Academic journal article Journal of Nursing Measurement

The Perception of Risk of Heart Disease Scale: Development and Psychometric Analysis

Academic journal article Journal of Nursing Measurement

The Perception of Risk of Heart Disease Scale: Development and Psychometric Analysis

Article excerpt

Perception of risk of getting heart disease is an important predictor of individuals' engagement in a healthy lifestyle. This study describes the development and testing of the Perception of Risk of Heart Disease Scale (PRHDS). The 20-item instrument was tested in successive steps with 295 individuals for internal consistency, test-retest reliability, and construct validity. The three subscales of dread risk, risk, and unknown risk had internal consistency values ranging from .68 to .80. The total scale alpha was .80. Evidence of the instrument's stability over time was supported by subscale test-retest reliabilities ranging from .61 to .76. Construct validity was documented with a positive correlation between PRHDS and the Health Promotion Lifestyle Profile II (r = .20 to .39). Further psychometric testing of the PRHDS in a larger sample with a heterogeneous cultural background is recommended.

Keywords: perception of risk; heart disease; psychometric properties; health behaviors

Despite efforts to decrease its incidence over the last several decades, coronary heart disease (CHD) remains the leading cause of death in developing and developed countries (World Health Organization [WHO], 2006). Each year, CHD accounts for more than 7.2 million deaths among men and women. In addition, at least 20 million people survive heart attacks and strokes every year (WHO, 2006), with a significant proportion of them requiring costly clinical care (American Heart Association [AHA], 2002).

The prevention of CHD traditionally relies on the control of risk factors among individuals as a major element of any strategy. Despite the benefits from risk reduction, lack of adherence is a fundamental problem in risk modification efforts in individuals at risk or with CHD (Burke, Dunbar-Jacob, & Hill, 1997). The challenge for clinicians caring for individuals at risk or with CHD includes the implementation of interventions designed to motivate the initiation of risk modification efforts and to facilitate sustained behavioral change (Playle & Keeley, 1998).

Perception of risk of getting heart disease is an important predictor of an individual's likelihood of engaging in and maintaining a healthy lifestyle (Tod, Read, Lacey, & Abbot, 2001). Assessment of an individual's perception of his/her risk of heart disease requires a well developed and tested instrument. The goal of this study was to test the psychometric properties of a new instrument, the Perception of Risk of Heart Disease Scale (PRHDS), designed to measure an individual's perception of his/her risk of getting heart disease. The purpose of this study was to determine the psychometric characteristics of the PRHDS in a large sample, including its dimensionality, reliability, and validity from the data obtained.

BACKGROUND AND CONCEPTUAL FRAMEWORK

Perception of Risk

In a study conducted by Lichtenstein, Slovic, Fischoff, Layman, and Combs (1988), a sample of the American public was asked to estimate the annual number of deaths from various case histories, some common, some rare. Subjects consistently overestimated the risk of death from very rare causes, for example, botulism, while mentally playing down the importance of common causes such as cardiovascular disease.

Health care workers tend to assume that patients have the same explanatory systems as their own. However, it is known that lay beliefs differ from professional ones, and that people consistently underestimate their personal risk of developing a disease. "Optimistic bias" (Weinstein, 1982), as this is called, has important implications for CHD prevention, because individuals who do not see themselves as vulnerable to CHD are unlikely to change their behavior to prevent it. Davison, Smith, and Frankel (1991) examined "lay theorising" about the possibility and probability of an individual becoming a coronary heart disease "candidate." They suggested that it may act as a potential barrier to the aims and outcomes of health education. …

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