Psychometric Testing of the Revised Self-Care of Heart Failure Index

Riegel, Bárbara; Barbaranelli, Claudio; Carlson, Beverly; Sethares, Kristen A.; Daus, Marguerite; Moser, Debra K.; Miller, Jennifer; Osokpo, Onome; Lee, Solim; Brown, Stacey; Vellone, Ercole

doi:10.1097/jcn.0000000000000543

Cited by 88 publications

(177 citation statements)

References 52 publications

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“…The 29‐item Self‐Care Heart Failure Index (SCHFI) (Chinese version) comprises three subscales to measure self‐care maintenance, self‐care management and symptom perception (Riegel et al, ). A four‐point response scale is used, and each subscale score is transformed to 100 points, with higher score representing better self‐care attribute.…”

Section: Methodsmentioning

confidence: 99%

The effects and cost‐effectiveness of an empowerment‐based self‐care programme in patients with chronic heart failure: A study protocol

Yue

et al. 2019

Journal of Advanced Nursing

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Aim This study aims to evaluate the effects of a 12‐week empowerment‐based self‐care programme on the cognitive, psychological and behavioural aspects of self‐care, health‐related quality of life and unplanned hospital service use of chronic heart failure patients and to estimate its cost‐effectiveness in reducing unplanned service use. Study design Randomized controlled trial with cost‐effectiveness analysis. Methods The study will recruit 236 community‐dwelling Chinese patients with chronic heart failure from regional hospitals in Hong Kong. Patients will be randomized in blocks to attend either the 12‐week empowerment‐based self‐care programme or a didactic education programme. Central to the empowerment‐based model is that the patients are the primary decision makers in self‐care and act autonomously to manage the disease. Collaborative approach and interactive teaching strategies are used to optimize patients' engagement and knowledge translation to real‐life practice. Outcome evaluation on self‐care maintenance and management, symptom perception, self‐care confidence, self‐care knowledge, health‐related quality of life and health service use will take place at baseline, on completion of the programme and at 12 weeks thereafter. Generalized estimating equations and Cox regression examine the intervention effects. Bootstrapping technique will be conducted to examine the cost‐effectiveness of the intervention. The study is formally funded in December 2016. Discussion Chronic heart failure is associated with high level of hospital admissions, of which 40% is avoidable through effective self‐care. Although self‐care confidence is known to improve self‐care, no structured educative method has been developed to enhance this attribute. This study addresses this research gap with a stringent application of theory and research design. Impact The study illustrates the application of the empowerment model for self‐care enhancement in patients with chronic heart failure. The findings will inform the ways and values of this care model to enhance the disease management of this expanding clinical cohort.

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Section: Methodsmentioning

confidence: 99%

The effects and cost‐effectiveness of an empowerment‐based self‐care programme in patients with chronic heart failure: A study protocol

Yue

et al. 2019

Journal of Advanced Nursing

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“…One of the most commonly used instruments worldwide to measure HF self-care is the Self-Care of Heart Failure Index (SCHFI; Barbaranelli et al, 2014;Riegel et al, 2004Riegel et al, , 2019. The SCHFI is a self-report instrument based on the situation-specific theory of HF self-care (Riegel & Dickson, 2008).…”

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confidence: 99%

“…The SCHFI has undergone several modifications and refinements over the years (Riegel & Dickson, 2008;Riegel et al, 2004Riegel et al, , 2009Riegel et al, , 2019Vellone et al, 2013). The aims of these modifications were to assure that behaviors measured are evidence-based, improve its psychometric characteristics, and address its theoretical underpinnings.…”

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confidence: 99%

“…The last modification was performed after updating the situation-specific theory of HF self-care (Riegel et al, 2016), which introduced the new concept of symptom perception. The SCHFI version 7.2 reflects this theoretical modification (Riegel et al, 2019). Now the SCHFI includes the prior components of self-care maintenance (10 items) and self-care management (eight items) and the new component of symptom perception (11 items).…”

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confidence: 99%

“…Now the SCHFI includes the prior components of self-care maintenance (10 items) and self-care management (eight items) and the new component of symptom perception (11 items). To date, the SCHFI v.7.2 has been tested only in a U.S. sample (Riegel et al, 2019). However, because the prior versions of the SCHFI are used widely in Europe, researchers and clinicians would benefit from testing of the SCHFI v.7.2 in a European population.…”

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confidence: 99%

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The Self‐Care of Heart Failure Index version 7.2: Further psychometric testing

