Laura P. Kimble, PhD, RN, FAHA Professor Piedmont Healthcare Endowed Chair in Nursing Georgia Baptist College of Nursing Mercer University Atlanta,

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1 Laura P. Kimble, PhD, RN, FAHA Professor Piedmont Healthcare Endowed Chair in Nursing Georgia Baptist College of Nursing Mercer University Atlanta, GA

2 Performance of Household Tasks Highly salient physical activity for women Resume household activities in early stages of cardiovascular convalescence Report higher levels of stress concerning household responsibilities as compared to men Feel guilty about limitations in performance of household tasks

3 Performance of Household Tasks as Marker for Cardiac Symptom Status Women continue to perform household tasks after retirement Performance of household tasks may represent most strenuous physical activity older women routinely attempt Gender-specific assessment tools may be warranted to evaluate symptom-related decline in functional status Gender-specific tools to assess physical function in women are lacking

4 Purpose To psychometrically evaluate evidence for construct validity for the Kimble Household Activities Scale (HAS), an instrument developed to measure physical function in women with heart disease.

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6 Design, Setting, and Sample Design: Cross sectional, descriptive Setting: Large metropolitan area in the Southeastern United States, participants were recruited from the community Sample: (N= 40 women) Inclusion/criteria included: Self-reported history of coronary heart disease Community dwelling Alert and oriented and able to complete study questionnaires independently

7 Procedures Recruitment via print advertising in large metropolitan area in Southwestern, United State Patients responding to the ad and expressing interest in the study were mailed an informed consent with the study questionnaires Questionnaires were returned to the study office in a postage paid envelope Participants received $10 for their participation

8 Variables/Instruments Kimble Household Activities Scale 14 items response options: perform without difficulty perform but have to change the way they do activity no longer attempt because of heart problems no longer attempt because of other reasons never have performed Total score represents the % of activities performed without difficulty among those routinely attempted.

9 Seattle Angina Questionnaire 19 items with 5 subscales exertional capacity (EC)- ability to perform physical activity angina frequency (FR)- frequency of episodes within previous month angina stability (ST)- change in frequency of episodes disease perception (DP)- worry about dying or having MI treatment satisfaction (TS)- satisfaction with angina tx. Possible score 0 to 100 Higher scores indicate better function

10 Additional Questionnaires to Assess Validity Cardiovascular Limitations and Symptoms Profile (CLASP) Multi-item questionnaire that assesses symptoms of angina, shortness of breath, and ankle swelling and home concerns Home concerns the subscale used for validity assessment Higher scores indicate greater limitation with home management Illness Intrusiveness Scale Measures the impact of illness on functioning across several domains Subscale measuring leisure and paid work used to assess validity Higher scores indicate greater illness intrusiveness

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12 Demographic and Clinical Characteristics (N = 40) Variable Mean (SD) Range Age 65.5 (11.1) Years Variable Percent N Married White/Non-Hispanic Current smoking History of heart failure History of diabetes History of acute myocardial infarction History of coronary artery bypass surgery

13 Household Activities Percentage of tasks performed without difficulty (out of tasks that would be routinely attempted) mean 49.6% (SD 33.2%) possible range 0 to 100%, observed 0 to 100%

14 Spearman s Correlations to Assess Construct Validity Household Activity Scale SAQ Exertional capacity CLASP Home Concerns P value Illness Intrusiveness Scale -.74 <.001

15 Conclusions Evidence for construct validity for the HAS was demonstrated Future research should focus on test-retest reliability and establishing difference or change scores that would reflect clinically significant decline or improvement in physical function