Development of a scale to gain insight into the experience of living with chronic heart failure: The UNAV-Experience of Living with Chronic Heart Failure Scale

Abstract

Background. To date, there are no tools for the nursing staff to gain systematic insight on the experience lived by patients with chronic heart failure. The objective of this study was to develop a scale for this purpose. Methods. The study was conducted between January 2018 and December 2020 in three Spanish hospitals. The process described by DeVellis was used for the development of the scale. The items were built based on a phenomenological study and a systematic review of the literature. Next, feedback from a panel of experts was obtained, the scale was administered to a sample of patients with chronic heart failure, and a cognitive interview and an observational study were conducted to create the final version of the scale. Results. The first version of the scale had in seven domains and 76 items. After its evaluation by a panel of experts, it was reduced to a second version with six domains and 55 items. Following the administration of Version 2 to 17 patients (58.8% male, mean age 59.53, 70.6% classified as NYHA functional class II), five items were modified and two eliminated. Thus, the third version of the UNAV-CHF Experience Scale was composed of six domains and 53 items. Conclusions. This study presents the development of the UNAV-experience of living with chronic heart failure scale. It is an original and novel instrument that allows systematically explore this experience. A larger -scale study is necessary to confirm the validity of our scale.Fundamento. Actualmente no existen herramientas para explorar de forma sistemática la experiencia de vivir con insuficiencia cardiaca crónica (ICC). El objetivo de este estudio es desarrollar una escala para conocer la experiencia de vivir con ICC. Métodos. El estudio se realizó entre enero de 2018 y diciembre de 2020 en tres hospitales españoles. Se aplicó la teoría de DeVellis para el desarrollo de una escala. Los ítems se formularon a partir de un estudio fenomenológico y de una revisión sistemática de la literatura. Tras la opinión del panel de expertos, se administró la escala a una muestra de pacientes con ICC y se generó la versión final de la escala tras realizar una entrevista cognitiva y un estudio observacional. Resultados. La versión 1 de la escala constaba de siete dominios y 76 ítems. Tras la evaluación por el panel de expertos, la versión 2 se diseñó con seis dominios y 55 ítems. Tras su aplicación a 17 pacientes (58,8% varones, edad media 59,53 años, 70,6% clasificados como clase funcional II de la NYHA) se modificaron cinco ítems y se eliminaron dos, resultando la versión 3 de la Escala de Experiencia UNAV-CHF con seis dominios y un total de 53 ítems. Conclusiones. Este estudio presenta el desarrollo de la Escala UNAV-Experiencia de vivir con insuficiencia cardiaca crónica, instrumento original y novedoso que permite explorar esta experiencia de forma sistemática. Es necesario un estudio a mayor escala para confirmar su validez.