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cardiovascular disease, disease management, Iran, psychometrics, self-efficacy



  1. Rajati, Fatemeh PhD
  2. Sharifiebad, Tahereh MS
  3. Tavakol, Kamran MD, PhD
  4. Almasi, Afshin PhD
  5. Karami, Sahar BSc
  6. Jamshidi, Hanieh Sadat BSc
  7. Pashaei, Tahereh PhD
  8. Greco, Andrea PhD
  9. Steca, Patrizia PhD


Background: Self-efficacy plays a major role in the management of cardiovascular disease (CVD). The original Cardiovascular Management Self-efficacy Scale (CMSS) was developed in 2016 in Italian patients with CVD; however, no such scale exists for Iranian patients with CVD.


Objective: We translated the CMSS into Persian and assessed its validity, reliability, and psychometric properties in Iranian patients with CVD.


Methods: This study was conducted for 4 months in 2017 on a group of consenting patients with CVD (N = 363) recruited from a cardiovascular hospital in Kermanshah, Iran. The reliability of the Persian CMSS was evaluated. We assessed validity, including face, content, construct, convergent, divergent, and discriminate validity, using the General Self-efficacy Scale, the Hospital Anxiety and Depression Scale, and the 36-item Short Form Health Survey Scale. Known-group validity was assessed among patients with high blood pressure.


Results: The Persian CMSS had acceptable face and content validity. No floor or ceiling effects were found for the total scale. Cronbach [alpha] was calculated as .68. Test-retest reliability was confirmed by intraclass correlation coefficient (ICC1,3 = 0.98, P < .001). Using exploratory factor analysis, 3 subscales were identified, similar to the original version. Significant correlations were found between the Persian CMSS and both the General Self-efficacy Scale (r = 0.94, P < .001) and Hospital Anxiety and Depression Scale (r = -0.35, P < .05). Self-efficacy measured using the Persian CMSS was statistically different between 2 levels of patients' health status (P < .05). Patients with hypertension had a lower level of self-efficacy than those in the healthy group (P < .05).


Conclusions: The Persian version of CMSS provides a practical, reliable, and valid scale for evaluating self-efficacy in the clinical management of Persian Iranian patients with CVD.