Development and evaluation of an antihypertensive therapy related attitudes and beliefs scale in hypertensive patients

Background Uncontrolled high blood pressure is mainly caused by poor compliance to antihypertensive therapy in hypertensive patients.Despite some studies have showed that improving antihypertensive therapy related attitudes and beliefs might enhance compliance,a major problem in research is the lack of adequate reliability and validity measurement tool.Objective To develop an antihypertensive therapy related attitudes and beliefs scale（ATRABS）in hypertensive patients,and assess its reliability and validity.Methods The original item pool combining with the contents of Chinese guidelines for prevention and treatment of hypertension,literature review and in-depth interview were developed.After two rounds of research group discussion and experts evaluation,the new scale were developed.A total of 404 patients with hypertension in three community health service centers and three grade-A teaching hospitals were selected by purposive sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that four common factors extracted by exploratory factor analysis had well corresponded with the theoretical construction.Factor loading of each item ranged between 0.468 and 0.846.The 4 factors explained for 50.75% of total variance.The correlations between the subscales and the total scale were moderate to high,ranging from 0.513-0.802（P＜0.01）.The correlations between the subscales of the scale were moderate to low,ranging from 0.160-0.302（P＜0.01）.The correlations between the medication attitudes subscale and the morisky medication adherence scale was 0.511（P＜0.01）.And the correlation coefficients of the ATRABS scores to the omission times of taking antihypertensive medication was obvious negative-0.481（P＜0.01）.The total scores in blood pressure control group was significantly higher than that in uncontrolled blood pressure group（P＜0.01）.The scale was reliable（α=0.804）,and the subscales Cronbach α were 0.841,0.733,0.639,0.643,respectively.Test-retest reliability was 0.922,and that of subscales were 0.859-0.936.Conclusion The newly developed antihypertensive therapy related attitudes and beliefs scale has showed acceptable reliability and validity,which can be used as a useful tool for clinicians and researchers in identifying and assessing cognitive problems in antihypertensive therapy.