Construct validity of the Heart Failure Screening Tool (Heart‐FaST) to identify heart failure patients at risk of poor self‐care: Rasch analysis

Aim The aim of this study was to psychometrically evaluate the Heart Failure Screening Tool (Heart‐FaST) via: (1) examination of internal construct validity; (2) testing of scale function in accordance with design; and (3) recommendation for change/s, if items are not well adjusted, to improve psych...

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Bibliographic Details
Published in:Journal of advanced nursing 2018-06, Vol.74 (6), p.1412-1422
Main Authors: Reynolds, Nicholas A., Ski, Chantal F., McEvedy, Samantha M., Thompson, David R., Cameron, Jan
Format: Article
Language:English
Subjects:
Beta blockers
Clinical assessment
Construct validity
Discrimination
Heart failure
Heart‐FaST
instrument development
Interdisciplinary aspects
Males
Medical screening
Nursing
Quantitative psychology
Questionnaires
Rasch analysis
Rasch model
Risk assessment
Self care
Thresholds
Validation studies
Validity
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Summary:Aim The aim of this study was to psychometrically evaluate the Heart Failure Screening Tool (Heart‐FaST) via: (1) examination of internal construct validity; (2) testing of scale function in accordance with design; and (3) recommendation for change/s, if items are not well adjusted, to improve psychometric credential. Background Self‐care is vital to the management of heart failure. The Heart‐FaST may provide a prospective assessment of risk, regarding the likelihood that patients with heart failure will engage in self‐care. Design Psychometric validation of the Heart‐FaST using Rasch analysis. Method The Heart‐FaST was administered to 135 patients (median age = 68, IQR = 59–78 years; 105 males) enrolled in a multidisciplinary heart failure management program. The Heart‐FaST is a nurse‐administered tool for screening patients with HF at risk of poor self‐care. A Rasch analysis of responses was conducted which tested data against Rasch model expectations, including whether items serve as unbiased, non‐redundant indicators of risk and measure a single construct and that rating scales operate as intended. Results The results showed that data met Rasch model expectations after rescoring or deleting items due to poor discrimination, disordered thresholds, differential item functioning, or response dependence. There was no evidence of multidimensionality which supports the use of total scores from Heart‐FaST as indicators of risk. Conclusion Aggregate scores from this modified screening tool rank heart failure patients according to their “risk of poor self‐care” demonstrating that the Heart‐FaST items constitute a meaningful scale to identify heart failure patients at risk of poor engagement in heart failure self‐care.
ISSN:0309-2402
1365-2648
DOI:10.1111/jan.13544