Document Type : Original Article(s)
Authors
1 Assistant Professor, Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
2 Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3 Associate Professor, Nursing Research Center, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
Abstract
BACKGROUND: Hypertension (HTN) is a public concern and treatment adherence has a key role in its management. This study was conducted to develop and test the reliability and validity of the Hypertensive Treatment Adherence scale (HTA-scale).METHODS: This was a cross-sectional and methodological study. After item generation using a qualitative study and literature review, the scale was developed. The psychometric properties of the scale were evaluated using face, content, construct, and criterion validity and reliability.RESULTS: Data analysis showed that the HTA-scale had acceptable face and content validity. The scale had excellent stability [Intraclass correlation coefficient (ICC) = 0.74] and good acceptability and internal consistency (Cronbach's a = 0.76). Exploratory factor analysis (EFA) showed that the HTA-scale consisted of 6 meaningful subscales including medication adherence and monitoring, adherence to safe diets, avoiding unsafe diets, self-medication, activity, and smoking. Participants in the controlled blood pressure group had significantly higher HTA-scale scores than the uncontrolled blood pressure group. At the cut-off point of 86, the scale had significant sensitivity and specificity.CONCLUSION: All of the psychometric properties of the HTA-scale achieved the standard level and were sufficient to recommend this scale for patients with HTN.
Keywords
- Haghdoost AA, Sadeghirad B, Rezazadehkermani M. Epidemiology and heterogeneity of hypertension in Iran: A systematic review. Arch Iran Med 2008; 11(4): 444-52.
- Sabate E. Adherence to Long-term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization; 2003.
- Voils CI, Maciejewski ML, Hoyle RH, Reeve BB, Gallagher P, Bryson CL, et al. Initial validation of a self-report measure of the extent of and reasons for medication nonadherence. Med Care 2012; 50(12): 1013-9.
- Ma C, Chen S, You L, Luo Z, Xing C. Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. J Adv Nurs 2012; 68(6): 1402-13.
- Perez-Escamilla B, Franco-Trigo L, Moullin JC, Martinez-Martinez F, Garcia-Corp. Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments. Patient Prefer Adherence 2015; 9: 569-78.
- Garfield S, Clifford S, Eliasson L, Barber N, Willson A. Suitability of measures of self-reported medication adherence for routine clinical use: A systematic review. BMC Med Res Methodol 2011; 11: 149.
- Nayeri ND, Dehghan M, Iranmanesh S. Being as an iceberg: Hypertensive treatment adherence experiences in southeast of Iran. Glob Health Action 2015; 8: 28814.
- Lawshe CH. A quantitative approach to content validity. Pers Psychol 1975; 28(4): 563-75.
- Chehrei A, Haghdoost AA, Fereshtehnejad SM, Bayat A. Statistical methods in medical science researches using SPSS software. Tehran, Iran: Elm Arya Publications; 2016. [In Persian].
- Dehghan M, Dehghan Nayeri N, Iranmanesh S. Validating the persian version of the hill-bone's scale of "compliance to high blood pressure therapy". Br J Med Med Res 2020.
- James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311(5): 507-20.
- Yong AG, Pearce S. A Beginner's Guide to Factor Analysis: Focusing on Exploratory Factor Analysis. Tutor Quant Methods Psychol 2013; 9(2): 79-94.
- Lorenzo-Seva U. How to report the percentage of explained common variance in exploratory factor analysis [Online]. [cited 2013]; Available from: URL: http://psico.fcep.urv.cat/utilitats/factor/ Width1
- Pituch KA, Stevens JP. Applied multivariate
- statistics for the social sciencES: Analyses with SAS and IBM's SPSS. London, UK: Routledge; 2009.
- Henson RK, Roberts JK. Use of Exploratory Factor Analysis in Published Research: Common Errors and Some Comment on Improved Practice. Educ Psychol Meas 2006; 66(3): 393-416.
- Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. COSMIN checklist manual. Amsterdam, Netherlands: VU University Medical Center; 2012.
- Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Prog Cardiovasc Nurs 2000; 15(3): 90-6.
- Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. J Clin Epidemiol 2010; 63(3): 299-306.
- Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008; 10(5): 348-54.
- Saleem F, Azmi Hassali M, Akmal S, Morisky DE, Atif M, Al-Qazaz HK, et al. Translation and validation study of Morisky Medication Adherence Scale (MMAS): The Urdu version for facilitating person-centered healthcare in Pakistan. Int J Pers Cent Med 2012; 2(3): 384-90.
