Abstract:

Objective To develop a Treatment Burden Scale for patients with chronic heart failure （CHF） and evaluate its reliability and validity，aiming to provide an effective tool for assessing treatment burden levels in this population. Methods According to Cumulative Complexity Model，the study was conducted in 2 phases.A preliminary item pool was established through literature review and semi-structured interviews，from August 2022 to March 2023，followed by expert consultation to finalize the initial scale. A convenience sample of CHF patients from 4 tertiary A hospitals in Hunan and Hubei provinces was conducted to refine scale items and assess psychometric properties，from June 2023 to April 2024. Results The final scale contained 26 items. Exploratory factor analysis revealed 6 domains，including family financial support burden，healthcare utilization burden，the challenges patients face in acquiring knowledge about proper medication use and water/sodium dietary management，the behavioral burden associated with tracking daily water/sodium intake and symptom patterns，psychological burden，and medication management burden，cumulatively explaining 68.661% of variance.Confirmatory factor analysis demonstrated satisfactory model fit；the χ²/df was 2.076；the root mean square error of approximation was 0.070；the normed fit index was 0.912；the content validity score was 0.974. The total Cronbach’s α coefficient of the scale was 0.903；the split-half reliability was 0.785；the test-retest reliability was 0.936. Conclusion The Treatment Burden Scale for CHF patients developed in this study has good reliability and validity psychometric properties，and it can be used to evaluate treatment burden levels and influencing factors in clinical practice.

Key words: Chronic Heart Failure, Treatment Burden, Scale, Reliability, Validity, Nursing Care

摘要：

目的 编制慢性心力衰竭患者治疗负担量表并评价其信效度，以期为评估慢性心力衰竭患者治疗负担水平提供有效工具。方法 以累计复杂模型为理论基础，2022年8月至2023年3月，通过文献回顾和半结构式访谈形成量表条目池；通过专家函询确定初始版量表；2023年6月至2024年4月，便利选取就诊于湖南省、湖北省4所三级甲等医院的慢性心力衰竭患者进行调查，筛选量表条目并进行信效度分析。结果 慢性心力衰竭患者治疗负担量表共26个条目，经过2次探索性因子分析得出6个公因子，包括家庭经济支持负担、医疗服务利用负担、用药和水钠饮食知识获取负担、水钠摄入和症状记录行为负担、心理负担、用药管理负担，累计方差贡献率为68.661%；验证性因子分析显示，卡方/自由度为2.076，近似误差均方根为0.070，比较拟合指数为0.912；量表内容效度指数为0.974。量表总的Cronbach’s α系数为0.903，折半信度为0.785，重测信度为0.936。结论 构建的慢性心力衰竭患者治疗负担量表具有科学性和规范性，且具有良好的信效度，可用于评估慢性心力衰竭患者治疗负担水平及影响因素。

关键词: 慢性心力衰竭, 治疗负担, 量表, 信度, 效度, 护理