Document Type




Format of Original

11 p.

Publication Date




Source Publication

Journal of Cardiac Failure

Source ISSN


Original Item ID

doi: 10.1016/j.cardfail.2003.12.001


Background: Self-care is believed to improve outcomes in heart failure (HF) patients. However, research testing this assumption is hampered by difficulties in measuring self-care. The purpose of this study was to evaluate the psychometric properties of a revised instrument measuring self-care in persons with HF, the Self-Care of Heart Failure Index (SCHFI). The SCHFI is a self-report measure comprised of 15 items rated on a 4-point response scale and divided into 3 subscales.

Methods and Results: Psychometric testing was done using data from 760 HF patients (age 70.36 ± 12.3 years, 51% male) from 7 sites in the United States. Reliability of the SCHFI (alpha .76) was adequate. Reliability of the Self-Care Maintenance subscale was lower than desired (alpha .56) but the reliability of the other subscales was adequate: Self-Care Management (alpha .70) and Self-Care Self-Confidence (alpha .82). Construct validity was supported with satisfactory model fit on confirmatory factor analysis (NFI = .69, CFI .73). Construct validity was supported further with significant total and subscale (all P < .05) differences between patients experienced with HF and those newly diagnosed, consistent with the underlying theory.

Conclusion: Low reliability of the Self-Care Maintenance subscale was expected because the items reflect behaviors known to vary in individuals. The reliability and validity of the SCHFI are sufficient to support its use in clinical research.


Accepted version. Journal of Cardiac Failure, Vol. 10, No. 4 (August 2004): 350-360. DOI. © 2004 Elsevier. Used with permission.

NOTICE: this is the author’s version of a work that was accepted for publication in the Journal of Cardiac Failure. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in the Journal of Cardiac Failure, [VOL 10, ISSUE 4, August 2004] DOI.

Margaret Sebern was affiliated with the University of Wisconsin - Milwaukee at the time of publication.

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