Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI)

Dickson, Victoria V
Lee, Christopher S
Yehle, Karen S
Mola, Ana
Faulkner, Kenneth M

Although coronary heart disease (CHD) requires a significant amount of self‐care, there are no instruments available to measure self‐care in this population. The purpose of this study was to test the psychometric properties of the Self‐Care of Coronary Heart Disease Inventory (SC‐CHDI). Using the Self‐Care of Chronic Illness theory, we developed a 22‐item measure of maintenance, management, and confidence appropriate for persons with stable CHD and tested it in a convenience sample of 392 adults (62% male, mean age 61.4 ± 9.6 years). Factorial validity was tested with confirmatory factor analysis. Convergent validity was tested with the Medical Outcomes Study MOS‐SAS Specific Adherence Scale and the Decision Making Competency Inventory (DMCI). Cronbach alpha and factor determinacy scores (FDS) were calculated to assess reliability. Two multidimensional self‐care scales were confirmed: self‐care maintenance included “consultative behaviors” (e.g., taking medicines as prescribed) and “autonomous behaviors” (e.g., exercising 30 minute/day; FDS = .87). The multidimensional self‐care management scale included “early recognition and response” (e.g., recognizing symptoms) and “delayed response” (e.g., taking an aspirin; FDS = .76). A unidimensional confidence factor captured confidence in each self‐care process (α = .84). All the self‐care dimensions were associated with treatment adherence as measured by the MOS‐SAS. Only self‐care maintenance and confidence were associated with decision‐making (DCMI). These findings support the conceptual basis of self‐care in patients with CHD as a process of maintenance that includes both consultative and autonomous behaviors, and management with symptom awareness and response. The SC‐CHDI confidence scale is promising as a measure of self‐efficacy, an important factor influencing self‐care.

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