Development of the health belief scale in adaptation to home hemodialysis and examining its psychometric properties

The aim of this study was to develop a scale based on the Health Belief Model that can reliably and validly evaluate the attitudes and beliefs of home hemodialysis patients towards dialysis problems and examine its psychometric properties. This methodological and descriptive study was conducted between November 2021 and August 2023. The population and sample consisted of patients undergoing home hemodialysis and nurses throughout Turkey. Number of patients in Turkey is determined jointly by the Ministry of Health and the Turkish Nephrology Association was 1107 according to the 2022 report. The research was carried out in two stages. In the first stage, in which the qualitative research design was used, in-depth individual interviews were held with 10 patients undergoing home hemodialysis and 10 nurses, and a draft scale item pool consisting of 34 items was created. In the second stage, in which the quantitative research design was used, validity and reliability analyses of the "Draft Health Belief Scale for Compliance with Home Hemodialysis" were performed with 202 patients. The data obtained were transferred to the IBM SPSS® Statistics 23 and IBM SPSS AMOS programs. The 5-point Likert-type draft scale consisting of 34 items was obtained with a content validity index of 0.67. After exploratory factor analysis, 7 items were removed, and the scale was finalized with a total of 27 items and 7 subscales (Health Belief/Activators, Perception of Seriousness, Perception of Sensitivity, Perception of Benefits, Perception of Symptom-Related Barriers, Perception of Machine-Related Barriers, and Perception of Self-Efficacy). In confirmatory factor analysis, the goodness of fit value of the scale was χ²/sd: 1.856; goodness of fit was 0.829; exploratory factor analysis Kaiser-Meyer-Olkin value was 0.85; incremental fit index was 0.902; normed fit index was 0.809; comparative fit index was 0.900; root mean square error of approximation value was 0.065; standardized root mean square residual value was 0.077. The Cronbach alpha reliability coefficient of the scale was 0.848 and the reliability coefficients of the subscales ranged between 0.680 and 0.895. In conclusion, it was determined that the Health Belief Scale for Compliance with Home Hemodialysis is a valid and reliable scale. Keywords: Home hemodialysis, Nursing, Scale, Scale Development, Treatment Compliance