https://orcid.org/0000-0001-6289-7528
Abstract
Background
Home blood pressure monitoring helps patients with chronic kidney disease to improve blood pressure control and can predict cardiovascular events, renal function progress, and risk of death. Few instruments are available to assess patient adherence to home blood pressure monitoring.
Objective
The aim of the study was to develop an instrument to evaluate home blood pressure monitoring adherence in patients with chronic kidney disease and test its reliability and validity.
Methods
An item pool was formed for the Home Blood Pressure Monitoring Adherence Scale by literature review. Patients with chronic kidney disease (n = 436) were surveyed to assess item selection and examine item reliability and validity. Scale reliability was evaluated using internal, split-half, and test–retest reliability, while validity was assessed according to content, construct, and criterion validity.
Results
The scale comprising eight items was formed from the item pool and item selection. Cronbach’s α was 0.906, split-half reliability was 0.947, and test–retest reliability was 0.716. Item-level and scale-level (both universal agreement and average) content validity indices were 1.00. According to the Self-Efficacy for Managing Chronic Disease 6-item Scale, criterion validity for our scale was 0.251. Exploratory factor analysis extracted one factor and the cumulative variance contribution rate was 61.568%. Confirmatory factor analysis showed the model fit well (Χ2=50.125, df=17, Χ2/df=2.949, root mean square error of approximation=0.095, confirmatory fit index=0.970).
Conclusion
The scale has good reliability and validity for patients with chronic kidney disease, representing an efficient instrument for clinical assessment of home blood pressure monitoring adherence.
Relevance for Clinical Practice
This study provides a sensitive and reliable quantitative assessment instrument for the specific adherence behavior of HBPM. It is suitable for rapid evaluation of HBPM behavior of CKD patients by medical personnel. Not only that the content of the items can also be used for non-CKD patients. During the clinical implementation of HBPM, healthcare professionals can use this instrument to assess patients’ HBPM performance, and according to the evaluation results to give tailored guidance.
Ethics Approval
This study was approved by the ethics and academic committee of Sun Yat-sen University in accordance with the Declaration of Helsinki.
Acknowledgments
We sincerely thank all the participants and health professionals who participated in this research.
Authorship
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
Jing Zheng reports grants from Guangdong scientific foundation committee, during the conduct of the study. The authors declare no other potential conflicts of interest relating to this work.