Caregiver Contribution to Heart Failure Self‐Care (CACHS)

AIM: While caregivers (CGs) make an important contribution to the self‐care of heart failure (HF) patients, there are no reliable and valid tools for measuring such contributions. Current interventions that strive to optimize patient outcomes through self‐care strategies neglect to account for CG contributions, a potential confounder on outcomes. The aim of the study was to develop an instrument that measures CG contributions to HF patients’ self‐care. DESIGN: The study design follows an established process for instrument development. METHODS: A systematic literature review and semi‐structured interviews of CGs were conducted to identify measureable CG activities. Items were derived from thematic analysis of CG narratives. A content validity index was computed for each item (I‐CVI). Items with an I‐CVI of >0·70 were retained. Items with an I‐CVI of 0·50–0·70 were revised for clarification and items with an I‐CVI <0·5 were discarded, except in instances where fulsome theoretical or empirical evidence supported their retention. RESULTS: 14 CGs completed interviews and 10 CGs with 4 expert nurses completed I‐CVI testing. Major interview themes included arranging appointments, medication adherence, monitoring, coordinating care, encouraging independence and taking action. A total of 36 items were constructed and underwent I‐CVI testing. Following I‐CVI testing, 27 items were retained, seven items were retained after revision based on CG feedback and two items were removed. This newly developed 34‐item questionnaire represents current literature, CGs’ experiences, excellent I‐CVI scores and ready for further psychometric testing.