The study aimed to develop and test the Coronary Artery Disease Empowerment Scale in Korea and assess its initial aspects of validity and reliability. The participants included 301 patients diagnosed with coronary artery disease, receiving regular outpatient and inpatient care. Data were collected from August to December 2019. The exploratory factor analysis resulted in extracting 25 items and three factors—self-determination, emotional self-regulation, and personal competence of disease management perception—with a cumulative explanatory power of 55.40%. A significant correlation was found between the Korean versions of the Cardiac Self-efficacy Scale (r = .31, p < .001) and the Health Empowerment Scale (r = .45, p < .001). The internal consistency reliability of all items was .93. The developed instrument can be used to evaluate empowerment in patients with coronary artery disease and identify an improved instrument to measure empowerment. However, further testing of the newly developed Coronary Artery Disease Empowerment Scale is required.
AghiliR.KhamsehM. E.MalekM.BanlkarimiA. S.BaradaranH. R.ValojerdiA. E. (2013). Development and validation of diabetes empowerment questionnaire in Iranian people with type 2 diabetes. International Nursing Review, 60(2), 267–273. https://doi.org/10.1111/inr.12007
2.
AlvesM. P.CunhaA. I.LopesT.AbreuP.VazC. (2018). Measuring empowerment in patients with chronic disease: Psychometric qualities of the Portuguese Rheumatic Disease Empowerment Scale. Portuguese Journal of Public Health, 36(2), 66–71. https://doi.org/10.1159/000492084
3.
AndersonR. M.FitzgeraldJ. T.GruppenL. D.FunnellM. M.OhM. S. (2003). The Diabetes Empowerment Scale-Short Form (DES-SF). Diabetes Care, 26(5), 1641–1642. https://doi.org/10.2337/diacare.26.5.1641-a
4.
AndersonR. M.FunnellM. M.FitzgeraldJ. T.MarreroD. G. (2000). The Diabetes Empowerment Scale: A measure of psychological self-efficacy. Diabetes Care, 23(6), 739–743. https://doi.org/10.2337/diacare.23.6.739
5.
ArnettD. K.BlumenthalR. S.AlbertM. A.BurokerA. B.GoldbergerZ. D.HahnE. J.HimmelfarbC. D.KheraA.Lloyd-JonesD.McEvoyJ. W.MichosE. D.MiedemaM. D.MuñozD.SmithS. C.JrViraniS. S.WilliamsK. A.SrYeboahJ.ZiaeianB. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11), e596–e646. https://doi.org/10.1161/CIR.0000000000000678
6.
BaekK. H.SonY. J. (2015). Literature review of nursing intervention studies for patients undergoing percutaneous coronary intervention. Perspectives in Nursing Science, 12(2), 82–93. https://doi.org/10.16952/pns.2015.12.2.82
7.
BoltonB.BrookingsJ. (1998). Development of a measure of intrapersonal empowerment. Rehabilitation Psychology, 43(2), 131–142. https://doi.org/10.1037/0090-5550.43.2.131
8.
BrookingsJ. B.BoltonB. (2000). Confirmatory factor analysis of a measure of intrapersonal empowerment. Rehabilitation Psychology, 45(3), 292–298. https://doi.org/10.1037/0090-5550.45.3.292
9.
CerezoP. G.Juvé-UdinaM. E.Delgado-HitoP. (2016). Concepts and measures of patient empowerment: A comprehensive review. Revista da Escola de Enfermagem da USP, 50(4), 667–674. https://doi.org/10.1590/S0080-623420160000500018
10.
ChingS. M.YeeA.LeeP. Y.RamachandranV.ShumK. M.IsmaelN. F. I.SulaimanW. A. W.HooF. K.FooY. L.LeeK. W.DanaeeM.TanK. A. (2020). Psychometric properties of the Malay version of the Diabetes Empowerment Scale among Hospital Serdang type 2 diabetes mellitus patients using exploratory factor analysis. Health and Quality of Life Outcomes, 18(1), 23. https://doi.org/10.1186/s12955-020-1280-0
11.
DeVellisR. F. (2017). Scale development: Theory and application (4th ed.). SAGE Publications.
12.
DullaghanL.LuskL.McGeoughM.DonnellyP.HerityN.FitzsimonsD. (2014). “I am still a bit unsure how much of a heart attack it really was!” Patients presenting with non ST elevation myocardial infarction lack understanding about their illness and have less motivation for secondary prevention. European Journal of Cardiovascular Nursing, 13(3), 270–276. https://doi.org/10.1177/1474515113491649
13.
