Self-Care Of Hypertension Inventory Research Articles

Medication Adherence, Blood Pressure Control, Knowledge, Self-care and Self-efficacy among Tunisian Hypertensive Patients

Objectives The aim of this study was to investigate the associated factors with adherence to antihypertensive therapy and to explore the association between medication adherence, blood pressure control, knowledge about hypertension (HTN), self-care, and self-efficacy in hypertensive patients. Methods A cross-sectional study was conducted among 750 hypertensive patients in Tunisia. The data collection tool was a 5-section questionnaire including an information sheet, the Girerd medication adherence scale, the HTN Knowledge Level Scale (HK-LS), the Self-care of HTN Inventory (SC-HI), and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM6S). Results A low and moderate level of medication adherence has been observed in 83.2% of the participants. Uncontrolled blood pressure was detected in 73.1% of cases. Only 11.5% have a good level of knowledge about HTN. Concerning Self-care practices, 48.8% of patients have inadequate practices of maintenance, 48.8% have inadequate practices of monitoring, and 83.9% have inadequate practices of management. The self-efficacy for managing HTN was weak in 42.1% of the participants. In multivariate analysis, low medication adherence was associated with the number of antihypertensive pills/day (ORa=2.668; CI95%= (1.447- 4.918) if ≥ 4 pills/day), side effects (ORa=1.834; CI95%= (1.263- 2.665); p=0.001), uncontrolled hypertension (ORa=2.74; CI95%= (1.798- 4.18); p<0.0001), insufficient self-efficacy for managing HTN (ORa=1.773; CI95%=(1.252- 2.512); p<0.0001), and insufficient self-care maintenance (ORa=2.220; CI95%=(1.562- 3.1570); p<0.0001). Conclusion Low medication adherence was associated with uncontrolled blood pressure, more anti-hypertensive pills, side effects, lower self-efficacy, and lower self-care maintenance. Nursing interventions improving the management skills of hypertensive patients may be beneficial in controlling the disease and its subsequent consequences.

Measuring Self-Care: A Description of the Family of Disease-Specific and Generic Instruments Based on the Theory of Self-Care of Chronic Illness.

In recent years, there has been an exponential increase in attention paid to the patient-reported outcome of self-care. Many investigators have used one of the families of self-care instruments freely available on the website www.self-care-measures.com. These self-care measures have been translated into many languages, which are also available on the website. The measures include both disease-specific and generic instruments, which are based on a common theoretical framework, the Middle Range Theory of Self-Care of Chronic Illness. The purpose of this article is to illustrate similarities among the instruments and to standardize their scoring, analysis, and use. We describe the Self-Care of Heart Failure Index, the Self-Care of Coronary Heart Disease Inventory, the Self-Care of Hypertension Inventory, the Self-Care of Diabetes Inventory, the Self-Care of Chronic Obstructive Pulmonary Disease Inventory, the Self-Care of Chronic Illness Inventory, and the Self-Care Inventory. Detailed guidance on scoring, translation, and analysis is provided. Complementary measures of self-care self-efficacy and those used to measure caregiver contributions to patient self-care are briefly described. Many of the common questions of instrument users are answered in this article. Following this guidance will facilitate consistent use of the instruments, which will enable users to compare their results to those of others worldwide and facilitate future reviews and meta-analyses.Clinical ImplicationsThis review, emphasizing standard scoring and interpretation, is useful for clinicians and researchers across various populations and settings.

The association between health literacy and self-care of hypertension among older adults in five regions in Jordan

Purpose This study aims to determine the relationship between health literacy and the self-care of hypertension in older adults in five regions in Jordan. Design/methodology/approach A cross-sectional study was conducted with 1,100 older adult patients with hypertension who had follow-ups in cardiac clinics of the five biggest hospitals in five regions of Jordan. The research instruments included a Health Literacy Questionnaire (CHEWQ) and the self-care of hypertension inventory. Findings The average health literacy score was 8.52 ± 1.6, indicating inadequate health literacy, while their self-care of hypertension score was 42.33 ± 10.9, indicating low self-care. Inadequate health literacy and factors such as marital status, education level, income and overall health status were linked to poor self-care of hypertension (p < 0.05). Practical implications This study suggests that there is a need to assess the effectiveness of various health literacy interventions, such as educational programs and customized communication strategies, in enhancing self-care behaviors across diverse populations, particularly among the elderly. Originality/value The study findings highlight the need for nursing interventions aimed at improving health literacy to enhance the ability of older adults in Jordan to manage their hypertension.

