Translation and Psychometric Evaluation of the Urdu Version of the Self-Care of Coronary Heart Disease Inventory Version 3.0 Among Patients With Coronary Heart Disease

Abstract

Objectives: This study aimed to translate the Self-Care of Coronary Heart Disease Inventory Version 3.0 (SC-CHDI v3.0) into Urdu and evaluate its psychometric properties among patients with coronary heart disease (CHD). Methodology: The SC-CHDI v3.0 was translated into Urdu using a standardized forward–backward translation procedure to ensure linguistic and conceptual equivalence. A cross-sectional study was conducted involving 150 patients diagnosed with CHD to evaluate the psychometric properties of the translated instrument. Sampling adequacy and factorability were assessed using the Kaiser–Meyer–Olkin (KMO) measure and Bartlett’s Test of Sphericity. Exploratory factor analysis (EFA) was performed to identify the underlying factor structure, followed by confirmatory factor analysis (CFA) using maximum likelihood estimation to examine model fit. Internal consistency reliability of the scale and its subscales was evaluated using Cronbach’s alpha. Results: The results demonstrated satisfactory sampling adequacy with a KMO value of 0.826, while Bartlett’s Test of Sphericity was statistically significant (p < 0.001), supporting the suitability of the data for factor analysis. EFA revealed a three-factor structure, consistent with the theoretical domains of self-care maintenance, monitoring, and management, explaining 53.43% of the total variance (maintenance 28.28%, monitoring 18.02%, management 7.13%). Factor loadings ranged from 0.15 to 0.68, with physical activity and weight monitoring items showing the lowest loadings. Initial CFA of the 23-item model demonstrated poor model fit (TLI = 0.63, CFI = 0.67). A refined 20-item second-order model showed improved but still suboptimal fit indices (TLI = 0.80, CFI = 0.83). Reliability analysis indicated good internal consistency, with an overall Cronbach’s alpha of 0.86 and acceptable reliability for the maintenance (0.76), monitoring (0.73), and management (0.84) subscales. Conclusion: The Urdu version of the SC-CHDI v3.0 demonstrated acceptable internal consistency reliability and preliminary support for the theoretical three-factor structure based on exploratory factor analysis. However, confirmatory factor analysis indicated limited structural validity in this sample.