A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Psychometrics

Background:

• Home-based cardiac rehabilitation offers proven benefits, yet lacks standardized adherence criteria for cardiovascular disease patients.
• Assessing long-term adherence is vital for effective home-based cardiac rehabilitation outcomes.
• Chronic heart failure patients require a reliable tool to monitor their adherence to prescribed exercises.

Purpose of the Study:

• To develop a novel scale for measuring adherence to home-based cardiac rehabilitation exercise.
• To validate the psychometric properties of this new adherence scale in patients with chronic heart failure.

Main Methods:

• Scale development involved grounded theory, literature review, and Delphi surveys for item generation and content validation.
• Item analysis, exploratory and confirmatory factor analyses were used to determine scale structure and validity.
• Reliability was assessed using Cronbach's alpha, split-half, and test-retest coefficients.

Main Results:

• A 20-item, four-dimensional scale for home-based cardiac rehabilitation exercise adherence was successfully developed.
• The scale demonstrated excellent content validity (0.986) and good calibration validity (0.726).
• Factor analysis confirmed a robust four-factor structure, explaining 75.1% of the variance, with high reliability (Cronbach's α = 0.894).

Conclusions:

• A psychometrically sound scale for assessing home-based cardiac rehabilitation exercise adherence has been established.
• This validated scale provides a crucial tool for monitoring and improving patient adherence in chronic heart failure management.
• The developed scale supports the consistent evaluation of home-based exercise programs in cardiovascular rehabilitation.