[French validation of the "Exercise of self-care agency" scale for heart patients]

Self-care agency is the practice of health-related activities that individuals deliberately initiate and perform in order to maintain life, health and well-being (OREM, 1987). A tool measuring self-care agency is useful to nurses for identifying patients lacking knowledge, motivation, and for those with limited self-care agency. KEARNEY and FLEISCHER (1979) have developed the Exercise of Self-care Agency (ESCA) scale to asses the extent to which individuals take action toward their health care. Several studies suggest that the ESCA scale possesses adequate psychometric properties (KEARNEY & FLEISCHER, 1979; LUCAS, MORRIS & ALEXANDER, 1988; MCBRIDE, 1987; RIESCH & HAUCK, 1988). The lack of a validated tool measuring self-care agency among french speaking populations, led us to translate the ESCA scale and to examine its psychometric properties in a sample of French Canadian individuals who have survived a recent non-complicated myocardial infarction (MI). At 8 and 14 weeks after their MI, 83 subjects aged 52 +/- 10 years with a 1,857 +/- 1,605 U/L MI and an ejection fraction of 51 +/- 10% completed the french-ESCA scale. Mean scores were 112.6 +/- 13.3 at 8 weeks and 117.9 +/- 14.0 at 14 weeks post-MI. Internal consistency coefficients of the french-ESCA scale (at 8 and 14 weeks post-MI) are acceptable (0.84 and 0.88, respectively). Internal consistency coefficients are similar to those obtained in previous studies whereas mean scores on the ESCA scale are somewhat higher (RIESCH & HAUCK, 1988). Cronbach alphas for the french-ESCA scale's sub-scales are generally lower: Self-concept (0.57 and 0.69), Initiative/responsibility (0.72 and 0.80), Knowledge/information seeking (0.80 and 0.79), and Taking actions (0.49 and 0.62). The french-ESCA scale appears stable within the 6 weeks period (r = 0.77, p < 0.001). We recommend to further assess the french-ESCA scale's psychometric properties using larger samples of subjects with or without various health problems.