#2869 Arterial hypertension: do self-care and knowledge of the disease matter?

Abstract Background and Aims Arterial hypertension (HTN) is the main risk factor for cardiovascular disease, which is in turn the leading cause of mortality worldwide. An adequate blood pressure (BP) control depends not only on biological factors, but also on individual behaviour and health literacy. In this area, there is scarce evidence on the potential impact of the level of knowledge and self-care related to the disease. This study aims to measure and characterise these variables in a population of hypertensive patients. Method We developed a retrospective, multi-centre study among patients with HTN, with follow-up at the hospital (at the Nephrology Department) or in primary care. The patients were randomly selected by convenience sampling, between November 2022 and December 2023. With their informed consent, we collected demographical and clinical variables, and applied the Portuguese version of the Self-Care of Hypertension Inventory (SC-HI) and Hypertension Knowledge Test (HKT) questionnaires. The statistical analysis was performed using Microsoft Excel and SPSS. The study is still ongoing; we hereby present a preliminary analysis. Results To date, we have collected data from 75 patients; 48% were female, with a median age of 69 (IQR 23). The follow-up was carried out at the hospital in 63% (n = 47) of the patients. 54.6% (n = 41) were retired and 66.7% (n = 50) had finished high school or higher education. Most patients (94.7%) had at least one comorbidity; the most common were dyslipidaemia (57.3%), obesity (33.3%), chronic kidney disease (20%) and diabetes (16%). 25 patients (33.3%) met the criteria for polypharmacy and 69.3% had been diagnosed for over 10 years. The median score at HKT was 16 (IQR 3), out of a maximum of 21, and the median score at SC-HI was 65 (IQR 16), out of a maximum of 92. There were 4.3% of invalid answers, which were scored as zero for the final calculations. Using the Spearman correlation test, we found no significant association between the scores (p = 0.061). When analysing subgroups (Figs 1 and 2), the polymedicated patients scored higher on SC-HI but lower on HKT. Those with controlled BP scored lower on both scores. Patients with Hypertension-Mediated Organ Damage (HMOD) scored higher on SC-HI but lower on HKT, while the contrary happened in those with a more long-standing diagnosis. Conclusion We must start by recognising that this is only a preliminary and mainly descriptive analysis of the sample, whose size is not yet representative. Moreover, the complexity of the questionnaires might have influenced the results, as seen by the non-negligible percentage of invalid responses. Taking these limitations into account, some considerations should still be made. Firstly, the median scores show that we still have a long way to go to increase health literacy, especially if we consider the relatively high level of education of the sample. The percentage of patients with comorbidities and polymedicated is also worthy of mention. The results suggest that these complex patients are forced to take more attitudes towards self-care, but do not necessarily know more about their disease; the same happens in patients with HMOD. On the other hand, those with a more long-standing diagnosis seem to know more but not necessarily be more self-cautious. These results, together with the absence of association between the scores, suggest that we must educate patients both on the appropriate self-care and the rationale behind it (and not solely on one of them), in order to maintain lasting positive behaviours. Surprisingly, patients whose BP was controlled were actually less self-conscious and informed—they could possibly have less complex disease, as there are many confounding factors that influence BP control for which the results were not corrected. In conclusion, this study reinforces the complexity of this topic and the need to invest in its understanding; the completion of this investigation, as well as the development of further studies and better tools to evaluate self-care and knowledge, are undoubtedly necessary.

