Objective. To adapt and evaluate the psychometric properties of the Brazilian version of the SCHFI v 6.2. Methods. With the approval of the original author, we conducted a complete cross-cultural adaptation of the instrument (translation, synthesis, back translation, synthesis of back translation, expert committee review, and pretesting). The adapted version was named Brazilian version of the self-care of heart failure index v 6.2. The psychometric properties assessed were face validity and content validity (by expert committee review), construct validity (convergent validity and confirmatory factor analysis), and reliability. Results. Face validity and content validity were indicative of semantic, idiomatic, experimental, and conceptual equivalence. Convergent validity was demonstrated by a significant though moderate correlation ( ) on comparison with equivalent question scores of the previously validated Brazilian European heart failure self-care behavior scale. Confirmatory factor analysis supported the original three-factor model as having the best fit, although similar results were obtained for inadequate fit indices. The reliability of the instrument, as expressed by Cronbach’s alpha, was 0.40, 0.82, and 0.93 for the self-care maintenance, self-care management, and self-care confidence scales, respectively. Conclusion. The SCHFI v 6.2 was successfully adapted for use in Brazil. Nevertheless, further studies should be carried out to improve its psychometric properties. 1. Introduction Over the last few decades, treatment of heart failure (HF) has been optimized substantially through the advent of new therapies that have improved morbidity and mortality outcomes. These therapies, combined with nonpharmacological management strategies, have provided several benefits for patients, particularly in quality of life and rate of hospitalization due to decompensated HF [1, 2]. Within this context, nonpharmacological management, which encompasses a continuous process of patient education and development of self-care skills, has been widely studied and shown to be beneficial in the achievement and maintenance of clinical stability [2]. Among available self-care strategies, the multidisciplinary approach appears to be associated with the greatest benefit over time, improving quality of life, reducing readmission rates, and cutting health care costs [3, 4]. Self-care in HF is defined as a naturalistic decision-making process used to maintain physiologic stability (self-care maintenance) and respond to symptoms when they occur (self-care management) [3]. During
References
[1]
M. Gheorghiade, M. Vaduganathan, G. C. Fonarow, and R. O. Bonow, “Rehospitalization for heart failure problems and perspectives,” Journal of the American College of Cardiology, vol. 61, no. 4, pp. 391–401, 2013.
[2]
C. M. Mussi, K. Ruschel, E. N. Souza, et al., “Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I,” Revista Latino-Americana de Enfermagem, vol. 21, pp. 20–28, 2013.
[3]
B. Riegel and V. V. Dickson, “A situation-specific theory of heart failure self-care,” Journal of Cardiovascular Nursing, vol. 23, no. 3, pp. 190–196, 2008.
[4]
R. Holland, J. Battersby, I. Harvey, E. Lenaghan, J. Smith, and L. Hay, “Systematic review of multidisciplinary interventions in heart failure,” Heart, vol. 91, no. 7, pp. 899–906, 2005.
[5]
V. V. Dickson and B. Riegel, “Are we teaching what patients need to know? Building skills in heart failure self-care,” Heart and Lung, vol. 38, no. 3, pp. 253–261, 2009.
[6]
M. H. L. van der Wal, D. J. van Veldhuisen, N. J. G. M. Veeger, F. H. Rutten, and T. Jaarsma, “Compliance with non-pharmacological recommendations and outcome in heart failure patients,” European Heart Journal, vol. 31, no. 12, pp. 1486–1493, 2010.
[7]
C. E. Connelly, “An empirical study of a model of self-care in chronic illness,” Clinical Nurse Specialist, vol. 7, no. 5, pp. 247–253, 1993.
[8]
M. J. Dodd, “Measuring informational intervention for chemotherapy knowledge and self-care behavior,” Research in Nursing & Health, vol. 7, no. 1, pp. 43–50, 1984.
[9]
A. Frei, A. Svarin, C. Steurer-Stey, and M. A. Puhan, “Self-efficacy instruments for patients with chronic diseases suffer from methodological limitations—a systematic review,” Health and Quality of Life Outcomes, vol. 7, article 86, 2009.
[10]
L. Khagram, C. R. Martin, M. J. Davies, and J. Speight, “Psychometric validation of the Self-Care Inventory-Revised (SCI-R) in UK adults with type 2 diabetes using data from the AT.LANTUS Follow-On study,” Health and Quality of Life Outcomes, vol. 11, article 24, 2013.
[11]
M. K. Feijó, C. W. ávila, E. N. Souza, T. Jaarsma, and E. R. Rabelo, “Cross-cultural adaptation and validation of the European Heart Failure Self-Care Behavior Scale for Brazilian Portuguese,” Revista Latino-Americana de Enfermagem, vol. 20, no. 5, pp. 988–996, 2012.
[12]
B. Riegel, C. S. Lee, V. V. Dickson, and B. Carlson, “An update on the self-care of heart failure index,” Journal of Cardiovascular Nursing, vol. 24, no. 6, pp. 485–497, 2009.
[13]
D. E. Beaton, C. Bombardier, F. Guillemin, and M. B. Ferraz, “Guidelines for the process of cross-cultural adaptation of self-report measures,” Spine, vol. 25, no. 24, pp. 3186–3191, 2000.
[14]
J. M. G. Fachel and S. Camey, “Avalia？？o psicométrica: a qualidade das medidas e o entendimento dos dados,” in Psicodiagnóstico, J. A. Cunha, Ed., pp. 158–170, Artmed, Porto Alegre, Brazil, 5th edition, 2000.
[15]
J. F. Hair, R. E. Anderson, R. L. Tatham, and W. C. Black, Multivariate Date Analysis, Bookman, Porto Alegre, Brazil, 6th edition, 2009.
[16]
S. Muzzarelli, H. Brunner-la Rocca, O. Pfister et al., “Adherence to the medical regime in patients with heart failure,” European Journal of Heart Failure, vol. 12, no. 4, pp. 389–396, 2010.
[17]
E. R. Rabelo, G. B. Aliti, L. Goldraich, F. B. Domingues, N. Clausell, and L. E. Rohde, “Non-pharmacological management of patients hospitalized with heart failure at a teaching hospital,” Arquivos Brasileiros de Cardiologia, vol. 87, no. 3, pp. 352–358, 2006.
[18]
D. S. Yu, D. T. Lee, D. R. Thompson, J. Woo, and E. Leung, “Assessing self-care behaviour of heart failure patients: cross-cultural adaptation of two heart failure self-care instruments,” Hong Kong Medical Journal, vol. 16, no. 3, pp. 13–16, 2010.
[19]
E. Vellone, B. Riegel, F. D'Agostino, et al., “Structural equation model testing the situation-specific theory of heart failure self-care,” Journal of Advanced Nursing, 2013.
