cross-cultural translation, heart failure, perceived control, psychometrics



  1. Lee, Kyoung Suk PhD, RN, MPH
  2. Park, Da-In PhD, RN


Background: Heart failure (HF) is a chronic heart condition that requires patients to adapt to the disease and maintain a high degree of self-management. Patients with HF commonly feel loss of control, which has a negative effect on their compliance to self-care, health-related quality of life, and health outcomes. To promote self-care behavior and to develop healthy coping mechanisms, it is important to understand individual HF patients' perceived control, a self-generated belief that one has the ability to bring forth desired outcomes. Currently, there is no valid and reliable Korean instrument available in measuring perceived control among patients with HF.


Objective: The objective of this study was to cross-culturally translate, adapt, and evaluate psychometric properties of the Korean version of Control Attitudes Scale-Revised (KCAS-R) in Korean patients with HF.


Methods: The KCAS-R was developed using a translation/back-translation process and an examination of semantic and conceptual equivalence. Reliability was assessed using Cronbach [alpha] to determine internal consistency, and item-total and interitem correlations were assessed to test item homogeneity. The construct validity was examined using exploratory factor analysis, confirmatory factor analysis, and testing hypotheses for known associations with self-efficacy, self-care confidence, and self-care.


Results: A convenience sample of 138 patients with HF were included for the psychometric testing of an 8-item KCAS-R. The Cronbach [alpha] for internal consistency was 0.835, and the item-total correlation was acceptable. The construct validity revealed a 2-factor structure accounting for 63.23% of the total variance. The KCAS-R was associated with higher levels of self-efficacy, self-care confidence, and self-care. In addition, patients with higher perceived control had less depression and anxiety compared with those with lower levels of perceived control.


Conclusion: This study provided support for the satisfactory reliability and validity of the 8-item KCAS-R in measuring perceived control in Korean patients with HF.