Psychometric Testing of the Self-care of Coronary Heart Disease Inventory Version 3.0

Abstract

Background: In this updated Self-Care of Coronary Heart Disease Inventory (SC-CHDI) v3.0, items were added to better reflect the theory of self-care of chronic illness and revised based on recent research. The expanded SC-CHDI now reflects the theoretical concepts of self-care maintenance, monitoring, and management. Objective: The aim of this study was to evaluate the psychometric properties of the SC-CHDI v3.0. Methods: In a sample of adults with coronary heart disease, we tested the SC-CHDI v3.0 validity with confirmatory factor analysis. Reliability was calculated using Cronbach α, factor score determinacy coefficient, and global reliability index for multidimensional scales, with values > 0.70 considered adequate. Results: The sample (n = 205) was predominantly male (79%) with a mean age of 65.3 ± 11.1 years. The self-care maintenance scale encompassed 2 distinct behaviors, namely, "illness related behaviors" and "health promoting behaviors," which reflect consulting and autonomous dimensions, respectively. The goodness-of-fit indices were adequate: χ 2 (25, N = 205) =31.86, P = .16, comparative fit index = 0.97, Tucker-Lewis Index = 0.95, root mean square error of approximation = 0.04 (90% confidence interval, 0.00-0.07), P = .705, and standardized root mean square residual = 0.045. Analysis of the new self-care monitoring scale yielded a single factor; goodness-of-fit indices were excellent: χ 2 (12, N = 205) =11.56, P = .48, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation < 0.001 (90% confidence interval, 0.000-0.07), P = .86, and standardized root mean square residual = 0.02. The self-care management scale had 2 dimensions of autonomous and consulting behavior with strong goodnessof-fit indices: χ 2 (7, N = 205) =6.57, P = .47, comparative fit index = 1.00, Tucker-Lewis Index = 1.00, root mean square error of approximation ≤ 0.001 (90% confidence interval, 0.00-0.08), P = .76, and standardized root mean square residual = 0.02. Reliability estimates were ≥0.80 for all scales. Conclusions: Our testing suggests that the SC-CHDI v3.0 is a sound measure of the essential elements of self-care for adults with coronary heart disease.

Psychometric testing of the caregiver contribution to self-care of coronary heart disease inventory

“…Interestingly, the excessive covariance we found between item 4 "do physical activity" and item 5 "do something to relieve stress", suggests that caregivers elicit physical activity in patients in order to cope with their stress. This hypothesis is reinforced by the results we found in the patient version of the scale, where the same covariance emerged [14]. The high correlation emerged between the factors of consulting and autonomous behaviors provides further proof that these latent factors faithfully represent the CC to self-care maintenance behaviors.…”

“…This approach is consistent with other validation studies conducted on the measures of caregiving contribution [19,22]. The three scales were tested separately, by maintaining the same factor structure of the SCHDI scale [14]. This decision was based on prior studies where the factorial structure of the caregiver contribution instruments reflected the same structure of the patients' instruments [18,22].…”

“…Specific tools were used to assess the predictors, process and outcomes of self-care and caregiver contribution to selfcare. For this analysis we used caregiver data collected by the CC-SC-CHDI, the Self-care of Coronary Heart Disease Inventory Version 3.0 (SC-CHDI v.3) [14], the Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) [15], and a sociodemographic questionnaire.…”

“…The CC-SC-CHDI was developed by referring to the patient version of the scale (SC-CHDI), which was developed in English and also validated in the Italian language [14]. SC-CHDI consists of three scales with items formulated on 5-point Likert-type options: self-care maintenance (9 items), self-care monitoring (8 items) and self-care management (6 items).…”

Advances in the Science of Heart Failure Self-care

“…28 Considering the maxim that it is easier to change attitudes than behavior, a measure of self-care behaviors is an important advance in our efforts to measure the results of our interventions. We have published several valid and reliable measures of self-care previously, 5,[29][30][31][32][33][34] but this was our first foray into exploring the behavior of self-care neglect. Self-care has been argued in the lay literature as the opposite of self-care neglect, but I would argue that self-care and self-care neglect are probably not polar opposites.…”