Psychometric Validation of the Mandarin Version Control Attitudes Scale-Revised Questionnaire in Taiwanese Patients With Heart Failure

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Perceived control is an important construct in patients with heart failure (HF) and related to improved health outcomes. There is no reliable and valid instrument available for the measurement of perceived control in Taiwan, limiting the practical application of the construct in research and clinical practice.


The aim of this study was to translate, culturally adapt, and validate the Mandarin version of the Control Attitudes Scale-Revised (Mandarin CAS-R) in Taiwanese patients with HF.


The Mandarin CAS-R was developed using a translation/back-translation process and semantic equivalence; importantly, conceptual equivalence was also examined. Reliability was assessed using Cronbach’s α to determine internal consistency, and item homogeneity was assessed using item-total and interitem correlations. Construct validity was examined using exploratory factor analysis and hypothesis testing for known associations.


Three hundred forty-eight patients with HF were included, and 5-item Mandarin CAS-R was validated in the study. The model performance was acceptable with all factor loadings greater than 0.70, a variance explained of 55.2%, and a Cronbach’s α of .79. The 5-item Mandarin CAS-R was associated with higher levels of self-care maintenance (β = 0.395, P < .001), management (β = 0.219, P < .01), and confidence (β = 0.524, P < .001); perceived social support (β = 0.246, P < .001); and depression (β = −0.125, P < .05).


This study provided evidence of the reliability and validity of the 5-item Mandarin CAS-R as a measure of perceived control in Taiwanese patients with HF.

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