GarcimartínP.Comín-ColetJ.Pardo-CladellasY.BadosaN.LinasA.RosenfeldL.FaraudoM.ValeroO.HidalgoE.Cainzos-AchiricaM.RuizS.Delgado-HitoP. (2020). Validation of the Spanish version of the questionnaire on patient empowerment in long-term conditions. PLoS One, 15(6), e0233338. https://doi.org/10.1371/journal.pone.0233338
14.
GeldhofG. J.PreacherK. J.ZyphurM. J. (2014). Reliability estimation in a multilevel confirmatory factor analysis framework. Psychological Methods, 19(1), 72–91. https://doi.org/10.1037/a0032138
15.
HairJ. F.BlackW. C.BabinB. J.AndersonR. E. (2010). Multivariate data analysis (7th ed.). Prentice Hall.
16.
JerofkeT.WeissM. (2016). Development and psychometric analysis of the Patient Perceptions of Patient-Empowering Nurse Behaviours Scale (PPPNBS). Journal of Advanced Nursing, 72(11), 2923–2936. https://doi.org/10.1111/jan.13060
17.
JørgensenC. R.ThomsenT. G.RossL.DietzS. M.TherkildsenS.GroenvoldM.RasmussenC. L.JohnsenA. T. (2018). What facilitates “patient empowerment” in cancer patients during follow-up: A qualitative systematic review of the literature. Qualitative Health Research, 28(2), 292–304. https://doi.org/10.1177/1049732317721477
18.
KähkönenO.SaaranenT.KankkunenP.LamidiM. L.KyngäsH.MiettinenH. (2018). Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention. Journal of Clinical Nursing, 27(5–6), 989–1003. https://doi.org/10.1111/jocn.14153
19.
KangY.YangI. S.KimN. (2010). Correlates of health behaviors in patients with coronary artery disease. Asian Nursing Research, 4(1), 45–55. https://doi.org/10.1016/S1976-1317(10)60005-9
20.
KashaniM.EliassonA. H.WalizerE. M.FullerC. E.EnglerR. J.VillinesT. C.VernalisM. N. (2016). Early empowerment strategies boost self-efficacy to improve cardiovascular health behaviors. Global Journal of Health Science, 8(9), 322. https://doi.org/10.5539/gjhs.v8n9p322
21.
KhanianZ. S.GhaffariF.AlipoorZ. J.FotokianZ. (2020). Designing and validating the empowerment scale for the older individuals with chronic obstructive pulmonary disease (ESOCOPD). Heliyon, 6(5), e03909. https://doi.org/10.1016/j.heliyon.2020.e03909
22.
KimJ. (2020). Convergence review of factors related to empowerment of patients with chronic diseases in Korea. Journal of the Korea Convergence Society, 11(8), 381–390. https://doi.org/10.15207/JKCS.2020.11.8.381
23.
KimJ.ShinN. (2021). Concept analysis of the empowerment of patients with coronary artery disease using a hybrid model. Advances in Nursing Science.
24.
KimS. H.YouH. S. (2017). The effects of an empowerment education program for kidney transplantation patients. Journal of Korean Academy of Nursing, 47(4), 445–455. https://doi.org/10.4040/jkan.2017.47.4.445
25.
KimS. Y.KimM. Y. (2017). Development and effectiveness of tailored education and counseling program for patients with coronary artery disease undergoing percutaneous coronary intervention. Korean Journal of Adult Nursing, 29(5), 547–559. https://doi.org/10.7475/kjan.2017.29.5.547
26.
KlineP. (2000). The handbook of psychological testing (2nd ed.). Routledge.
27.
KlineR. B. (2011). Principles and practice of structural equation modeling (3rd ed.) The Guilford Press.
28.
KöhlerA. K.TingströmP.JaarsmaT.NilssonS. (2018). Patient empowerment and general self-efficacy in patients with coronary heart disease: A cross-sectional study. BMC Family Practice, 19(1), 76. https://doi.org/10.1186/s12875-018-0749-y
29.
KoK.TakH. (2016). The treatment of missing values using the integrated multiple imputation and callback method. Korean Journal of Public Administration, 12, 291–319.
30.
KoM. S.KangK. J. (2018). Influence of health literacy and health empowerment on health behavior practice in elderly outpatients with coronary artery disease. Journal of Korean Clinical Nursing Research, 24(3), 293–302. https://doi.org/10.22650/JKCNR.2018.24.3.293
31.
LeechN. L.BarrettK. C.MorganG. A.ClayJ. N.QuickD. (2005). SPSS for intermediate statistics: Use and interpretation (2nd ed.). Lawrence Erlbaum Associates.
32.
