Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI).
Although coronary heart disease (CHD) requires a significant amount of self-care, there are no instruments available to measure self-care in this population. The purpose of this study was to test the psychometric properties of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). Using the Self-Care of Chronic Illness theory, we developed a 22-item measure of maintenance, management, and confidence appropriate for persons with stable CHD and tested it in a convenience sample of 392 adults (62% male, mean age 61.4 ± 9.6 years). Factorial validity was tested with confirmatory factor analysis. Convergent validity was tested with the Medical Outcomes Study MOS-SAS Specific Adherence Scale and the Decision Making Competency Inventory (DMCI). Cronbach alpha and factor determinacy scores (FDS) were calculated to assess reliability. Two multidimensional self-care scales were confirmed: self-care maintenance included "consultative behaviors" (e.g., taking medicines as prescribed) and "autonomous behaviors" (e.g., exercising 30 minute/day; FDS = .87). The multidimensional self-care management scale included "early recognition and response" (e.g., recognizing symptoms) and "delayed response" (e.g., taking an aspirin; FDS = .76). A unidimensional confidence factor captured confidence in each self-care process (α = .84). All the self-care dimensions were associated with treatment adherence as measured by the MOS-SAS. Only self-care maintenance and confidence were associated with decision-making (DCMI). These findings support the conceptual basis of self-care in patients with CHD as a process of maintenance that includes both consultative and autonomous behaviors, and management with symptom awareness and response. The SC-CHDI confidence scale is promising as a measure of self-efficacy, an important factor influencing self-care. © 2016 Wiley Periodicals, Inc.
Associate Professor, Rory Meyers College of Nursing, New York University, 433 First Ave, #742, New York, NY, 10010.
Victoria
V
Vaughan Dickson
Carol A. Lindeman Distinguished Professor, Associate Professor, School of Nursing, Oregon Health & Science University, Portland, OR.
Christopher S
CS
Lee
Associate Professor, School of Nursing, Center on Aging and the Life Course, Purdue University, West Lafayette, IN.
Karen S
KS
Yehle
Director of Care Transitions and Population Health, NYU Langone Medical Center, New York, NY.
Ana
A
Mola
Doctoral Student, Rory Meyers College of Nursing, New York University, New York, NY.
Kenneth M
KM
Faulkner
Edith Clemmer Steinbright Professor of Gerontology, School of Nursing, University of Pennsylvania, Philadelphia, PA.
Barbara
B
Riegel
D000368:Aged; D003327:Coronary Disease / Q000628:therapy*; D019468:Disease Management; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation*; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires
adherence; coronary heart disease; instrument development; measurement; self-care