Development and psychometric testing of the European Heart Failure Self-Care behaviour scale caregiver version (EHFScB-C)

Angela Durante*, Maddalena De Maria, Josiane Boyne, Tiny Jaarsma, Raul Juarez-Vela, Anna Stromberg, Ercole Vellone

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: The European Heart Failure Self-Care Behaviour Scale (EHFScBS) is used worldwide to measure heart failure (HF) patient self-care, but a caregiver version does not exist.

Objective: To develop and test the European HF Self-Care Behaviour Scale for Caregivers (EHFScBS-C) in a population of informal caregivers of HF patients.

Methods: The EHFScBS-C was derived from the EHFScBS to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C was developed in English and then translated into Italian, Spanish and Dutch, after which it was back-translated. EHFScBS-C data were collected from 193 HF caregivers enrolled in Italy, Spain and the Netherlands.

Results: Exploratory factor analysis revealed two factors with supportive fit indices (CFI = 0.990; RMSEA = 0.048): caregivers' contributions to HF self-care related to medical issues, and caregivers' contributions related to lifestyle. Internal consistency reliability was supported as well (Cronbach's alpha 0.90 for the overall scale). Construct validity was demonstrated with significant correlations with the Caregiver Preparedness Scale.

Conclusion and Practice Implications: The EHFScBS-C has adequate validity and reliability for its use in clinical practice and research to measure the extent to which caregivers contribute to HF patient selfcare. The EHFScBS-C can be used in combination with the EHFScBS to conduct dyadic studies. (C) 2021 Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)2106-2111
Number of pages6
JournalPatient Education and Counseling
Issue number8
Publication statusPublished - Aug 2021


  • Self-care
  • Caregivers
  • Dyad
  • Heart failure
  • Instrument development
  • Psychometrics

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