Psychometric evaluation of the Heart Failure Somatic Perception Scale in a European heart failure population

Background: The Heart Failure Somatic Perception Scale (HFSPS) is a four-factor instrument used to assess how bothersome are 18 physical signs and symptoms of heart failure. To date, construct validity and reliability of the HFSPS have been evaluated in only one American study and never in a European population. Aim: To evaluate psychometric properties (validity and reliability) of the HFSPS in a European heart failure population. Methods: This was an Italian multicentre study in which the HFSPS factorial structure was assessed using confirmatory factor analysis. Criterion related validity of the HFSPS was evaluated by correlating its factor scores with the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using Pearson's r. The HFSPS internal consistency reliability was evaluated using the factor score determinacy coefficient, Cronbach's alpha and model-based internal consistency index. Results: Most of the participants (n=321) were male (56.6%), with a mean age of 71.48 years (SD, 12.75) and in New York Heart Association class II (61.8%). The confirmatory factor analysis, testing the original HFSPS four-factor structure (dyspnoea, chest discomfort, early and subtle, and oedema), resulted in the following supportive fit indices: chi(2) (126, N=321)=337.612, p<0.001, comparative fit index =0.920, Tucker-Lewis index =0.903, root mean square error of approximation =0.072 and standardized root mean square residual =0.045. With regard to the criterion related validity, all the correlations with the KCCQ were statistically significant. The HFSPS reliability resulted in factor score determinacy coefficients > 0.87 and Cronbach's alpha > 0.75, with the exception of the two-item chest discomfort subscale; the model-based reliability coefficient was 0.914. Conclusion: The validity and reliability of the HFSPS were supportive in this European sample. The HFSPS can be used to assess how bothersome heart failure signs and symptoms are in order to improve their management.