Reliability and validity of the Turkish version of the Self-care of Hypertension Inventory Version 3.0 in adults with hypertension

BackgroundHypertension is an important cardiovascular disease risk factor. Blood pressure control for hypertensive patients is crucial to prevent hypertension related complications. Ensuring and assessing self-care of hypertensive patients is important for blood pressure control and hypertension management. The Self-care of Hypertension Inventory (SC-HI) is an inventory developed for assessing self-care of hypertensive individuals. SC-HI has three subscales; maintenance, monitoring and management. ObjectiveThe aim of this study was to conduct Turkish version of SC-HI Version 3.0 (SC-HI V3.0) and assessing its psychometric properties for adults with hypertension. MethodsWe included 120 hypertensive patients in this methodological study. SC-HI V3.0 translated Turkish and tested for reliability and validity. To analyse structural validity item-total correlations and factor analyses was used. Intraclass correlation coefficient (ICC) method was selected for analysing scale's consistency and convergent validity was conducted. ResultsThe mean age of participants were 54.74 ± 7.19 years and the mean duration from hypertension diagnosis were 38.19 ± 19.42 months. Translated Turkish version's factor loadings were ranged between 0.419 and 0.841. Cronbach's alpha coefficient values were 0.661, 0.880, 0.805 and ICC values were 1.0, 0.99, 0.99 for maintenance, monitoring and management, respectively. Convergent validity's correlation coefficients weak to very strong and statistically significant. ConclusionsTurkish version of the SC-HI Version 3.0 is reliable, valid and useful scale for assessing self-management in hypertensive adults for clinical practice and research purposes.

Turkish Validity and Reliability of the Self-care of Hypertension Inventory (SC-HI) among Older Adults

ABSTRACT Purpose To assess the psychometric properties of the Turkish version of the Self-care of Hypertension Inventory (SC-HI) among older adults with hypertension. Design This was a methodological study. Methods The study sample enrolled 176 older adults. The study carried out preliminary psychometric analyses. Findings Item-level content validity index ranged between 0.87 to 1.0, and the index of content validity was 0.98. The Cronbach’s α for the total scale was 0.84. Conclusion The cross-cultural adaptation of SC-HI has been realized successfully in Turkish. Clinical Evidence Health care providers may utilize the scale to evaluate “older individuals” hypertension self-care abilities.

Evaluating the Dimensionality and Reliability of the Thai Self-Care of Hypertension Inventory Version 2.0

Self-care is essential for hypertensive individuals to promote optimal health and illness treatment. We developed the Thai Self-Care of Hypertension Inventory (SC-HI) version 2.0 from the original US version using a multi-stage approach for cross-cultural adaptation. Scales previously studied outside a US context had different dimensions and factor solutions. Therefore, we examined the Thai SC-HI's factorial validity, construct validity, and internal reliability within a Thai context. We administered a cross-sectional survey with hypertensive patients in 10 primary care settings, and conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on two sets of separate samples from each of five sites to examine the model's factorial validity and construct validity. We estimated scale reliability with Cronbach's alpha and McDonald's omega coefficients. Participants were predominantly female, older adults, with mean age 66 years (SD = 11.94; range 36-97 years). The Self-Care Maintenance scale had three factors and demonstrated good fit when the error covariances were respecified. The two-factor Self-Care Management scale had different factorial solutions compared to previous models. The CFA result showed good fit indices for the Thai, original US, and Brazilian models. The Self-Care Confidence scale was unidimensional, with partially supported fit indices that improved after we respecified the error covariances. Reliability coefficients estimated by difference methods were nearly equal: slightly lower than desired for Self-Care Maintenance (.68-.70) and inadequate for Self-Care Management (.62-.65); Self-Care Confidence reliability was adequate (.89-.90). The Thai SC-HI has good psychometric characteristics and reflects the original instrument's theoretical basis.

Translation and Cross-cultural Adaptation of the Self-care of Hypertension Inventory for Thais With Hypertension.

