Self-Care for a Heart-Healthy Lifestyle scale in cardiovascular disease prevention: development and psychometric...

We aimed to develop the Self-Care for a Heart-Healthy Lifestyle (SC-HeartLife) scale among community-dwelling adults without a history of cardiovascular disease and evaluate its psychometric properties.

The 'SC-HeartLife' scale was developed in three phases-initial item pool generation, content and face validity, and psychometric testing-guided by the Middle-Range Theory of Self-Care of Chronic Illness. A total of 946 community-dwelling adults in South Korea were recruited through an online survey. From an initial 83 items, 43 were retained following content and face validity evaluations. Using two split random samples, exploratory factor analysis and the first confirmatory factor analysis (CFA) were performed with Subsample 1 (n = 473) to develop a seven-factor hierarchical model. The second CFA with Subsample 2 (n = 473) was then conducted for cross-validation. Structural validity was supported by a 38-item, seven-factor hierarchical model demonstrating good fit (CMIN/DF = 2.07, CFI = 0.91, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06). The model comprises three scales: self-care maintenance (five factors), self-care monitoring (one factor), and self-care management (one factor). It was also evidenced by significant correlations of the 'SC-HeartLife' with health-promoting behaviours and health-related quality of life. Reliability was acceptable, with strong internal consistency (global reliability = 0.94) and test-retest stability (intraclass correlation coefficient = 0.89).

The 38-item 'SC-HeartLife' scale, on a 5-point Likert scale, is a valid and reliable tool. It is applicable across both clinical and research settings, supporting the identification of individuals and communities vulnerable to inadequate 'SC-HeartLife' and the evaluation of tailored interventions designed to promote self-care in the context of cardiovascular disease prevention.