Development Of Weight Management Behavior Scale For Patients With Chronic Heart Failure Based On The Theory Of Planned Behavior

Objective The weight management behavior scale for chronic heart failure patients in China was developed based on the theory of planned behavior.The reliability and validity of the scale were tested to explore a set of clinical practice evaluation indicators for weight management in patients with chronic heart failure,to provide a theoretical basis for chronic disease management.Methods Literature review and semi-structured interview with patients with chronic heart failure to construct a pool of scale entries.Through two rounds of Delphi consultation and a preliminary survey 25 items of the initial scale were formed.Project distribution method,coefficient of variation method,project decision value,homogeneity test,factor analysis method were used to screen the scale items after a convenient sample survey of 300 patients with chronic heart failure.The reliability of the scale was evaluated by using Cronbach's ? coefficient,split-half reliability,and test-retest reliability.The validity of the scale was tested by content validity,structural validity and calibration associated validity to form a formal scale.Results 1.Item pool construction:The pool of scale entries was based on the theory of planned behavior,refer to the 2014 Guidelines for Diagnosis and Treatment of Heart Failure to build.The basic structure includes Attitude toward the Behavior,Subject Norm,Perceived Behavior Control,Behavioral Intention,and Weight Management Behaviors.The initial entries were 26 included the patient's attitude,the influence of important others,the perceived behavior control ability,the preparation status and the compliance.2.Item screening: The scale entries becomed 25 after 2 rounds of expert consultation.After the formal investigation,there were 25 items retained after screening by the project distribution method,the coefficient of variation method,the project decision value,the homogeneity test,and the factor analysis method.The five common factors extracted for the factor analysis were named and completely consistented with the theoretical structure.3.Reliability and validity analysis of the scale:(1)Reliability:(1)The Cronbach's ? coefficient of whole scale was 0.922,the Cronbach's ? coefficient of each dimension was between 0.779 to 0.840;(2)The split-half reliability coefficient of the scale was 0.799.All dimensions split-half reliability coefficient were between 0.749 to 0.856;(3)The test-retest reliability of the whole scale was 0.940,and the test-retest reliability of each dimension was between 0.791 to 0.872.(2)Validity:(1)Content validity: The I-CVI of the formal scale were between 0.79 and 1.00,the S-CVI of the formal scale were 0.90.(2)Structural validity: There were 5 factors extracted by EFA,which explained for 63.1% variances and there was no cross load of the item.(3)Criterion-related validity:The results showed that the correlation coefficient of “The Weight Management Behavior TPB scale for Chronic Heart Failure Patients” with “The CHF Weight Management Scale” was 0.661.(P<0.01),the correlation coefficient between each dimension and the scale was between 0.388?0.613(P<0.01),indicated that the two scales have medium correlation.Conclusion 1.The Weight Management Behavior TPB scale for Chronic Heart Failure Patients developed in this study consists of 25 items in 5 dimensions,including 4 items of Attitude toward the Behavior,8 items of Subject Norm,5 items of Perceived Behavior Control,4 items of Behavioral Intention and 4 items of Weight Management Behavior.2.The Weight Management Behavior TPB scale for Chronic Heart Failure Patients has good reliability and validity,and can be used as a tool for evaluating weight management behavior in patients with chronic heart failure.3.The Weight Management Behavior TPB scale for Chronic Heart Failure Patients evaluates the influencing factors of weight management behavior in patients with chronic heart failure from four aspects: attitude perception,important influence of others,perceived behavior control ability and behavioral intention.It Provides a scientific basis for medical staff formulate planned and targeted intervention measures to improve the performance of weight management behavior.