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The European Heart Failure Self-care Behaviour Scale: New insights into factorial structure, reliability, precision and scoring procedure
University of Roma Tor Vergata, Italy .
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
University of Roma La Sapienza, Italy .
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2014 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, no 1, 97-102 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier , 2014. Vol. 94, no 1, 97-102 p.
Keyword [en]
Heart Failure; Self-care; Psychometrics; Instrument validity and reliability
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-104293DOI: 10.1016/j.pec.2013.09.014ISI: 000329887300015OAI: diva2:697180
Available from: 2014-02-17 Created: 2014-02-14 Last updated: 2014-02-20

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Jaarsma, TinyStrömberg, AnnaFranzén Årestedt, Kristofer
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Division of Health, Activity and CareFaculty of Health SciencesDivision of Nursing ScienceDepartment of Cardiology in Linköping
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