Psychometric evaluation of the Arabic version of the heart failure-specific health literacy scale in a socio-politically challenged setting.

INTRODUCTION: Low levels of formal education among Lebanese people with HF were reported. Additionally, limited discharge education is provided to this population. Therefore, it was necessary to evaluate the health literacy levels among this population following the translation of the heart failure-specific health literacy scale into Arabic and to evaluate its psychometric properties in the Lebanese setting. METHODS: A cross-sectional design conducted on participants from the community with confirmed cases of heart failure. A research team was trained for data collection. Following securing participants' consents, baseline sociodemographic characteristics and the Arabic version of the heart failure-specific health literacy scale were administered. Data collection took place between June and December 2022. A pilot sample analysis was done to confirm homogeneity between the English and the Arabic versions. Exploratory and confirmatory factor analysis were performed to evaluate content and construct validity of the scale. Cronbach alpha was done to evaluate reliability. RESULTS: The pilot analysis confirmed homogeneity of the items of the Arabic and English versions of the scale. The final sample of 343 participants was randomly divided to two parts for each of the exploratory factor analysis and confirmatory factor analysis. The mean age was 64 years with the majority being male participants. In terms of exploratory factor analysis, the three subscales of the literacy scale explained 60% of the variance. The best acceptable fit was found on 11 items of the scale after dropping the 10th item from the analysis. The Cronbach alpha of the scale was 0.68. CONCLUSION: The Arabic version of the heart failure-specific health literacy scale was evaluated to be a valid and reliable tool. Further analysis should be done on the dropped item, and correlations should be done with significant variables such as self-care. REPORTING METHOD: STROBE checklist. PATIENT/PUBLIC CONTRIBUTION: No patient/public contribution. CONTRIBUTION TO THE WIDER GLOBAL COMMUNITY: Participants with heart failure were shown to have low levels of literacy in Lebanon. Additionally, low literacy levels are also common among Lebanese older adults living in high income, Western Countries. Therefore, this valid and reliable scale can be used to evaluate health literacy among people with heart failure in Lebanon and among Lebanese and other Arabic-speaking older adults globally.

Differences in presentation, diagnosis and management of heart failure in women. A scientific statement of the Heart Failure Association of the ESC.

Despite the progress in the care of individuals with heart failure (HF), important sex disparities in knowledge and management remain, covering all the aspects of the syndrome, from aetiology and pathophysiology to treatment. Important distinctions in phenotypic presentation are widely known, but the mechanisms behind these differences are only partially defined. The impact of sex-specific conditions in the predisposition to HF has gained progressive interest in the HF community. Under-recruitment of women in large randomized clinical trials has continued in the more recent studies despite epidemiological data no longer reporting any substantial difference in the lifetime risk and prognosis between sexes. Target dose of medications and criteria for device eligibility are derived from studies with a large predominance of men, whereas specific information in women is lacking. The present scientific statement encompasses the whole scenario of available evidence on sex-disparities in HF and aims to define the most challenging and urgent residual gaps in the evidence for the scientific and clinical HF communities.

Psychometric Evaluation of the Heart Failure Somatic Perception Scale in a Middle Eastern Heart Failure Population.

BACKGROUND: The Heart Failure Somatic Perception Scale (HFSPS) is an 18-item instrument used to assess how bothersome are common signs and symptoms of heart failure (HF). To date, the psychometric properties of the HFSPS have been tested in American, Italian, and Japanese samples. OBJECTIVE: The aim of this study was to evaluate the validity and reliability of the HFSPS in a population of Lebanese patients living with HF. METHODS: A rigorous translation and back-translation process was performed. Cultural appropriateness ratings were assessed by an expert panel. Exploratory factor analysis was conducted to confirm construct validity, whereas an independent t test using the Minnesota Living With HF Questionnaire's scores was conducted to confirm convergent validity. Pearson correlation was performed to confirm discriminant validity using the Self-Care in HF Index Management subscale, whereas predictive validity was evaluated using the Control Attitudes Scale-Revised. Internal consistency reliability was evaluated using Cronbach α. RESULTS: A total of 109 patients (mean age, 63.66 ± 10.55 years; 69.7% male) were included. A series of exploratory factor analyses was conducted and resulted in a 4-factor model. Cronbach α was 0.869. Convergent (high correlation with total Minnesota Living With HF Questionnaire; r = 0.762, P < .0001), discriminant (no correlation with self-care management; r = 0.180, P = .078), and predictive (significant correlation with the Control Attitudes Scale-Revised; r = -0.523, P < .0001) validity was supported. CONCLUSION: The reliability and validity of the HFSPS were supportive in this Middle Eastern sample. The HFSPS can be used to assess how bothersome HF symptoms are to improve their management.