate the healthy lifestyle in these survivors can lead healthcare providers to detect deficiencies and plan the lifestyle of CRC survivors during the post-treatment period.