Reliability and practical aspects of the disease impact
					measure on hypertensive patients

Pavan, Renata Bigatti Bellizzotti; Padilha, Kátia Melissa; Rodrigues, Simey de Lima Lopes; Rodrigues, Roberta Cunha Matheus; Gallani, Maria Cecília Jayme Bueno

doi:10.1590/0104-1169.2900.2362

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 21 (06) • Nov-Dec 2013 • https://doi.org/10.1590/0104-1169.2900.2362 copy

Reliability and practical aspects of the disease impact measure on hypertensive patients ¹ 1 Paper extracted from master’s thesis “Validation of an instrument to measure the impact of the disease in daily valvopata - IDCV in patients with hypertension” presented to Faculdade de Enfermagem, Universidade Estadual de Campinas, Campinas, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to evaluate the feasibility, acceptability, the ceiling and floor effects and the reliability of the Instrument to Measure the Impact of Coronary Disease on Patient's Daily Life (IDCV) when applied to hypertensive patients.

METHOD:

one hundred and thirty seven hypertensive outpatients were interviewed, using questionnaires to collect sociodemographic and clinical data, followed by the IDCV. Reliability was assessed according to the temporal stability and internal consistency criteria.

RESULTS:

the IDCV was applied in 8.0 (±3.0) minutes with 100% of the items answered. A ceiling effect of 31.4% was observed in the domain Adjustment to the Disease. The stability measure was observed for the total score and for all domains. There was evidence of internal consistency of the total IDCV (α=0.83) and the domains Physical Impact of the Disease - Symptoms (α=0.78) and Social and Emotional Impact of the Disease (α=0.74).

CONCLUSION:

the IDCV is an instrument of easy use and its reliability among hypertensive patients is evidenced. The domain Adjustment to the Disease, however, should be reviewed in further studies.

Nursing; Hypertension; Sickness Impact Profile

Socio demographic Variables		N	%	Average (sd*)	Median	Variation
Age (in years)				59.8 (10.6)	60	21-87
Gender (female)		74	54
Race (Caucasian)		97	70.8
Education				6.1 (4.3)	5	0–21
Marital Status (with partner)		102	74.5
Employment Status
	Inactive	93	67.8
	Active		31	22.6
	Housework		13	9.6
Monthly Individual Income (MS)				1.5 (1.4)	1	0–7
Monthly Family Income (MS)				2.7 (2.2)	2	0–20
Clinical Variables
	Time of SAH (in years)			13.5 (9.5)	11	1-50
Target Organs Damage
	Coronary artery disease		24	17.5
	Kidney failure		17	12.4
	Heart failure		10	7.2
	Cerebrovascular accident		3	2.1
	Hypertensive Retinopathy		1	0.7
Associated Clinical Conditions
	Dyslipidemia		86	62.8
	Smoking		66	48.2
	Diabetes Mellitus		51	37.2
	Peripheral vascular disease		12	8.7
	Body mass index			29.7 (5.2)	28.0	17.2-48.1
Medications used per class
	ACEI/ARB		109	79.5
	Diuretic		80	58.4
	Alpha/Beta blocker		61	44.5
	Calcium channel blocker		43	31.4
	Vasodilators		3	2.2
Hypertension severity
	Excellent		15	11
	Normal		28	20.4
	Borderline		29	21.2
	SAH – Stage 1		44	32.1
	SAH – Stages 2 and 3		18	13.1

Domain	Average (sd)	Median	Variation	Floor Effect*	Ceiling Effect	Floor Effect %	Ceiling Effect %
Physical Impact of the Disease – Symptoms	38.5 (21.1)	49.0	12-75	Scores ≥67.8	Scores ≤10.2	12.4	-
Impact of the Disease on Daily Activities	58.1 (23.4)	64.0	18-110	Scores ≥113.0	Scores ≤17.0	-	-
Social and Emotional Impact of the Disease	45.1 (24.0)	54.0	15-100	Scores ≥90.4	Scores ≤13.6	2.9	-
Adjustment to the Disease	13.3 (8.3)	9.0	2-40	Scores ≥45.2	Scores ≤6.8	-	31.3
Total – IDCV	155.0 (60.7)	172.0	54-298	Scores ≥316.4	Scores ≤47.6	-	-

Variable	ICC*	ICC 95%
Physical impact of the disease	0.998	[0.996-0.998]
Impact of the disease on daily activities	0.996	[0.994-0.997]
Social and emotional impact of the disease	0.996	[0.993-0.997]
Adjustment to the disease	0.994	[0.991-0.996]
Total IDCV	0.998	[0.998-0.999]

Variable		Total item score/domains correlation	Item/total score correlation	Cronbach Alpha	Cronbach Alpha of the domain if item deleted	Cronbach Alpha of the total score if item deleted
Total IDCV				0.83
Physical Impact of the Disease – Symptoms				0.78
	11 Due to the heart problem, I often have shortness of breath	0.62	0.62		0.70	0.81
	12 Due to the heart problem, I feel very tired	0.64	0.57		0.68	0.81
	13 Due to the heart problem. I often feel dizzy	0.60	0.56		0.73	0.81
Impact of the Disease on Daily Activities				0.57
	5 I cope well with my heart problem	0.20	0.86		0.58	0.83
	7 After I got the heart problem, I started to fear thatsomething could happen to me	0.44	0.44		0.44	0.82
	9 Due to the heart problem, I have difficulty sleeping	0.25	0.46		0.56	0.82
	10 Due to the heart problem, I have a lot of difficulty performing daily tasks	0.39	0.63		0.48	0.81
	14 Having a heart problem concerns me	0.39	0.32		0.48	0.83
Social and Emotional Impact of the Disease				0.74
	2The heart problem made me become dependent on other people	0.43	0.41		0.74	0.82
	3My heart problem affected my ability to work like before	0.63	0.61		0.63	0.81
	4I now feel more irritated and stressed due to the heart problem	0.60	0.62		0.65	0.81
	6I feel very anxious after I got a heart problem	0.50	0.59		0.71	0.81
Adjustment to the Disease				-0.01
	1After I got a heart problem, I started to pay more attention to my health	-	0.11		-	0.83
	8My sexual life remained the same as before I got the heart problem		0.15			0.84

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[1] Corresponding Author: Renata Bigatti Bellizzotti Pavan Universidade Estadual de Campinas. Faculdade de Enfermagem Caixa Postal 6111 Rua Tessália Vieira de Camargo, 126 Cidade Universitária Zeferino Vaz Distrito de Barão Geraldo CEP: 13083-887, Campinas, SP, Brasil E-mail: renata.bigatti@gmail.com