title: Development of the Heart Failure Screening Tool (Heart-FaST) to measure barriers that impede engagement in self-care.
abstract: BACKGROUND
  Screening for self-care capacity is advocated before applying educational strategies. No screening tool has been specifically developed to assess barriers that impede engagement in self-care in people with heart failure. Earlier conceptual work (InCOGNITO) identified NYHA class, mild cognitive impairment and depressive symptoms as barriers that impede engagement in HF self-care.
  
  
  OBJECTIVE
  Study aims were: 1) to develop the Heart Failure Screening Tool (Heart-FaST) as a means of assessing three critical barriers to self-care; 2) to assess the content validity of the Heart-FaST; and 3) to test the feasibility of implementing the Heart-FaST in clinical practice.
  
  
  METHODS
  The Heart-FaST was developed from barriers identified in previous research (InCOGNITO) and from expert panel consensus. Content validity was assessed by examining the proportion of experts who scored each item as relevant.
  
  
  RESULTS
  The InCOGNITO study indicated that four cognitive tasks, seven emotional questions and NYHA functional class were significantly correlated with the self-care scales: maintenance, management and confidence. These factors were used to create the Heart-FaST items. Consensus on wording and items to be included in the Heart-FaST was reached after two rounds of panel discussion. All items had an item-level content validity index ≥ 0.78. High scores on each barrier (physical, cognitive and emotional functioning) suggest poor self-care and the need for more intensive disease management efforts.
  
  
  CONCLUSIONS
  The Heart-FaST measures three critical barriers that impede engagement in self-care. In clinical practice this tool may assist in individually tailoring educational and support strategies to promote effective heart failure self-care.
authors: Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia Jan.Cameron@acu.edu.au.
authors: Jan
authors: J
authors: Cameron
authors: Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia.
authors: Chantal F
authors: CF
authors: Ski
authors: School of Psychology, Australian Catholic University, Melbourne, Australia.
authors: Skye N
authors: SN
authors: McLennan
authors: School of Psychology, Australian Catholic University, Melbourne, Australia.
authors: Peter G
authors: PG
authors: Rendell
authors: Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia.
authors: Robert J
authors: RJ
authors: Whitbourn
authors: Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia.
authors: David R
authors: DR
authors: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis*; D003144:Communication Barriers; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000451:nursing*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000523:psychology*; D008875:Middle Aged; D008962:Models, Theoretical; D010865:Pilot Projects; D015397:Program Evaluation; D011594:Psychometrics; D012648:Self Care / Q000295:instrumentation* / Q000592:standards
keywords: Heart failure; individualised support strategies; patient education; screening tool; self-care