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Measurement of Patient Confidence in Self-Management of Atrial Fibrillation: Initial Validation of The Confidence in Atrial fibriLlation Management (CALM) Scale

Abstract Background: The patient experience of atrial fibrillation (AF)
involves several daily self-care behaviors and ongoing confidence to
manage their condition. Currently, no standardized self-report measure
of AF patient confidence exists. The purpose of this study is to
establish the reliability and validity of a newly developed confidence
in AF management measure. Methods: This study provides preliminary
analysis of the Confidence in Atrial FibriLlation Management (CALM)
scale, which was rationally developed to measure patient confidence
related to self-management of AF. The scale was provided to a sample of
AF patients N=120, (59% male) electronically through a patient
education platform. Principle components analysis (PCA) and Cronbach’s
alpha were employed to provide preliminary assessment of the validity
and reliability of the measure. Results: PCA identified a four-factor
solution. Internal consistency of the CALM was considered excellent with
Cronbach’s α = .910. Additional PCA confirmed the value of a single
factor solution to produce a total confidence score for improved utility
and ease of clinical interpretation. Conclusions: Initial assessment of
a novel scale measuring patient confidence in managing AF provided
promising reliability and validity. Patient confidence in
self-management of AF may prove useful as a key marker and endpoint of
the patient experience beyond QOL.