A psychometric evaluation of the four-item version of the Control Attitudes Scale for patients with cardiac disease and their partners

Kristofer Årestedt, Susanna Ågren, Inger Flemme, Debra K. Moser, Anna Strömberg

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: The four-item Control Attitudes Scale (CAS) was developed to measure control perceived by patients with cardiac disease and their family members, but extensive psychometric evaluation has not been performed. Objective: The aim was to translate, culturally adapt and psychometrically evaluate the CAS in a Swedish sample of implantable cardioverter defibrillator (ICD) recipients, heart failure (HF) patients and their partners. Methods: A sample (n=391) of ICD recipients, HF patients and partners were used. Descriptive statistics, item-total and inter-item correlations, exploratory factor analysis, ordinal regression modelling and Cronbachs alpha were used to validate the CAS. Results: The findings from the factor analyses revealed that the CAS is a multidimensional scale including two factors, Control and Helplessness. The internal consistency was satisfactory for all scales (α=0.740.85), except the family version total scale (α=0.62). No differential item functioning was detected which implies that the CAS can be used to make invariant comparisons between groups of different age and sex. Conclusions: The psychometric properties, together with the simple and short format of the CAS, make it to a useful tool for measuring perceived control among patients with cardiac diseases and their family members. When using the CAS, subscale scores should be preferred.

Original languageEnglish
Pages (from-to)317-325
Number of pages9
JournalEuropean Journal of Cardiovascular Nursing
Issue number4
StatePublished - Aug 16 2015

Bibliographical note

Funding Information:
This study was supported by Linköping University, University of Kalmar, the Swedish Research Council, The Swedish Heart and Lung Association, and The Swedish Heart and Lung Foundation.

Publisher Copyright:
© The European Society of Cardiology 2014.


  • Family
  • heart disease
  • prevention and control
  • psychometrics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing


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