Development and psychometric evaluation of the Beliefs about Home Hemodialysis Scale for patients on in-center hemodialysis

Abstract

Objective: There is no valid and reliable instrument that evaluates health beliefs related to home hemodialysis of patients. This study aimed to develop the Beliefs about Home Hemodialysis Scale (BHHS) and evaluate its psychometric properties in a sample of patients on in-center hemodialysis. Methods: This methodological study was carried out with 102 patients on in-center hemodialysis. Data were collected by a questionnaire, the Perceived Social Support from Family Scale, and the BHHS. The analysis of data was carried out using descriptive statistics, Mann-Whitney U test, Pearson's correlation coefficients, and psychometric tests. Results: The overall content validity index of the scale was satisfactory with 1.00 for relevance and 0.97 for clarity. The exploratory factor analysis yielded a four-factor structure (perceived benefits, perceived barriers toward the environment, perceived barriers toward the procedure, and perceived barriers toward socioeconomic support) accounting for 64.5% of the total variance. The BHHS had acceptable internal consistency (Cronbach's alpha coefficient = 0.69-0.91), test-retest reliability (intraclass correlation coefficient = 0.88-0.95), concurrent validity with the Perceived Social Support from Family Scale scores and known group validity with wanting to start home hemodialysis. Conclusions: The initial psychometric testing of the BHHS is favorable. The BHHS is a valid and reliable instrument for assessing the perceived benefits and barriers to home hemodialysis in patients on incenter hemodialysis. The results of this study will gain a better understanding of the beliefs about home hemodialysis of patients and will lead to more effective intervention strategies.