Validity and Reliability Evaluation of the Persian Version of the Heart Failure-Specific Health Literacy Scale

Document Type : Original Article

Authors

1 Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2 Department of Anesthesiology, School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran

3 Students Research committee, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran

4 Department of Surgery, Nekooei Hedayati Hospital, Qom University of Medical Sciences, Qom, Iran

5 Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria

Abstract

Background: Health literacy (HL) has important implications for health outcomes in heart failure (HF) patients. Studying health literacy requires culturally appropriate and valid instruments. The aim of the study was validation of the Persian version of the heart failure-specific health literacy scale (HF-Specific HL Scale).
Methods: One hundred patients with heart failure were selected in Qom, Iran in 2017. The ‘forward-backward’ procedure was applied to translate the questionnaire from English into Persian. Content validity, face validity, construct validity have been employed to validate the prepared scale. Cronbach’s alpha coefficients and the test-retest were used to assess the scale reliability.Data were analyzed using SPSS, version 16, and Smart PLS 3.0 software.
Results: Confirmatory factor analysis completely supported the three-factor model of the HL scales. Convergent validity was satisfied in that all factor loadings and the average variance extracted exceeded 0.5. The divergent validity was verified using Fornel and Larcker method. R-square and path coefficient were higher than 0.43 and 0.65 respectively, indicating the good structural model. Composite reliability and Cronbach’s α coefficient for all of the constructs were over the recommended threshold of 0.70, ensuring adequate internal consistency of the scale. The test-retest reliability ranged from 0.78-0.90, which indicated a good level of stability.
Conclusion: The findings indicated that the Persian HF-specific HL scale is reliable and valid for measuring health literacy among heart failure patients. Further research is required to measure the sensitivity and specificity of the scale.

Keywords


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    References

     

    1. Müller-Tasch T, Löwe B, Lossnitzer N, et al. Anxiety and self-care behaviour in patients with chronic systolic heart failure: A multivariate model. European Journal of Cardiovascular Nursing. 2018;17:170-7.
    2. Wu JR, Reilly CM, Holland J, et al. Relationship of Health Literacy of Heart Failure Patients and Their Family Members on Heart Failure Knowledge and Self-Care. Journal of Family Nursing. 2017;23:116-37.
    3. Al-Sutari MM, Ahmad MM. Effect of educational program on self-care behaviors and health outcome among patients with heart failure: an experimental study. International Journal of Evidence-based Healthcare. 2017;15:178-85.
    4. Heidenreich PA, Albert NM, Allen LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circulation, Heart Failure. 2013;6:606-19.
    5. Lee KS, Moser DK, Pelter MM, et al. Self-care in rural residents with heart failure: What we are missing. European Journal of Cardiovascular Nursing. 2017;16:326-33.
    6. Riegel B, Moser DK, Anker SD, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120:1141-63.
    7. Cajita MI, Cajita TR, Han HR. Health literacy and heart failure: a systematic review. The Journal of Cardiovascular Nursing. 2016;31:121-30.
    8. Canadian Council on Learning. Health literacy in Canada: Initial results from the international adult literacy and skills survey. Ottawa: Canadian Council on Learning; 2007.
    9. World Health Organization. Commission on Social Determinants of Health final report. Geneva: World Health Organization; 2008.
    10. Evangelista LS, Rasmusson KD, Laramee AS, et al. Health literacy and the patient with heart failure-implications for patient care and research: a consensus statement of the Heart Failure Society of America. Journal of Cardiac Failure. 2010;16:9-16.
    11. Halleberg*Nyman M, Nilsson U, Dahlberg K, Jaensson M. Association Between Functional Health Literacy and Postoperative Recovery, Health Care Contacts, and Health-Related Quality of Life Among Patients Undergoing Day Surgery: Secondary Analysis of a Randomized Clinical Trial. JAMA Surgery. 2018;153:738-45.
    12. MacLeod S, Musich S, Gulyas S, et al. The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. Geriatric Nursing. 2017;38:334-41.
    13. Farghadani Z, Taheri-Kharameh Z, Amiri-Mehra A, et al. The relationship between health literacy and self-care behaviors among patients with heart failure. Hayat. 2018;24:186-96. [In Persian]
    14. Macabasco-O’Connell A, DeWalt DA, Broucksou KA, et al. Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. Journal of General Internal Medicine. 2011;26:979-86.
    15. Chen AMH, Yehle KS, Albert NM, et al. Health literacy influences heart failure knowledge attainment but not self-efficacy for self-care or adherence to self-care over time. Nursing Research and Practice. 2013;2013.
    16. Speros CI. Promoting health literacy: a nursing imperative. The Nursing Clinics of North America. 2011;46:321-33.
    17. Parker RM, Baker DW, Williams MV, Nurss JR. The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. Journal of General Internal Medicine. 1995;10:537-41.
    18. Davis TC, Long SW, Jackson RH, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Family Medicine. 1993;25:391-5.
    19. Nutbeam D. The evolving concept of health literacy. Social Science & Medicine. 2008;67:2072-8.
    20. Taheri-Kharameh Z, Heravi-Karimooi M, Rejeh N, et al. Translation and psychometric testing of the Farsi version of the Seattle angina questionnaire. Health and Quality of Life Outcomes. 2017;15:234.
    21. Matsuoka S, Kato N, Kayane T, et al. Development and Validation of a Heart Failure–Specific Health Literacy Scale. The Journal of Cardiovascular Nursing. 2016;31:131-9.
    22. Heijmans M, Waverijn G, Rademakers J, et al. Functional, communicative and critical health literacy of chronic disease patients and their importance for self-management. Patient Education and Counseling. 2015;98:41-8.
    23. Yue M, Zhang L, Lu Y, Jin C. Translation and psychometric evaluation of the Chinese version of the Heart Failure-Specific Health Literacy Scale. International Journal of Nursing Sciences. 2016;3:342-6.
    24. Poureslami I, Nimmon L, Rootman I, Fitzgerald MJ. Health literacy and chronic disease management: drawing from expert knowledge to set an agenda. Health Promotion International. 2017;32:743-54.
    25. Aaronson NK, Acquadro C, Alonso J, et al. International Quality of Life Assessment (IQOLA) Project. Quality of Life Research. 1992;1:349-51.
    26. Lawshe CH. A quantitative approach to content validity. Personnel Psychology. 1975;28:563-75.
    27. Nunnally JC, Bernstein IH. Psychometric Theory. 3rd ed. USA: McGraw-Hill Education; 2010.
    28. Vinzi VE, Chin WW, Henseler J, Wang H. Handbook of partial least squares. Germany: Springer; 2010.
    29. Henseler J, Ringle CM, Sinkovics RR. The use of partial least squares path modeling in international marketing. UK: Emerald Group Publishing Limited; 2009.
    30. Henseler J, Sarstedt M. Goodness-of-fit indices for partial least squares path modeling. Computational Statistics. 2013;28:565-80.
    31. Henseler J, Ringle CM, Sarstedt M. A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science. 2015;43:115-35.