Daniele Cristina Bosco Aprile , Karina Aparecida Lopes da Costa , Renata Eloah de Lucena Ferretti-Rebustini , Vinicius Batista Santos , Mirian Ueda Yamaguchi , Camila Takáo Lopes
{"title":"评估巴西版数字健康素养工具对心力衰竭患者的心理测量特性","authors":"Daniele Cristina Bosco Aprile , Karina Aparecida Lopes da Costa , Renata Eloah de Lucena Ferretti-Rebustini , Vinicius Batista Santos , Mirian Ueda Yamaguchi , Camila Takáo Lopes","doi":"10.1016/j.ijnsa.2025.100391","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.</div></div><div><h3>Objective</h3><div>To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.</div></div><div><h3>Design</h3><div>A psychometric study analyzing internal structure validity and reliability.</div></div><div><h3>Settings</h3><div>The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.</div></div><div><h3>Participants</h3><div>Outpatients with heart failure who used the internet.</div></div><div><h3>Methods</h3><div>The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett’s test should have <em>p</em> < 0.05. Target explained variance was approximately 60 %, with factor loadings >0.3 and communalities >0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05–0.08. Reliability was measured using ordinal alpha and McDonald’s omega (>0.9).</div></div><div><h3>Results</h3><div>A unidimensional model emerged. Five items were removed due to factor loadings <0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy >0.75, explained variance = 59 %, factor loadings 0.53–0.86, and communalities 0.28–0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.</div></div><div><h3>Conclusions</h3><div>The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100391"},"PeriodicalIF":3.1000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument for individuals with heart failure\",\"authors\":\"Daniele Cristina Bosco Aprile , Karina Aparecida Lopes da Costa , Renata Eloah de Lucena Ferretti-Rebustini , Vinicius Batista Santos , Mirian Ueda Yamaguchi , Camila Takáo Lopes\",\"doi\":\"10.1016/j.ijnsa.2025.100391\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.</div></div><div><h3>Objective</h3><div>To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.</div></div><div><h3>Design</h3><div>A psychometric study analyzing internal structure validity and reliability.</div></div><div><h3>Settings</h3><div>The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.</div></div><div><h3>Participants</h3><div>Outpatients with heart failure who used the internet.</div></div><div><h3>Methods</h3><div>The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett’s test should have <em>p</em> < 0.05. Target explained variance was approximately 60 %, with factor loadings >0.3 and communalities >0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05–0.08. Reliability was measured using ordinal alpha and McDonald’s omega (>0.9).</div></div><div><h3>Results</h3><div>A unidimensional model emerged. Five items were removed due to factor loadings <0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy >0.75, explained variance = 59 %, factor loadings 0.53–0.86, and communalities 0.28–0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.</div></div><div><h3>Conclusions</h3><div>The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.</div></div>\",\"PeriodicalId\":34476,\"journal\":{\"name\":\"International Journal of Nursing Studies Advances\",\"volume\":\"9 \",\"pages\":\"Article 100391\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Nursing Studies Advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666142X25000967\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nursing Studies Advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666142X25000967","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Evaluation of the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument for individuals with heart failure
Background
Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.
Objective
To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.
Design
A psychometric study analyzing internal structure validity and reliability.
Settings
The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.
Participants
Outpatients with heart failure who used the internet.
Methods
The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett’s test should have p < 0.05. Target explained variance was approximately 60 %, with factor loadings >0.3 and communalities >0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05–0.08. Reliability was measured using ordinal alpha and McDonald’s omega (>0.9).
Results
A unidimensional model emerged. Five items were removed due to factor loadings <0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy >0.75, explained variance = 59 %, factor loadings 0.53–0.86, and communalities 0.28–0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.
Conclusions
The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.