Psychometric Analysis of the Heart Failure Somatic Perception Scale as a Measure of Patient Symptom Perception

Abstract

Background Symptoms are known to predict survival among patients with heart failure (HF) but discrepancies exist between patients’ and health providers’ perceptions of HF symptom burden. Objective The purpose of this study was to quantify the internal consistency, validity and prognostic value of patient perception of a broad range of HF symptoms using a HF-specific physical symptom measure, the 18-item HF Somatic Perception Scale v.3. Methods Factor analysis of the HFSPS was conducted in a convenience sample of 378 patients with chronic HF. Convergent validity was examined using the Physical Limitation subscale of the Kansas City Cardiomyopathy Questionnaire (KCCQ). Divergent validity was examined using the Self-Care of HF index self-care management score. One-year survival based on HFSPS scores was quantified using Cox regression controlling for Seattle HF Model scores to account for clinical status, therapeutics and lab values. Results The sample was 63% male, 85% Caucasian, 67% functionally compromised (NYHA class III-IV) with a mean age of 63, SD12.8 years. Internal consistency of the HFSPS was α =.90. Convergent (r=−0.54, p=<0.0001) and divergent (r=0.18, p>0.05) validity were supported. Controlling for Seattle HF scores, HFSPS was a significant predictor of one-year survival with those most symptomatic having worse survival (HR=1.012 (95%CI=1.001–1.024), p=0.038). Conclusions Perception of HF symptom burden as measured by the HFSPS is a significant predictor of survival contributing additional prognostic value over and above objective Seattle HF Risk Model scores. This analysis suggests that assessment of a broad range of HF symptoms, or those related to dyspnea or early and subtle symptoms may be useful in evaluating therapeutic outcomes and predicting event-free survival.

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

“…Chest discomfort. Participants in this study reported a higher level of chest discomfort than those in prior studies [29,30,33]. Chest pain was experienced by 41% of patients in Jurgens' (2006) study and was reported by 85.1% of the sample in this study.…”

“…Scores range from 0 to 90, with higher scores indicating higher perceived somatic awareness and symptom distress [29,30]. In addition to the total score, which has good reliability (Cronbach's α: 0.90), a six-item dyspnea subscale, and seven-item early and subtle subscale were significantly associated with 1-year event-risk [29]. Psychometrics for the Chinese version of the HFSPS was 0.87 [31].…”

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

“…Patient physical symptoms of HF (eg, fatigue, weight gain, orthopnea, and dyspnea) pre-implantation were measured using the Heart Failure Somatic Perception Scale (HFSPS). 20 The 18-item HFSPS asks patients about how bothersome symptoms are on a 6-point (0-5) Likert scale, with 0 indicating the patient did not have the symptom, and 1 to 5 indicating symptom severity. Scores are summed for a potential range of 0 to 90, with higher scores indicating worse symptoms.…”

Brief Report: Patient Activation Among Urban Hospitalized Patients With Heart Failure

“…Physical HF symptoms were measured with the use of the Heart Failure Somatic Perception Scale, which has a total score and a dyspnea subscale, both of which are associated with survival in HF. 14 Other patient-reported health outcomes included the Patient-Reported Outcomes Measurement Information System short-form questionnaires for Physical Function, Depression, Anxiety, Fatigue, Applied Cognition, and Sleep Disturbance, many of which have been validated in patients with HF. 15 …”