Iyngkaran Pupalan, Smith David, McLachlan Craig, Battersby Malcolm, De Courten Maximilian, Hanna Fahad
Melbourne Clinical School, University of Notre Dame, Melbourne, VIC 3029, Australia.
Centre for Healthy Futures, Torrens University Australia, Surry Hills, NSW 2010, Australia.
J Clin Med. 2024 Dec 3;13(23):7374. doi: 10.3390/jcm13237374.
Congestive heart failure (CHF) is a complex chronic disease, and it is associated with a second comorbid condition in more than half of cases. Self-management programs can be specific to CHF or generic for chronic diseases. Several tools have been validated for CHF. Presently, there are no established generic instruments that are validated for measuring self-management in CHF. This study aims to evaluate the internal reliability and construct validity (psychometric properties) of the Partners in Health (PIH) scale for patients with congestive heart failure, a generic chronic disease self-management tool. The study included 210 adult CHF patients [120 with heart failure with reduced ejection fraction (HfrEF), 90 with preserved ejection fraction (HfpEF)], from Community Cardiology Outpatients in West Melbourne, Australia, who were treated in community cardiology and were included between May 2022 and Jan 2024. The screened patient population were diagnosed with CHF and were eligible for an SGLT-2 inhibitor. Cohort analysis used the Bayesian confirmatory factor analysis to evaluate the a priori four-factor structure. Omega coefficients and 95% credible intervals (CI) were used to assess internal reliability. In the CHF (HFrEF) and preserved ejection fraction (HFpEF) cohorts, participants' mean [standard deviation (SD)] age was 66.8 (13.5) and 71.3 (9.76) years. Description of study sociodemographics highlighted that 88% and 52% of patients were male, there was a BMI > 50% in both cohorts, eGFR > 60 mL/min were 59% and 74%, and LVEF < 40% and > 50% were 99% and 100%, respectively. Model fit for the hypothesised model was adequate (posterior predictive = 0.073) and all hypothesised factor loadings were substantial (>0.6) and significant ( < 0.001). Omega coefficients (95% CI) for the PIH subscales of Knowledge, Partnership, Management and Coping were 0.84 (0.79-0.88), 0.79 (0.73-0.84), 0.89 (0.85-0.91) and 0.84 (0.79-0.88), respectively. This study is original in confirming the dimensionality, known-group validity, and reliability of the PIH scale for measuring generic self-management in outpatients with CHF syndrome.
充血性心力衰竭（CHF）是一种复杂的慢性疾病，超过半数的病例伴有第二种合并症。自我管理项目可以是针对CHF的特定项目，也可以是针对慢性病的通用项目。有几种工具已在CHF中得到验证。目前，尚无经证实可用于测量CHF自我管理情况的通用工具。本研究旨在评估一种通用的慢性病自我管理工具——健康伙伴（PIH）量表在充血性心力衰竭患者中的内部信度和结构效度（心理测量特性）。该研究纳入了210名成年CHF患者[120名射血分数降低的心力衰竭（HfrEF）患者，90名射血分数保留的心力衰竭（HfpEF）患者]，他们来自澳大利亚墨尔本西部的社区心脏病门诊患者，在社区心脏病科接受治疗，并于2022年5月至2024年1月期间被纳入研究。筛选出的患者群体被诊断为CHF，且符合使用钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂的条件。队列分析采用贝叶斯验证性因子分析来评估先验四因子结构。使用欧米伽系数和95%可信区间（CI）来评估内部信度。在CHF（HFrEF）和射血分数保留（HFpEF）队列中，参与者的平均年龄[标准差（SD）]分别为66.8（13.5）岁和71.3（9.76）岁。对研究社会人口统计学的描述突出显示，两个队列中88%和52%的患者为男性，体重指数（BMI）>50%的患者在两个队列中均存在，估算肾小球滤过率（eGFR）>60 mL/min的患者分别为59%和74%，左心室射血分数（LVEF）<40%和>50%的患者分别为99%和100%。假设模型的模型拟合良好（后验预测值=0.073），所有假设因子载荷均较大（>0.6）且具有显著性（<0.001）。PIH知识、伙伴关系、管理和应对子量表的欧米伽系数（95%CI）分别为0.84（0.79 - 0.88）、0.79（0.73 - 0.84）、0.89（0.85 - 0.91）和0.84（0.79 - 0.88）。本研究首次证实了PIH量表在测量CHF综合征门诊患者通用自我管理方面的维度、已知组效度和信度。
