Jaarsma Tiny, Arestedt Kristofer Franzén, Mårtensson Jan, Dracup Kathleen, Strömberg Anna
Department of Cardiology, Thoraxcenter, University Medical Centre, University of Groningen, PO Box 30.001 9700 RB, Groningen, the Netherlands.
Eur J Heart Fail. 2009 Jan;11(1):99-105. doi: 10.1093/eurjhf/hfn007.
Improved self-care is the goal of many heart failure (HF) management programmes. The 12-item European Heart Failure Self-Care Behaviour Scale (EHFScB scale) was developed and tested to measure patient self-care behaviours. It is now available in 14 languages. The aim of this study was to further determine reliability and validity of the EHFScB scale.
Data from 2592 HF patients (mean age 73 years, 63% male) from six countries were analysed. Internal consistency was determined by Cronbach's alpha. Validity was established by (1) interviews with HF experts and with HF patients; (2) item analysis; (3) confirmatory factor analysis; and (4) analysing the relationship between the EHFScB scale and scales measuring quality of life and adherence. Internal consistency of the 12-item scale was 0.77 (0.71-0.85). After factor analyses and critical evaluation of both psychometric properties and content of separate items, a nine-item version was further evaluated. The reliability estimates for the total nine-item scale (EHFScB-9) was satisfactory (0.80) and Cronbach's alpha varied between 0.68 and 0.87 in the different countries. One reliable subscale was defined (consulting behaviour) with a Cronbach's alpha of 0.85. The EHFScB-9 measures a different construct than quality of life (r = 0.18) and adherence (r = 0.37).
The 12-item EHFScB scale was revised into the nine-item EHFScB-9, which can be used as an internally consistent and valid instrument to measure HF-related self-care behaviour.
改善自我护理是许多心力衰竭（HF）管理项目的目标。12项欧洲心力衰竭自我护理行为量表（EHFScB量表）已开发并经过测试，用于衡量患者的自我护理行为。该量表目前有14种语言版本。本研究的目的是进一步确定EHFScB量表的信度和效度。
分析了来自六个国家的2592例HF患者（平均年龄73岁，63%为男性）的数据。通过Cronbach's α系数确定内部一致性。通过以下方式确定效度：（1）与HF专家和HF患者进行访谈；（2）项目分析；（3）验证性因素分析；（4）分析EHFScB量表与生活质量量表和依从性量表之间的关系。12项量表的内部一致性为0.77（0.71 - 0.85）。经过因素分析以及对各项目心理测量特性和内容的严格评估后，对9项版本进行了进一步评估。9项总量表（EHFScB - 9）的信度估计值令人满意（0.80），不同国家的Cronbach's α系数在0.68至0.87之间。定义了一个信度良好的子量表（咨询行为），其Cronbach's α系数为0.85。EHFScB - 9所测量的结构与生活质量（r = 0.18）和依从性（r = 0.37）不同。
12项EHFScB量表修订为9项EHFScB - 9，可作为一种内部一致性良好且有效的工具，用于测量与HF相关的自我护理行为。