Self-care is essential for treating hypertension by lowering and controlling blood pressure, to ultimately reduce cardiovascular disease. A valid and reliable hypertension self-care measure is needed for the Thai population. The aim of this study was to translate a cross-cultural adaptation of the Self-care of Hypertension Inventory (SC-HI) into Thai and conduct a pretest of the Thai SC-HI (version 2.0). We performed a methodological study. The stepped approach included translation of the original version of the SC-HI into Thai (forward), synthesis of translation, translation of the Thai version back to English, expert committee review, and pretesting. Pretest phase for feasibility, interobserver agreement, and temporal stability tests were performed in 140 patients with hypertension. Translation equivalence was obtained between the Thai and the original US versions. The item-level content validity index was rated by 9 experts; the relevance, clarity, simplicity, and ambiguity criteria were all 1.00. Similarly, the scale-level content validity indices were 1.00 for the overall instrument and the self-care maintenance, self-care management, and self-care confidence scales. The item-level intraclass correlation coefficients (ICCs) had a range of 0.97 to 1.00 for interobserver agreement and 0.95 to 1.00 for test-retest, respectively. The interobserver ICCs were 0.99 for the total scale and 3 separate scales. The test-retest ICCs were 0.99 for the total scale, with a range of 0.97 to 0.99 for the three separate scales. The process of cross-cultural adaptation warranted validity and reliability testing of the Thai SC-HI. Psychometric testing of this instrument is needed for evaluation in a large sample of individuals with hypertension.

The effectiveness of nurse-led group interventions on hypertension lifestyle management: A mixed method study.

Hypertension is prevalent in Uganda and achieving treatment goals remains a challenge. Our aim was to assess the impact of a bundled nurse-led intervention on hypertension physiologic measures and lifestyle modification, and to explore perceptions of the interventions to enhance sustainability. We employed a sequential explanatory mixed-method design. The study was conducted at a large urban private hospital in Uganda from September 2018 to May 2019. Participants were clinic patients with hypertension currently under care. A total of 54 participants were enrolled in two study groups. Two focus groups with 16 participants and 2 nurse-educator interviews were conducted. Blood pressure and weight were measured at baseline, three, six, and nine months. The Self-Care of Hypertension Inventory was used to assess lifestyle modification. Monthly education and group-support with text-message follow-up were implemented. Two focus-groups and nurse-educator interviews were conducted to assess perceptions post-implementation. The analysis included descriptive statistic, multivariate analysis and qualitative analysis for themes and subthemes. Overall, participants had a mean weight loss of 7.7kg (p=0.001) and a mean reduction in systolic blood pressure (SBP) of 9.5mm Hg (p=0.001). Improvement in biometric outcomes was associated with lifestyle modification such as taking medicine as prescribed (p=0.008), eat lots of fruit and vegetables (p=0.043), and control your body weight (p=0.015). Thematic analysis yielded the following themes: Knowledge and understanding, Attitude change, Adherence-a real struggle, and Adapting to what suits us. Participants found group support, shared learning, and knowledge reinforcement enhanced their knowledge and self-efficacy. Nurse educators were motivated by the patients' favorable responses to the Bundled Education and Support with Text (BEST) intervention. Findings support the use of nurse-led interventions to enhance the achievement of hypertension treatment goals. To sustain the achieved lifestyle modification and blood pressure outcomes, participants expressed a desire for continued support, information access, and inclusion of patients as champions for knowledge dissemination. Future studies need to explore the provision of enabling structures to support nurse-led interventions in routine non-Communicable disease (NCD) care. Hypertension knowledge-gaps exist among patients and may reflect missed opportunities for patient engagement and education for behavior change. Bundled nurse-led hypertension interventions can significantly improve lifestyle modification and enhance hypertension outcomes. Persons supported and empowered with knowledge can act as conduits to wider communities in championing knowledge dissemination.

