Development and Evaluation of an Antihypertensive Therapy Related Attitudes and Beliefs Scale in Hypertensive Patients

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 pools were developed by combining with the contents of Chinese Guidelines for Prevention and Treatment of Hypertension, literature review and in-depth interview. After two rounds of research group discussion and experts’ evaluation, the new scale was developed. A total of 404 patients with hypertension in three community health service centers and 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: The results showed that four common factors extracted by exploratory factor analysis were well corresponded with the theoretical construction. Factor loading of each item ranged from 0.468 to 0.846. The 4 factors explained for 50.75% of total variance. The correlations between the subscales and the total scale were ranging from 0.513 to 0.802 (P<0.01). The correlations between the subscales of the scale were ranging from 0.160 to 0.302 (P<0.01). The correlations between the medication attitudes subscale and the Morisky medication adherence scale was 0.511 (P<0.01). The correlation coefficient of the ATRABS scores to the omission times of taking antihypertensive medication was 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’s α were 0, 841, 0.733, 0.639 and 0.643, respectively. Test-retest reliability was 0.922, and that of subscales was 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.