Abstract 13707: Psychometric Testing of the Self-Care of Chronic Angina Index (SCCAI)
Coronary heart disease (CHD) requires a significant amount of self-care conceptualized as a process of treatment adherence (self-care maintenance) and symptom response (self-care management).Yet, there are no instruments that measure self-care in this population. Purpose: To test the psychometric properties of the Self-Care of Chronic Angina Index (SCCAI).
Methods: A sample of 392 adults with CHD (e.g., history of MI, angina) completed the SCCAI and the General Adherence Scale (GAS). Multidimensional factor analysis was used to identify item structure. Factor determinacy scores (FDS) were computed for multidimensional scales. Cronbach’s alpha and FDS were computed for unidimensional scales. Validity was tested using correlations to test associations between observed domains of self-care and adherence (GAS).
Results: 62% of the sample was male; mean age 61.4±9.6 years; mean duration of CHD 7±10 years. A multidimensional self-care maintenance factor entailed “consultative behaviors” (keep appointments, take aspirin and medicines as prescribed, check blood pressure, use medication reminder system, and avoid smoking/smokers) and “autonomous behaviors” (exercise, ask for low sodium foods, eat fruits/vegetables, and try to lose weight) (FDS = 0.83). A multidimensional self-care management factor entailed “immediate recognition and response” (recognize symptoms, reduce activity and take nitroglycerine) and “delayed response” (call doctor, take aspirin and evaluate treatment effectiveness) (FDS = 0.74). A unidimensional confidence factor captured patients’ self-efficacy in following treatment advice, and recognizing, evaluating and treating symptoms (α=0.84, FDS = 0.91). Consultative (r=0.89) and autonomous (r=0.82) behaviors, immediate recognition and response (r=0.86), delayed response behaviors (0.79) and confidence (r=0.27) were associated with adherence (all p<0.001).
Conclusion: The findings support the conceptual basis of self-care in patients with CHD as a process of maintenance, i.e. consultative and autonomous behaviors, and management, with symptom awareness and response. The SCCAI confidence scale as a measure of self-efficacy can be used to identify behaviors to target in future interventions.
Author Disclosures: V. Dickson: None. C. Lee: None. K. Yehle: None. K. Faulkner: None. A. Mola: None. B. Riegel: None.
- © 2015 by American Heart Association, Inc.