Abstract P126: Self-management Program And Black Women With Hypertension

Introduction: Prevalence rates of hypertension (HTN) among Black adults (males 58.3% and females 57.6%) in the United States is among the highest in the world. Black females (46%) experience a higher incidence of Stage 2 HTN than Black males (42%) contributing to a greater risk of heart failure, stroke, and kidney disease. Levels of awareness, treatment, and control of HTN among Black women are decreasing. Effective strategies to combat these trends are imperative. Lifestyle changes and medication adherence are proven strategies to facilitate blood pressure (BP) control. Getting individuals with HTN to incorporate these strategies into the context of their everyday physical and social environments where they can be performed independently requires active individual engagement in healthcare behaviors and self-care activities. Aim: This study examined the effects of the Chronic Disease Self-Management Program (CDSMP) on self-care (maintenance, management, and confidence) and BP control in Black women with HTN at baseline and then 3-, 6-, and 9-months post CDSMP. Methods: The current study used data from the Interactive Technology Enhanced Coaching Intervention RCT for Black Women with HTN study. All participants completed a 6-week CDSMP at the beginning of the study. Self-care data were collected using the Self-Care of HTN Inventory along with manual BP readings at baseline, and repeated measures at 3-, 6-, and 9-months. Results: Of the 90 community-dwelling Black women enrolled in the study, 83 completed the CDSMP and 69 completed the study. The mean age was 53.57 ( SD = 10.07) years and the average number of years diagnosed with HTN was 11.06 ( SD = 8.47). All participants had BP readings greater than 130/80 mmHg at baseline and 44.92% (31 of 69) moved to less than 130/80 mmHg at 9-months. A weak negative correlation occurred at 9-months between systolic BP and self-care management, r (67) = -.26, p = .029, and confidence, r (67) = -.25, p = .035; and diastolic BP and self-care management, r (67) = -.31, p = .009, and confidence, r (67) = -.28, p = .018. Conclusion: The CDSMP was feasible, successfully delivered, and well-received by those enrolled in the study. Future studies should evaluate effective interventions for self-care strategies to improve long-term BP control.

Psychometric Properties of the Polish Version of the Self-care of Hypertension Inventory.

BackgroundAccording to evidence-based guidelines, adherence to blood pressure–lowering medication and lifestyle modifications is a crucial part of hypertension management. Self-care is an effective method for secondary prevention. However, patients continue to exhibit major deficits in terms of adherence, self-control, and self-care. Standardized instruments for the effective monitoring of patients' self-care abilities are still lacking.ObjectiveThe objectives of this study were to produce a translation and cross-cultural adaptation of the Self-care of Hypertension Inventory (SC-HI) and to evaluate the psychometric properties of its Polish version.MethodsThe scale underwent translation and psychometric assessment using the standard methodology (forward-backward translation, review, psychometric analysis, criterion validity). The study included 250 patients, with a mean age of 61.23 ± 14.34 years, treated in a hypertension clinic.ResultsMean self-care levels were evaluated in 3 domains: self-care maintenance (56.73 ± 18.57), self-care management (64.17 ± 21.18), and self-care confidence (62.47 ± 24.39). The Cronbach α for each domain showed satisfactory parameters: 0.755 for maintenance, 0.746 for management, and 0.892 for confidence. In the Polish version, the 3-factor structure of the SC-HI was not directly confirmed. Therefore, so-called modification indices were applied to obtain a standardized root mean square residual value less than 0.09 and a root mean square error of approximation value less than 0.06.ConclusionsThe SC-HI has been successfully translated and adapted for Polish settings, and is suitable for application among patients with hypertension.

Impact of satisfaction with physician\u2013patient communication on self-care and adherence in patients with hypertension: cross-sectional study

