Tampa Scale of Kinesiophobia for Heart Turkish Version Study: cross-cultural adaptation, exploratory factor analysis, and reliability

PURPOSE Individuals with cardiac problems avoid physical activity and exercise because they expect to feel shortness of breath, dizziness, or chest pain. Assessing kinesiophobia related to heart problems is important in terms of cardiac rehabilitation. The Tampa Scale of Kinesiophobia Swedish Version for the Heart (TSK-SV Heart) is reliable and has been validated for cardiac diseases in the Swedish population. The aim of this study was to investigate the reliability, parallel-form validity, and exploratory factor analysis of the TSK for the Heart Turkish Version (TSK Heart Turkish Version) for evaluating kinesiophobia in patients with heart failure and pulmonary arterial hypertension. METHODS This cross-sectional study involved translation, back translation, and cross-cultural adaptation (localization). Forty-three pulmonary arterial hypertension and 32 heart failure patients were evaluated using the TSK Heart Turkish Version. The 17-item scale, originally composed for the Swedish population, has four factors: perceived danger for heart problem, avoidance of exercise, fear of injury, and dysfunctional self. Cronbach's alpha (internal consistency) and exploratory factor analysis were used to assess the questionnaire's reliability. Results of the patients in the 6-minute walk test, International Physical Activity Questionnaire, and Nottingham Health Profile were analyzed by Pearson's correlation analysis with the TSK Heart Turkish Version to indicate the convergent validity. RESULTS Cronbach's alpha for the TSK Heart Turkish Version was 0.75, indicating acceptable internal consistency. Although exploratory factor analysis showed a different subgroup distribution than the original questionnaire, the model was acceptable for the four-factor model hypothesis. Therefore, the questionnaire was rated as reliable. CONCLUSION These results supported the reliability of the TSK Heart Turkish Version. Since the acceptable four-factor model fits the subgroups and measures of reliability are sufficiently high, the questionnaire seems reliable for pulmonary arterial hypertension and heart failure patients.