Development of the participation scale for patients with congestive heart failure

OBJECTIVE: We report on the development of a participation measure for patients with congestive heart failure (CHF)-the Participation Scale for Patients with CHF (PS-CHF)-and the determination of its unidimensionality, reliability, and validity. DESIGN: This study included two rounds of data collections: 62 patients enrolled in the first round for the purpose of item reduction, and 130 CHF patients and 96 healthy controls participated in the second round for questionnaire validation. RESULTS: The PS-CHF was organized into five items designed to ask about limitations to participation. The PS-CHF score ranges from 5 points (lowest level of participation) to 20 points (highest level of participation). On Rasch analysis, the item calibrations ranged from +0.51 logit for the most difficult item to -0.56 logit for the least difficult item. The range of mean square statistics values was 1.20-0.81 for infit and 1.34-0.72 for outfit. The intraclass correlation coefficient between scores from two successive administrations of the PS-CHF, separated by 2 wks, was 0.94. The total PS-CHF score in CHF patients was significantly lower than in healthy controls. CONCLUSIONS: The PS-CHF was developed to determine a disease-specific participation measure for patients with CHF. The PS-CHF may serve as a clinically meaningful outcome measure for CHF patients.