BackgroundHypertension (HT) requires patients to continuously monitor their blood pressure, strictly adhere to therapeutic recommendations, and self-manage their illness. A few studies indicate that physician–patient communication and the patient’s satisfaction with the therapeutic relationship may affect the course and outcomes of the treatment process. Research is still lacking on the association between satisfaction with physician–patient communication and adherence to treatment or self-care in chronically ill patients. The aim of the study was to evaluate the relationship between satisfaction with physician–patient communication and self-care and adherence in patients with HT undergoing chronic treatment.MethodsThe following instruments were used: the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence (12–48 points), the Self-Care of Hypertension Inventory (SCHI) for self-care level (0–100 points), and the Communication Assessment Tool (CAT) for evaluating satisfaction with physician–patient communication. Socio-demographic and clinical data were obtained from patients’ medical records. The research has a cross-sectional and observational study design. Inclusion criteria were as follows: age > 18 years, hypertension diagnosed per European Society of Hypertension (ESH) guidelines, treatment with at least one antihypertensive drug for the past 6 months, and informed consent. Cognitively impaired patients unable to complete the surveys without assistance were excluded (MMSE ≤18). Correlations between quantitative variables were analyzed using Pearson’s or Spearman’s correlation coefficient. Linear regression was performed. Variable distribution normality was verified using the Shapiro-Wilk test.ResultsThe study included 250 patients (110 male, mean age 61.23 ± 14.34) with HT, treated at a hypertension clinic. In the CAT questionnaire individual questions pertaining to satisfaction with physician communication (on the CAT) were rated “excellent” 28.4–50.4% of the time. The best-rated aspects of communication included: letting the patient talk without interruptions (50.4% “excellent” ratings), speaking in a way the patient can understand (47.6%), and paying attention to the patient (47.2%). According to patient reports, physicians most commonly omitted such aspects as encouraging the patient to ask questions (28.4%), involving them in decisions (29.2%), and discussing the next steps (35.2%). The respondents had a low level of adherence to pharmaceutical treatment (16.63 ± 4.6). In terms of self-care, they scored highest in self-care management (64.17 ± 21.18), and lowest in self-care maintenance (56.73 ± 18.57). In correlation analysis, satisfaction with physician–patient communication (total CAT score) was positively correlated with all SCHI domains (self-care maintenance β = 0.276, self-care management β = 0.208, self-care confidence β = 0.286, p < 0.05), and negatively correlated with ARMS scores (indicating better adherence).ConclusionsSatisfaction with physician–patient communication has a significant impact on self-care and pharmaceutical adherence in patients with hypertension. The more satisfied the patient is with communication, the better their adherence and self-care.Trial registrationSIMPLE: RID.Z501.19.016.

Motivational interviewing to reduce blood pressure in hypertensive patients: randomized clinical trial

Abstract Background Uncontrolled hypertension is the leading risk factor for cardiovascular disease. This factor is often due to poor self-care; however, patients find lifestyle modifications difficult to achieve. Motivational interviewing has been proposed as an approach to enhance intrinsic motivation to change, develop autonomy, and promote healthy behaviors, but few randomized controlled trials have explored this approach, especially in hypertension. Purpose To evaluate the effectiveness of motivational interviewing in reducing blood pressure and improving self-care behaviors and medication adherence in patients with hypertension. Methods Single-center, parallel, randomized clinical trial with outcome-assessor blinding. The study included 120 adult patients diagnosed with hypertension who received regular follow-up in an outpatient hypertension clinic in Southern Brazil. Patients were allocated to one of two groups: the intervention group (IG), which received motivational interviewing by a trained nurse, and the control group (CG), which received standard care. All patients in the IG and the CG were assessed face-to-face once monthly for 6 months. The primary outcome was the reduction in systolic blood pressure and changes in mean blood pressure measured by 24-hour ambulatory blood pressure monitoring; secondary outcomes included self-care behaviors, measured with the Self-Care of Hypertension Inventory, and medication adherence, measured with Medication Assessment Questionnaire. Outcomes of interest were measured at baseline and at 6-month follow-up. Results The sample consisted largely of white (72%) females (70%), with a mean age of 62 years (SD=10), and a median duration of hypertension of ≥13 years. There were no statistically significant differences between groups at baseline. Over time, a statistically significant decrease in blood pressure levels occurred in the motivational interviewing group, except for daytime systolic blood pressure. The magnitude of change was greatest for nighttime systolic blood pressure (−6.4 mmHg) and 24h systolic blood pressure (−5.3 mmHg). Furthermore, patients in the IG showed improvement in all dimensions of the self-care score (P&amp;lt;0.05). Medication adherence improved in the IG (within-group analysis), but not in controls (P&amp;gt;0.05). Conclusion Motivational interviewing is effective in reducing blood pressure and improving self-care and medication adherence in patients with hypertension. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior- Brasil (CAPES)- Finance code 001.

Cross-Cultural Adaptation, Validity, and Reliability of the Arabic Version of the Self-care of Hypertension Inventory Scale Among Older Adults.

