Publicação
Heart Failure Symptom Tracker (HFaST) : Translation, Cross-cultural Adaptation, and Psychometric Validation for the Portuguese Population
| Resumo: | ABSTRACT - Introduction: Heart Failure (HF) is a global public health issue with high morbidity and mortality rates. Effective symptom management and self-monitoring improve the quality of life in HF patients. The European Society of Cardiology recommends integrating these strategies for early symptom detection and potential reduction in hospitalisation, particularly among individuals aged 65 and over. Objectives: This study aims to translate, cross-culturally adapt and validate the Heart Failure Symptom Tracker (HFaST) for the Portuguese population and to analyse the association between the HFaST scores and the hospitalisation risk due to HF decompensation. Methods: This cross-sectional study involved two phases: the first phase with the translation and cross-cultural adaptation of the HFaST tool into European Portuguese. Ten experts evaluated the clarity, relevance and equivalence of the pre-final version, while forty individuals pre-tested item comprehensibility; second phase for the psychometric validation with sixty HF patients recruited from an Outpatient Heart Failure Consultation, who completed a demographical and clinical assessment, the Portuguese versions of the HFaST tool and the KCCQ-23 questionnaire. Additionally, the association between HFaST scores and HF hospitalisations were analysed. Results: Translation and back-translation were consistent. Expert judgement revealed I-CVI scores of 0.7 and 1.00 in terms of clarity and relevance of the instructions, respectively, while on the Likert scale items ranged from 0.5 to 0.9, leading to adjustments and removal of two items. Equivalence between versions showed substantial to perfect agreement, with Fleiss’ k ranging from 0.678 to 1.000. The pre-test confirmed 95% comprehensibility. Internal consistency was acceptable, with a Cronbach’s Alpha of 0.724, moderate to strong inter-item correlations, and significant correlations between the HFaST and the KCCQ-23 items were observed. Higher HFaST scores were significantly associated with an increased hospitalisation risk. Conclusion: The Portuguese version of the HFaST is reliable and valid for the Portuguese population, serving as an important tool for HF patients for monitoring and managing symptoms, demonstrating the importance of culturally adapted instruments to improve patients’ quality of life. Likewise, by facilitating early worsening symptoms detection, it has a crucial role in preventing hospital admissions and it may reduce costs at the Portuguese National Health Service. |
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| Autores principais: | Perez, Maria Inês Antunes da Conceição |
| Assunto: | Heart Failure Symptom Tracker Disease Management Psychometric Validation Insuficiência Cardíaca Monitorização de Sintomas Gestão da Doença Validação Psicométrica |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade Nova de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório Institucional da UNL |
| Resumo: | ABSTRACT - Introduction: Heart Failure (HF) is a global public health issue with high morbidity and mortality rates. Effective symptom management and self-monitoring improve the quality of life in HF patients. The European Society of Cardiology recommends integrating these strategies for early symptom detection and potential reduction in hospitalisation, particularly among individuals aged 65 and over. Objectives: This study aims to translate, cross-culturally adapt and validate the Heart Failure Symptom Tracker (HFaST) for the Portuguese population and to analyse the association between the HFaST scores and the hospitalisation risk due to HF decompensation. Methods: This cross-sectional study involved two phases: the first phase with the translation and cross-cultural adaptation of the HFaST tool into European Portuguese. Ten experts evaluated the clarity, relevance and equivalence of the pre-final version, while forty individuals pre-tested item comprehensibility; second phase for the psychometric validation with sixty HF patients recruited from an Outpatient Heart Failure Consultation, who completed a demographical and clinical assessment, the Portuguese versions of the HFaST tool and the KCCQ-23 questionnaire. Additionally, the association between HFaST scores and HF hospitalisations were analysed. Results: Translation and back-translation were consistent. Expert judgement revealed I-CVI scores of 0.7 and 1.00 in terms of clarity and relevance of the instructions, respectively, while on the Likert scale items ranged from 0.5 to 0.9, leading to adjustments and removal of two items. Equivalence between versions showed substantial to perfect agreement, with Fleiss’ k ranging from 0.678 to 1.000. The pre-test confirmed 95% comprehensibility. Internal consistency was acceptable, with a Cronbach’s Alpha of 0.724, moderate to strong inter-item correlations, and significant correlations between the HFaST and the KCCQ-23 items were observed. Higher HFaST scores were significantly associated with an increased hospitalisation risk. Conclusion: The Portuguese version of the HFaST is reliable and valid for the Portuguese population, serving as an important tool for HF patients for monitoring and managing symptoms, demonstrating the importance of culturally adapted instruments to improve patients’ quality of life. Likewise, by facilitating early worsening symptoms detection, it has a crucial role in preventing hospital admissions and it may reduce costs at the Portuguese National Health Service. |
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