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atrial fibrillation, patient education, patient knowledge, psychometric testing, self-management



  1. McCabe, Pamela J. PhD, APRN-CNS, FAHA
  2. Sendin, Mary Janette MSN, APRN-CNS
  3. Stuart-Mullen, Lynette MSN, APRN-CNS
  4. Kronebusch, Beckie MS, APRN-CNS
  5. Fowler, Susan PhD, RN, FAHA
  6. Krecke, Catherine BA, CCRP
  7. Kopecky, Stephen MD


Background: Guidelines endorse educating patients to self-manage atrial fibrillation (AF) to mitigate AF-related adverse events contributing to personal and societal burden. Published interventions to improve patients' knowledge about AF and self-management are emerging, but evaluations of interventions are limited by lack of a psychometrically sound instrument to measure learning outcomes.


Objective: We report results of initial psychometric testing of the Knowledge about Atrial Fibrillation and Self-Management (KAFSM) survey.


Methods: Participants (N = 383), from midwest and southeast medical centers, completed the KAFSM survey. Content validity was evaluated by expert review. Construct validity was evaluated using the Pearson correlation procedure for convergent validity with the Knowledge about Atrial Fibrillation test and independent t test for known groups. Factor analysis using principal axis factoring was performed with a tetrachoric matrix. The Kuder-Richardson procedure was used to determine internal consistency reliability.


Results: A content validity index of 0.86 resulted from expert review. A positive (r = 0.60) correlation between the KAFSM survey and Knowledge about Atrial Fibrillation test demonstrated convergent validity. Higher KAFSM scores (difference, 3.28; t = 6.44, P < .001) observed in participants who underwent AF ablation compared with those with an AF diagnosis of less than or equal to 6 months supported known groups validity. Factor analysis revealed a single-factor structure explaining 35% of the variance. The Kuder-Richardson coefficient was 0.86.


Conclusions: The KAFSM survey demonstrates content and construct validity and internal consistency reliability. Implementation of the KAFSM in the clinical setting will permit evaluation of the feasibility of its use and value to assess learning outcomes of AF education.