ArticleBMC nursing2024
Translation, adaptation, and validation of a Chinese version of the Hypertension Self-Care Activity Level effects (H-SCALE) for patients with hypertension.
Article in BMC nursing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Trends and Associations of Physical Fitness and Dietary Behaviors Among Children Aged 10-12 Years in Ningxia Between 2019 and 2024.Nutrients · 2026Article
- Translation, adaptation, and validation of a Moroccan version of the H-SCALE (Hypertension Self-Care Activity Level effects) for hypertensive patients.BMC primary care · 2026Article
- Urban-Rural Disparities in the Association Between Dietary Patterns and Physical Fitness Among Chinese Children, Adolescents, and Young Adults.Nutrients · 2025Article
- Psychometric Validation of the Cantonese Version of the Patient-Centered Primary Care Instrument for Multimorbid Patients in Hong Kong.Journal of primary care & community healthArticle
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Abstract
backgroundLifestyle modification is an essential component of prevention and management of hypertension. Existing instruments in Taiwan focus on assessing lifestyle modifications by evaluating medication adherence or confidence in controlling blood pressure. However, other self-care activities, such as diet, physical activity, weight management, smoking, and alcohol consumption are also important. The Hypertension Self-Care Activity Level Effects (H-SCALE) is one such instrument, but there are no similar tools available in Taiwan.
aimThis study aimed to translate the H-SCALE into Chinese and test its validity, and reliability in a sample of adults with hypertension.
methodsThe English version of the 31-item H-SCALE was translated into Chinese using the forward-backward method. The content validity index (CVI) of the translated scale was determined by five experts in hypertension. Item analysis was conducted with a pilot sample of 20 patients with hypertension. Cronbach's α was used to establish the internal consistency reliability for the Chinese version of the H-SCALE (H-SCALE-C). Exploratory factor analysis (EFA) explored the structure of the H-SCALE-C. Additionally, construct validity was examined with confirmatory factor analysis (CFA). Patients with hypertension were recruited by convenience sampling from a cardiovascular outpatient clinic of a medical center in northern Taiwan. A total of 318 patients met the inclusion criteria and participated in factor analysis in the study.
resultsPilot testing of the scale items indicated most patients could not accurately estimate the number of days of alcohol consumption for the previous week. Therefore, three alcohol-related items were removed. The adaptation resulted in a 28-item H-SCALE-C. EFA revealed a 4-factor solution with 13 items that explained 63.93% of the total variance. CFA indicated a good fit for a 4-factor model and construct validity was acceptable. Internal consistency reliability was acceptable (Cronbach's alpha for the four subscales ranged from 0.65 to 0.94). Convergent validity was acceptable, and discriminant validity was significant.
conclusionsThe H-SCALE-C is a valid, reliable tool for promptly assessing life-style activities for patients with hypertension in Taiwan. The instrument is suitable for assisting healthcare providers in evaluating self-care activities, which could be used to facilitate lifestyle modifications for patients with hypertension.
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