Self-care is considered as the best method of blood pressure control. Because the prevalence of hypertension in Arab countries is high and continuously increasing through the years, more attention is needed to evaluate patients' self-care for hypertension, to enable further studies to develop the appropriate intervention. The Self-care of Hypertension Inventory (SC-HI) is a scale that has been developed to measure the maintenance, monitoring, and management of a person with hypertension. The aim of this study was to assess the psychometric properties of the Arabic version of the SC-HI scale among older adults. A cross-cultural adaptation process was used, where structural validity was assessed through factor analysis and interobserver agreement using Cohen κ. The reliability of internal consistency was determined through Cronbach's α and scale item correlation. Test-retest examined the interclass correlation and was tested by paired t test. The mean age of our sample is 63 ± 7.8 years, and most were educated (illiterate patients, 14%). Some modification was done for the scale items. Item-level content validity index ranged between 0.85 and 1, and average scale-level content validity was 0.96. Interobserver adjustment showed high agreement. Cronbach's α was 0.89. Test-retest reliability showed no differences (t = -0.298, P = 0,767), and interclass correlation was 0.85 (95% confidence interval, 0.078-0.90; P < .01). Factor analysis extracted 2, 3, and 1 signal factors for maintenance, management, and confidence subscales, respectively. The adapted Arabic version of SC-HI scale is shown to be valid and reliable among older adults. Further studies are need for further reliability analyses among large groups from various Arab countries.

Validity and reliability of the self-care of hypertension inventory (SC-HI) in a Brazilian population

BackgroundPoor self-care in patients with hypertension is associated with worse patient outcomes. The Self-Care of Hypertension Inventory (SC-HI) measures self-care in patients with hypertension and includes three scales: self-care maintenance, which measures adherence to prescribed treatments and behaviors; self-care management, which evaluates the responses to signs and symptoms of high blood pressure; and self-care confidence, which measures self-efficacy in dealing with the entire process. ObjectiveTo test the psychometric characteristics of the Brazilian version of the SC-HI. MethodsWe enrolled a sample of 360 patients with hypertension and performed confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) to test the factorial structure of the SC-HI and computed the factor score determinacy coefficient to evaluate the SC-HI internal consistency reliability. ResultsThe sample was predominantly female (65%), mean age of 65 years (SD = 10), white (70%). The self-care maintenance scale resulted in a unidimensional scale, with supportive fit indices (CFI = 0.901, RMSEA = 0.048); the self-care management did not reflect the original factorial structure and had unsupportive fit indices. EFA showed a different factorial solution in reference to the original study. Finally, the self-care confidence scale resulted in a unidimensional scale with supportive fit indices (CFI = 0.940, RMSEA = 0.093). The reliability of the self-care maintenance, management, and confidence scales resulted in factor score determinacy coefficients of 0.83, 0.78, and 0.97 respectively. ConclusionThis study shows that the SC-HI is a valid and reliable tool to measure self-care in patients with hypertension among the Brazilian population.

Psychometric Testing of the Self-care of Hypertension Inventory.

Hypertension (HTN) is a global public health issue. Self-care is an essential component of HTN treatment, but no instruments are available with which to measure self-care of HTN. The purpose of this study is to test the psychometric properties of the Self-care of Hypertension Inventory (SC-HI). Using the Self-care of Chronic Illness theory, we developed a 24-item measure of maintenance, monitoring, and management appropriate for persons with chronic HTN, tested it for content validity, and then tested it in a convenience sample of 193 adults. Exploratory factor analysis was used to identify measure structure. Cronbach's α and factor determinacy scores and were used to assess reliability. Validity was tested with the Medical Outcomes Study General Adherence Scale and the Decision Making Competency Inventory. Seventy percent of the sample was female; mean age was 56.4 ± 13 years; mean duration of HTN was 11 ± 9 years. Removal of 1 item on alcohol consumption resulted in a unidimensional self-care maintenance factor with acceptable structure and internal consistency (α = .83). A multidimensional self-care management factor included "consultative" and "autonomous" factors (factor determinacy score = 0.75). A unidimensional confidence factor captured confidence in and persistence with each aspect of self-care (α = .83). All the self-care dimensions in the final 23-item instrument were associated with treatment adherence and several with decision making. These findings support the conceptual basis of self-care in patients with HTN as a process of maintenance, monitoring, and management. The SC-HI confidence scale is promising as a measure of self-efficacy in self-care.