LeeE. O.ImN. Y.ParkH. A.LeeI. S.KimJ. I.BaeJ.LeeS. M. (2009). Nursing research and statistical analysis (4th ed.). Soomoonsa.
33.
LewinD.PiperS. (2007). Patient empowerment within a coronary care unit: Insights for health professionals drawn from a patient satisfaction survey. Intensive and Critical Care Nursing, 23(2), 81–90. https://doi.org/10.1016/j.iccn.2006.09.003
34.
MoslehS. M.AlmalikM. M. A. (2016). Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients. European Journal of Cardiovascular Nursing, 15(4), 223–230. https://doi.org/10.1177/1474515114563885
35.
MusavinasabM.RavanipourM.PouladiS.MotamedN.BarekatM. (2016). The effect of self-management empowerment model on the sense of coherence among elderly patients with cardiovascular disease. Educational Gerontology, 42(2), 100–108. https://doi.org/10.1080/03601277.2015.1078691
36.
NunnallyJ. C.BernsteinI. H. (1994). Psychometric theory (3rd ed.). McGraw-Hill.
37.
OhH. W.KimK. U. (2016). The effect of self-efficiency and leisure activity participation on empowerment program elderly people with chronic pulmonary disease. The Journal of Humanities and Social Sciences, 7(3), 829–841. https://doi.org/10.22143/hss21.7.3.43
38.
OthmanL. B.YahiaS. B. (2018). A multiple criteria evaluation technique for missing values imputation. 2018 12th International conference on Research Challenges in Information Science (RCIS) (pp. 1–12). IEEE. https://doi.org/10.1109/RCIS.2018.8406659
39.
ParkC.ParkY. H. (2013). Validity and reliability of Korean version of Health Empowerment Scale (K-HES) for older adults. Asian Nursing Research, 7(3), 142–148. https://doi.org/10.1016/j.anr.2013.07.004
40.
ParkH. A. (2005). Problems and issues in developing measurement scales in nursing. Journal of Nursing Query, 14(1), 46–72.
41.
ParkK.LeeH.LeeY.ChoJ.KimB.SongY. (2017). Reliability and validity of Korean version of diabetes empowerment instrument short form. Journal of Korean Academy of Fundamentals of Nursing, 24(4), 296–303. https://doi.org/10.7739/jkafn.2017.24.4.296
42.
PetersonN. A.LoweJ. B.HugheyJ.ReidR. J.ZimmermanM. A.SpeerP. W. (2006). Measuring the intrapersonal component of psychological empowerment: Confirmatory factor analysis of the Sociopolitical Control Scale. American Journal of Community Psychology, 38(3–4), 263–274. https://doi.org/10.1007/s10464-006-9070-3
43.
PolitD. F.BeckC. T.OwenS. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459–467. https://doi.org/10.1002/nur.20199
44.
PriggeJ. K.DietzB.HomburgC.HoyerW. D.BurtonJ. L. (2015). Patient empowerment: A cross-disease exploration of antecedents and consequences. International Journal of Research in Marketing, 32(4), 375–386. https://doi.org/10.1016/j.ijresmar.2015.05.009
45.
QiuR.Schick-MakaroffK.TangL.WangX.ZhangQ.YeZ. (2020). Chinese hospitalized cardiovascular patients’ attitudes towards self-management: A qualitative study. Patient Preference and Adherence, 14, 287–300. https://doi.org/10.2147/PPA.S236348
46.
ShinS. H.ParkH. (2015). Development and validation of the empowerment scale for woman with breast cancer. Journal of Korean Academy of Nursing, 45(4), 613–624. https://doi.org/10.4040/jkan.2015.45.4.613
47.
SonH.KimG. S. (2017). Health empowerment of older adults with high-risk of cardio-cerebrovascular diseases. Journal of Korean Academy of Community Health Nursing, 28(4), 410–420. https://doi.org/10.12799/jkachn.2017.28.4.410
48.
SullivanM. D.LaCroixA. Z.RussoJ.KatonW. J. (1998). Self-efficacy and self-reported functional status in coronary heart disease: A six-month prospective study. Psychosomatic Medicine, 60(4), 473–478. https://doi.org/10.1097/00006842-199807000-00014
ZhangP.HuY. D.XingF. M.LiC. Z.LanW. F.ZhangX. L. (2017). Effects of a nurse-led transitional care program on clinical outcomes, health-related knowledge, physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial. International Journal of Nursing Studies, 74, 34–43. https://doi.org/10.1016/j.ijnurstu.2017.04.004
51.
ZimmermanM. A. (1995). Psychological empowerment: Issues and illustrations. American Journal of Community Psychology, 23(5), 581–599. https://doi.org/10.1007/BF02506983
