Translation and validation of the Italian version of the European Heart Failure Self-care Behaviour Scale

Abstract

Heart failure (HF) patients can benefit from management programmes that include education, discharge planning and structured follow-up. Therefore, it is important to evaluate the improvement of self-care as a result of these interventions. The European Heart Failure Self-care Behaviour Scale (EHFScBS) was developed as a reliable and valid instrument for self-care evaluation. The aims were to translate and validate the Italian version of the EHFScBS and to evaluate factors related to self-care. The translation and validation were performed as follows: translation and back-translation; evaluation by four bilingual cardiologists; administration to healthy individuals of different ages and education to test language comprehension; final correction by cardiologists experienced in cognitive assessment; and administration in HF patients to test validity and internal consistency. A sample of 93 HF patients (mean age 77 +/- 6 years, 53% women) was considered for the validation procedure. Fifty-four (58%) patients were already followed in the HF clinic (HFC), with previous HF education, and 39 (42%) were evaluated at baseline. The reliability analysis showed a Cronbach's alpha of 0.82. At multivariate analysis, age, not already followed in HFC and female sex were associated to worse self-care behaviour. When HFC patients were considered separately, an association between self-care and cognitive dysfunction was observed. The EHFScBS appears to be a valid and reliable instrument in the Italian version also. Self-care behaviour appears to depend on age and sex and a previous HF education. Mild to moderately impaired cognitive function seems to influence self-care in patients who have already received HF education.