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Psychometric Testing of the Heart Failure Somatic Awareness Scale

Jurgens, Corrine Y. PhD, RN, CS, ANP; Fain, James A. PhD, RN, BC-ADM, FAAN; Riegel, Barbara DNSc, RN, CS, FAAN

Journal of Cardiovascular Nursing: March-April 2006 - Volume 21 - Issue 2 - p 95-102

Background: Self-management of heart failure relies on patients to assess their symptoms, but their ability to do so is often difficult to determine. The 12-item self-report Heart Failure Somatic Awareness Scale (HFSAS) was developed to measure awareness of and distress secondary to heart failure symptoms. The purpose of this study was to test the psychometric properties of the HFSAS.

Methods and Results: Feasibility and discriminant validity of the HFSAS were tested in 49 patients admitted for an exacerbation of heart failure. The HFSAS was acceptable to patients and discriminated between heart failure symptoms and anxiety (r = 0.25, P = .08). When reliability and validity were tested in 201 patients with acute heart failure, theta reliability was adequate (0.71). The HFSAS was low to moderately correlated with general bodily awareness (r = 0.48). No difference was found based on gender, but younger patients had higher mean and median HFSAS scores (more distress). The HFSAS was a significant predictor of symptom duration prior to seeking care for heart failure; higher scores were associated with longer delay before seeking care.

Conclusion: The HFSAS is reliable with content, discriminant, and construct validity. Evaluation of its usefulness in teaching patients to monitor daily symptoms is needed.

Corrine Y. Jurgens, PhD, RN, CS, ANP Clinical Associate Professor, School of Nursing, Stony Brook University, Stony Brook, NY.

James A. Fain, PhD, RN, BC-ADM, FAAN Dean and Professor, College of Nursing, University of Massachusetts Dartmouth, Dartmouth, Mass.

Barbara Riegel, DNSc, RN, CS, FAAN Associate Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pa.

Funding: Sigma Theta Tau, Kappa Gamma Chapter: Pilot phase American Heart Association, Heritage Affiliate.

Corresponding author Corrine Y. Jurgens, PhD, RN, CS, ANP, Stony Brook University, School of Nursing, HSC L2-202, Stony Brook, NY 11794-8240 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.