Translation and validation of the Arabic version of the Self-care of Heart Failure Index

Abstract

Background Heart failure is a complex clinical syndrome with high demands for self-care. The Self-care of Heart Failure Index (SCHFI) was developed to measure self-care and has demonstrated robust psychometric properties across populations. Aim To assess the psychometric properties of the Arabic version of the SCHFI (A-SCHFI). Discussion The scores of the A-SCHFI administered to 223 Lebanese patients with heart failure were used to validate this instrument. Face and content validity, assessed by a panel of experts, were found sufficient. The three constructs of the A-SCHFI explained 37.5% of the variance when performing exploratory factor analysis. Adequate fit indices were achieved using the modification procedure of controlling error terms with the confirmatory factor analysis. The reliability coefficient was adequate in the maintenance, management and confidence scales. Conclusion Following adaptation, the modified A-SCHFI was shown to be a valid and reliable measure of self-care among the Lebanese population. Implications for practice Cross-cultural adaptation is a rigorous process involving complex procedures and analyses. The adaptation of the A-SCHFI should be further analysed, including sensitivity and test-retest analysis, with methods to assess the degree of agreement among the panel.

Determinants of Self-Care in Patients With Heart Failure: Observations From a Developing Country in the Middle East

“…Participants in this sample scored lowest on the self-care management subscale than the other subscales of the ScHFI instrument. This is similar to findings of a study carried out in 15 countries worldwide (Jaarsma et al, 2013) as well as other developing countries like Taiwan (Tung et al, 2012), Iran (Zamanzadeh, Valizadeh, Jamshidi, Namdar, & Maleki, 2012), and Lebanon (Deek et al, 2016). Self-care management had the highest mean score among the ScHFI subscales in the Jordanian sample (53.89), but significantly lower than this sample (Tawalbeh et al, 2017).…”

“…The Arabic Self-Care in HF index (ScHFI) is a 22-item instrument with three subscales that measure: maintenance, management, and confidence (Riegel, Lee, Dickson, & Carlson, 2009). The Arabic version had composite reliability coefficients of .87 for the maintenance scale, .97 for the management scale, and .97 for the confidence scale (Deek et al, 2016). All items use a 4-point format and scores of each scale are transformed to generate a standardized score from 0 to 100; higher scores indicate better self-care.…”

The Lebanese Heart Failure Snapshot: A National Presentation of Acute Heart Failure Admissions

“…The low scores on the self‐care scale were not surprising in the Lebanese setting; similar scores were previously reported for the baseline measures in a randomized trial. These scores improved significantly with an educational intervention on family involvement in self‐care (Deek, Chang, et al, 2016). Additionally, those having a higher level of education in the current study scored higher on the self‐care confidence scale than did their less educated counterparts, which matches the findings of the literature, in which those with at least a high school education had significantly higher self‐care confidence scores than those having less than a high school education (Chen, Yehle, Plake, Murawski, & Mason, 2011).…”

“…The validity of this tool was evaluated using exploratory factor analysis, in which the three constructs of the tool explained 37% of the variance. Confirmatory factor analysis yielded adequate fit indices (chi‐square = 339.800, goodness of fit index = 0.918, Tucker‐Lewis Index = 0.912, comparative fit index = 0.931, and root mean square error of approximation = 0.069), and the tool was found to be reliable in the maintenance, management, and confidence subscales, with composite reliability coefficients of 0.87, 0.97, and 0.97, respectively (Deek, Chang, et al, 2016). Adequate self‐care was assumed with a cut‐off score of 70 or above on any of the three subscales: self‐care maintenance, self‐care management, and self‐care confidence (Vellone et al, 2013).…”

“…Interventions conducted to improve HF outcomes included an educational family intervention on self‐care and symptom management (Deek et al, 2017) through a multisite randomized controlled trial. Readmission and mortality were significantly reduced, and self‐care, poor at baseline, was significantly improved 30 days following the intervention (Deek et al, 2017; Deek, Chang, et al, 2016). These findings showed the importance of structuring caregiving by involving the family members.…”