- Dehghan M, Dehghan Nayeri N, Karimzadeh P, Iranmanesh S. Psychometric properties of the Persian version of the morisky medication adherence scale-8. Br J Med Med Res 2015; 9(9): 1-10.
- Dehghan M, Dehghan-Nayeri N, Iranmanesh S. Translation and validation of the Persian version of the treatment adherence questionnaire for patients with hypertension. ARYA Atheroscler 2016; 12(2): 76-86.
- Al-Qazaz HK, Hassali MA, Shafie AA, Sulaiman SA, Sundram S, Morisky DE. The eight-item Morisky Medication Adherence Scale MMAS: Translation and validation of the Malaysian version. Diabetes Res Clin Pract 2010; 90(2): 216-21.
- de Oliveira-Filho AD, Morisky DE, Neves SJ, Costa FA, de Lyra DPJ. The 8-item Morisky Medication Adherence Scale: Validation of a Brazilian-Portuguese version in hypertensive adults. Res Social Adm Pharm 2014; 10(3): 554-61.
- Lee WY, Ahn J, Kim JH, Hong YP, Hong SK, Kim YT, et al. Reliability and validity of a self-reported measure of medication adherence in patients with type 2 diabetes mellitus in Korea. J Int Med Res 2013; 41(4): 1098-110.
- Sakthong P, Chabunthom R, Charoenvisuthiwongs R. Psychometric properties of the Thai version of the 8-item Morisky Medication Adherence Scale in patients with type 2 diabetes. Ann Pharmacother 2009; 43(5): 950-7.
- Kim JH, Lee WY, Hong YP, Ryu WS, Lee KJ, Lee WS, et al. Psychometric properties of a short self-reported measure of medication adherence among patients with hypertension treated in a busy clinical setting in Korea. J Epidemiol 2014; 24(2): 132-40.
- Lambert EV, Steyn K, Stender S, Everage N, Fourie JM, Hill M. Cross-cultural validation of the hill-bone compliance to high blood pressure therapy scale in a South African, primary healthcare setting. Ethn Dis 2006; 16(1): 286-91.
- Svarstad BL, Chewning BA, Sleath BL, Claesson C. The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Educ Couns 1999; 37(2): 113-24.
- Sriwarakorn S, Krittiyanunt S, Sakulbumrungsil R. Sensitivity and specificity of thai-version brief medication questionnaire. J Health Res 2018; 24(3): 129-34.
- Ben AJ, Neumann CR, Mengue SS. The Brief Medication Questionnaire and Morisky-Green test to evaluate medication adherence. Rev Saude Publica 2012; 46(2): 279-89.
- Gliem JA, Gliem RR. Calculating, interpreting, and reporting Cronbach's alpha reliability coefficient for likert-type scales [Online]. [cited 2003]; Available from: URL:
- https://scholarworks.iupui.edu/handle/1805/281
- Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ 2011; 2: 53-5.
- Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
- Risser J, Jacobson TA, Kripalani S. Development and psychometric evaluation of the Self-efficacy for Appropriate Medication Use Scale (SEAMS) in low-literacy patients with chronic disease. J Nurs Meas 2007; 15(3): 203-19.
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42(6): 1206-52.
- Jolles EP, Padwal RS, Clark AM, Braam B. A Qualitative Study of Patient Perspectives about Hypertension. Hypertension 2013; 2013: 671691.
- Noohi F, Sarrafzadegan N, Khosravi A, Andalib E. The first Iranian recommendations on prevention, evaluation and management of high blood pressure. ARYA Atheroscler 2012; 8(3): 97-118.
- Dasgupta K, Quinn RR, Zarnke KB, Rabi DM, Ravani P, Daskalopoulou SS, et al. The 2014 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 2014; 30(5): 485-501.
- Hackam DG, Quinn RR, Ravani P, Rabi DM, Dasgupta K, Daskalopoulou SS, et al. The 2013 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol 2013; 29(5): 528-42.
- Drewnowski A, Bellisle F. Liquid calories, sugar, and body weight. Am J Clin Nutr 2007; 85(3): 651-61.
- Ebbeling CB, Feldman HA, Chomitz VR, Antonelli TA, Gortmaker SL, Osganian SK, et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med 2012; 367(15): 1407-16.
- Ebbeling CB, Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS. Effects of decreasing sugar-sweetened beverage consumption on body weight in adolescents: A randomized, controlled pilot study. Pediatrics 2006; 117(3): 673-80.
- Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res 2001; 9(3): 171-8.
- Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: A systematic review. Am J Clin Nutr 2006; 84(2): 274-88.
- Hamer M. Coffee and health: Explaining conflicting results in hypertension. J Hum Hypertens 2006; 20(12): 909-12.
- Jee SH, He J, Whelton PK, Suh I, Klag MJ. The effect of chronic coffee drinking on blood pressure: A meta-analysis of controlled clinical trials. Hypertension 1999; 33(2): 647-52.
- Klag MJ, Wang NY, Meoni LA, Brancati FL, Cooper LA, Liang KY, et al. Coffee intake and risk of hypertension: The Johns Hopkins precursors study. Arch Intern Med 2002; 162(6): 657-62.
- Zhang Z, Hu G, Caballero B, Appel L, Chen L. Habitual coffee consumption and risk of hypertension: A systematic review and meta-analysis of prospective observational studies. Am J Clin Nutr 2011; 93(6): 1212-9.
- Uiterwaal CS, Verschuren WM, Bueno-de-Mesquita HB, Ocke M, Geleijnse JM, Boshuizen HC, et al. Coffee intake and incidence of hypertension. Am J Clin Nutr 2007; 85(3): 718-23.
- Bharucha NE, Kuruvilla T. Hypertension in the Parsi community of Bombay: A study on prevalence, awareness and compliance to treatment. BMC Public Health 2003; 3: 1.
- DeVellis RF. Scale development: Theory and applications. Thousand Oaks, CA: SAGE; 2003.
- Choudhury A, Lip GY. Exercise and hypertension. J Hum Hypertens 2005; 19(8): 585-7.
- Wallace JP. Exercise in hypertension. A clinical review. Sports Med 2003; 33(8): 585-98.
- Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33(13): 1635-701.
- Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: An update. J Am Coll Cardiol 2004; 43(10): 1731-7.
- Niskanen L, Laaksonen DE, Nyyssonen K, Punnonen K, Valkonen VP, Fuentes R, et al. Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension 2004; 44(6): 859-65.
- Narkiewicz K, Kjeldsen SE, Hedner T. Is smoking a causative factor of hypertension? Blood Press 2005; 14(2): 69-71.
- Talukder MA, Johnson WM, Varadharaj S, Lian J, Kearns PN, El-Mahdy MA, et al. Chronic cigarette smoking causes hypertension, increased oxidative stress, impaired NO bioavailability, endothelial dysfunction, and cardiac remodeling in mice. Am J Physiol Heart Circ Physiol 2011; 300(1): H388-H396.
- Al-Safi SA, Ayoub NM, Mosab AA, Al-Doghim I, Aboul-Enein FH. Does shisha smoking affect blood pressure and heart rate? J Public Health 2009; 17(2): 121-6.
- Islami F, Pourshams A, Vedanthan R, Poustchi H, Kamangar F, Golozar A, et al. Smoking water-pipe, chewing nass and prevalence of heart disease: A cross-sectional analysis of baseline data from the Golestan Cohort Study, Iran. Heart 2013; 99(4): 272-8.
- Shaikh RB, Vijayaraghavan N, Sulaiman AS, Kazi S, Shafi MS. The acute effects of Waterpipe smoking on the cardiovascular and respiratory systems. J Prev Med Hyg 2008; 49(3): 101-7.
- Rawaf D, Elgindi A, Ismail S. Asking the shisha question. Br J Gen Pract 2013; 63(608): 127.
- Taremian F, Bolhari J, Peyravi H, Asgari A. Drug use prevalence among students of universities of medical sciences in Tehran. Journal of Research on Addiction 2014; 7(28): 9-21.
- Yousefi F, Darabi H, Nabipour I, Assadi M, Vahdat K, Kardeh E, et al. Prevalence of Tobacco Smoking in Bushehr Province: Comparison of Two Phases of the Persian Gulf Healthy Heart Study. Iran South Med J 2014; 17(3): 487-95. [In Persian].
- Sparrenberger F, Cichelero FT, Ascoli AM, Fonseca FP, Weiss G, Berwanger O, et al. Does psychosocial stress cause hypertension? A systematic review of observational studies. J Hum Hypertens 2009; 23(1): 12-9.
- Nagele E, Jeitler K, Horvath K, Semlitsch T, Posch N, Herrmann KH, et al. Clinical effectiveness of stress-reduction techniques in patients with hypertension: Systematic review and meta-analysis. J Hypertens 2014; 32(10): 1936-44.
- Mancia G, De BG, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007; 28(12): 1462-536.