The European Heart Failure Self-care Behaviour Scale: new insights into factorial structure, reliability, precision and scoring procedure

Patient Educ Couns. 2014 Jan;94(1):97-102. doi: 10.1016/j.pec.2013.09.014. Epub 2013 Sep 25.

Abstract

Objective: To evaluate a new factorial structure of the European Heart Failure Self-care Behaviour Scale 9-item version (EHFScBS-9), and to test its reliability, floor and ceiling effect, and precision. To propose a new 0-100 score with a higher score meaning better self-care.

Methods: A sample of 1192 Heart Failure (HF) patients (mean age 72 years, 58% male) was enrolled. Psychometric properties of the EHFScBS-9 were tested with confirmative factor analysis, factor score determinacy, determining the floor and ceiling effect, and evaluating the precision with the standard error of measurement (SEM) and the smallest real difference (SRD).

Results: We identified three well-fitting factors: consulting behaviour, autonomy-based adherence, and provider-based adherence (comparative fit index=0.96). Reliability ranged from 0.77 to 0.95. The EHFScBS-9 showed no floor and ceiling effect except for the provider-based adherence which had an expected ceiling effect. The SEM and the SRD indicated good precision of the EHFScBS-9.

Conclusion: The new factorial structure of the EHFScBS-9 showed supportive psychometric properties.

Practice implications: The EHFScBS-9 can be used to compute a total and specific scores for each identified factor. This may allow more detailed assessment and tailored interventions to improve self-care. The new score makes interpretation of the EHFScBS-9 easier.

Keywords: Heart Failure; Instrument validity and reliability; Psychometrics; Self-care.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Factor Analysis, Statistical
  • Female
  • Health Behavior*
  • Heart Failure / therapy*
  • Humans
  • Italien
  • Male
  • Middle Aged
  • Psychometrics / statistics & numerical data*
  • Reproducibility of Results
  • Self Care*
  • Socioeconomic Factors
  • Surveys and Questionnaires*