Vellone

Iovino

Barbaranelli

et al. 2020

Research in Nursing & Health

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Clinicians and researchers need valid and reliable instruments to evaluate heart failure (HF) self-care. The Self-Care of Heart Failure Index (SCHFI) is a theoretically driven instrument developed for this purpose. The SCHFI measures self-care with three scales: self-care maintenance, measuring behaviors to maintain HF stability; symptom perception, measuring monitoring behaviors; and self-care management, assessing the response to symptoms. After the theory underpinning the SCHFI was updated, the instrument was updated to version 7.2 but it was only tested in the United States. In this study we tested the psychometric characteristics (structural and construct validity, internal consistency, and test-retest reliability) of the SCHFI v.7.2 in an Italian population of HF patients. We used a cross-sectional design to study 280 HF patients with additional data collected after 2 weeks for test-retest reliability. Adults with HF (mean age 75.6 (±10.8); 70.8% in New York Heart Association [NYHA] classes II and III) were enrolled from six centers across Italy. Confirmatory factor analysis showed supportive structural validity in the three SCHFI v.7.2 scales (CFI from 0.94 to 0.95; RMSEA from 0.05 to 0.07). Internal consistency reliability estimated with Cronbach's α and composite reliability ranged between .73 and .88; test-retest reliability ranged between 0.73 and 0.92. Construct validity was supported with significant correlations between the SCHFI v.7.2 scale scores and quality of life, brain natriuretic peptide levels and NYHA class. This study further supports the psychometric characteristics of the SCHFI v.7.2, illustrating that it can be used in clinical practice and research also in an Italian population.

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Effectiveness and Cost-effectiveness of an Empowerment-Based Self-care Education Program on Health Outcomes Among Patients With Heart Failure

et al. 2022

JAMA Netw Open

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IMPORTANCEStrategies that enhance self-care of patients with heart failure reduce mortality and health care use. OBJECTIVE To examine whether an empowerment-based self-care education program was more effective and cost-effective to improve self-care, health status, and hospital service use than a didactic education program in patients with heart failure. DESIGN, SETTING, AND PARTICIPANTS In this double-blind randomized clinical trial, a consecutive sample of 988 patients with heart failure from the cardiac clinics of 2 regional hospitals underwent eligibility screening from February 1, 2017, to May 31, 2019, using the criteria of age of 55 years or older, heart failure diagnosed 6 months before screening, and New York Heart Association class II to IV. A total of 236 participants were randomized to the empowerment (n = 118) or education (n = 118) group. INTERVENTIONS The 12-week, group-based, empowerment-based education program included self-care assessment, goal-orientated actions in symptom recognition and response, fluid and dietary modification, and lifestyle management. Didactic education covered the same topics without empowerment strategies. MAIN OUTCOMES AND MEASURESThe primary outcome was self-care measured by the Self-care Heart Failure Index (SCHFI) maintenance, management, and symptom perception subscales at posttest and 3-month end points. Secondary outcomes included measures of knowledge, confidence, health-related quality of life, and health service use. Direct, indirect, and social costs of the 2 programs were collected for cost-effectiveness analysis. RESULTSA total of 236 Chinese patients (mean [SD] age, 70 [8.0] years; 149 [63.1%] men) were included in the study. The empowerment group reported significantly greater improvement in SCHFI management scores (mean difference, 13.76; 95% CI, 5.89-21.62; Cohen d = 0.46 at posttest and Cohen d = 0.35 at 3 months) and symptom perception scores (mean difference, 20.36; 95% CI, 13.98-26.75; Cohen d = 0.84 at posttest and Cohen d = 0.61 at 3 months). The empowerment group had lower risks of emergency department attendance (incidence rate ratio, 0.55; 95% CI, 0.31-0.95; P = .03) and hospital admission (incidence rate ratio, 0.38; 95% CI, 0.21-0.68; P = .001) and better improved self-care knowledge (change in score [empowerment minus education], 1.29; 95% CI, 0.48-2.09) and confidence (change in score [empowerment minus education], 7.98; 95% CI, 1.91-14.05). Empowerment was cost-saving and cost-effective at T2 compared with the education group for quality-adjusted life-years, with an incremental cost-effectiveness ratio of −114 485.(continued) Key Points Question What are the effectiveness and cost-effectiveness of a 12-week, empowerment-based self-care intervention on health outcomes and health care use among patients with heart failure? Findings In this randomized clinical trial of 236 patients with heart failure, when compared with didactic education, an empowerment-based self-care intervention was effective and costeffective, resulting in improvement in s...

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Psychometric Testing of the Revised Self-Care of Heart Failure Index

Cited by 88 publications

References 52 publications

The effects and cost‐effectiveness of an empowerment‐based self‐care programme in patients with chronic heart failure: A study protocol

The effects and cost‐effectiveness of an empowerment‐based self‐care programme in patients with chronic heart failure: A study protocol

The Self‐Care of Heart Failure Index version 7.2: Further psychometric testing

Effectiveness and Cost-effectiveness of an Empowerment-Based Self-care Education Program on Health Outcomes Among Patients With Heart Failure

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