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Author Notes:

Corresponding author: Carolyn Miller Reilly, RN, PhD, Nell Hodgson Woodruff School of Nursing, Emory University, 1599 Clifton Rd. NE, Mailstop 1599-001-1AJ, Atlanta, GA 30322 (cmill02@emory.edu)


Research Funding:

National Institute of Nursing Research : NINR


  • education
  • heart failure
  • knowledge

Development, Psychometric Testing, and Revision of the Atlanta Heart Failure Knowledge Test


Journal Title:

Journal of Cardiovascular Nursing


Volume 24, Number 6


, Pages 500-509

Type of Work:

Article | Post-print: After Peer Review


Background and Research Objective Several heart failure (HF) knowledge tools have been developed and tested over the past decade; however, they vary in content, format, psychometric properties, and availability. This article details the development, psychometric testing, and revision of the Atlanta Heart Failure Knowledge Test (A-HFKT) as a standardized instrument for both the research and clinical settings. Participants and Methods Development and psychometric testing of the A-HFKT were undertaken with 116 New York Heart Association (NYHA) class II and III community-dwelling HF patients and their family members (FMs) participating in a family intervention study. Internal consistency, reliability, and content validity were examined. Construct validity was assessed by correlating education level, literacy, dietary sodium ingestion, medication adherence, and healthcare utilization with knowledge. Results Content validity ratings on relevance and clarity ranged from 0.55 to 1.0, with 81% of the items rated from 0.88 to 1.0. Cronbach α values were .84 for patients, .75 for FMs, and .73 for combined results. Construct validity testing revealed a small but significant correlation between higher patient and FM knowledge on sodium restriction questions and lower ingested sodium, r = −0.17, P = .05 and r = −0.19, P = .04, respectively, and between patient knowledge and number of days that medications were taken correctly (diuretics: r = 0.173, P < .05, and angiotensin-converting enzyme: r = 0.223, P = .01). Finally, patients seeking emergency care or requiring hospitalization in the 4 months before study entry were found to have significantly lower FM knowledge using both t test and logistic regression modeling. Conclusions The A-HFKT was revised using the content and construct validity data and is available for use with HF patients and FMs. The construct validity testing indicates that patient knowledge has a significant relationship to aspects of self-care. Furthermore, family knowledge may influence patient adherence with sodium restriction and healthcare utilization behavior.

Copyright information:

© 2009, © 2009 Lippincott Williams

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