Cameron Jan, Ski Chantal F, McLennan Skye N, Rendell Peter G, Whitbourn Robert J, Thompson David R
Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia
Cardiovascular Research Centre, Australian Catholic University, Melbourne, Australia.
Eur J Cardiovasc Nurs. 2014 Oct;13(5):408-17. doi: 10.1177/1474515113502461. Epub 2013 Aug 22.
Screening for self-care capacity is advocated before applying educational strategies. No screening tool has been specifically developed to assess barriers that impede engagement in self-care in people with heart failure. Earlier conceptual work (InCOGNITO) identified NYHA class, mild cognitive impairment and depressive symptoms as barriers that impede engagement in HF self-care.
Study aims were: 1) to develop the Heart Failure Screening Tool (Heart-FaST) as a means of assessing three critical barriers to self-care; 2) to assess the content validity of the Heart-FaST; and 3) to test the feasibility of implementing the Heart-FaST in clinical practice.
The Heart-FaST was developed from barriers identified in previous research (InCOGNITO) and from expert panel consensus. Content validity was assessed by examining the proportion of experts who scored each item as relevant.
The InCOGNITO study indicated that four cognitive tasks, seven emotional questions and NYHA functional class were significantly correlated with the self-care scales: maintenance, management and confidence. These factors were used to create the Heart-FaST items. Consensus on wording and items to be included in the Heart-FaST was reached after two rounds of panel discussion. All items had an item-level content validity index ≥ 0.78. High scores on each barrier (physical, cognitive and emotional functioning) suggest poor self-care and the need for more intensive disease management efforts.
The Heart-FaST measures three critical barriers that impede engagement in self-care. In clinical practice this tool may assist in individually tailoring educational and support strategies to promote effective heart failure self-care.
在应用教育策略之前，提倡对自我护理能力进行筛查。尚未专门开发出用于评估阻碍心力衰竭患者进行自我护理的障碍的筛查工具。早期的概念性研究（InCOGNITO）确定纽约心脏协会（NYHA）心功能分级、轻度认知障碍和抑郁症状是阻碍心力衰竭自我护理的障碍。
研究目的如下：1）开发心力衰竭筛查工具（Heart-FaST），作为评估自我护理的三个关键障碍的一种手段；2）评估Heart-FaST的内容效度；3）测试在临床实践中实施Heart-FaST的可行性。
Heart-FaST是根据先前研究（InCOGNITO）中确定的障碍以及专家小组的共识开发的。通过检查将每个项目评为相关的专家比例来评估内容效度。
InCOGNITO研究表明，四项认知任务、七个情绪问题和NYHA功能分级与自我护理量表（维持、管理和信心）显著相关。这些因素被用于创建Heart-FaST项目。经过两轮小组讨论，就Heart-FaST的措辞和纳入项目达成了共识。所有项目的项目级内容效度指数均≥0.78。每个障碍（身体、认知和情绪功能）得分高表明自我护理差，需要更强化的疾病管理措施。
Heart-FaST测量了阻碍自我护理的三个关键障碍。在临床实践中，该工具可能有助于个性化定制教育和支持策略，以促进有效的心力衰竭自我护理。
