Validation of Psychometric Properties of Partners in Health Scale for Heart Failure

Background: Congestive heart failure (CHF) is a complex chronic disease, and it is associated with a second comorbid condition in more than half of cases. Self-management programs can be specific to CHF or generic for chronic diseases. Several tools have been validated for CHF. Presently, there are no established generic instruments that are validated for measuring self-management in CHF. Objective: This study aims to evaluate the internal reliability and construct validity (psychometric properties) of the Partners in Health (PIH) scale for patients with congestive heart failure, a generic chronic disease self-management tool. Methods: The study included 210 adult CHF patients [120 with heart failure with reduced ejection fraction (HfrEF), 90 with preserved ejection fraction (HfpEF)], from Community Cardiology Outpatients in West Melbourne, Australia, who were treated in community cardiology and were included between May 2022 and Jan 2024. The screened patient population were diagnosed with CHF and were eligible for an SGLT-2 inhibitor. Cohort analysis used the Bayesian confirmatory factor analysis to evaluate the a priori four-factor structure. Omega coefficients and 95% credible intervals (CI) were used to assess internal reliability. Results: In the CHF (HFrEF) and preserved ejection fraction (HFpEF) cohorts, participants' mean [standard deviation (SD)] age was 66.8 (13.5) and 71.3 (9.76) years. Description of study sociodemographics highlighted that 88% and 52% of patients were male, there was a BMI > 50% in both cohorts, eGFR > 60 mL/min were 59% and 74%, and LVEF < 40% and > 50% were 99% and 100%, respectively. Model fit for the hypothesised model was adequate (posterior predictive p = 0.073) and all hypothesised factor loadings were substantial (>0.6) and significant (p < 0.001). Omega coefficients (95% CI) for the PIH subscales of Knowledge, Partnership, Management and Coping were 0.84 (0.79-0.88), 0.79 (0.73-0.84), 0.89 (0.85-0.91) and 0.84 (0.79-0.88), respectively. Conclusion: This study is original in confirming the dimensionality, known-group validity, and reliability of the PIH scale for measuring generic self-management in outpatients with CHF syndrome.