Development of a self-assessment tool for transition to daily life post-cardiac surgery

AIMS: Physical, psychological, and social distress experienced by patients undergoing cardiac surgery has long-term effects on quality of life. Therefore, patient-centred, continuous, and comprehensive transitional care is required. We aimed to develop a Self-Assessment Tool for Transition to Daily Life (SAT-TDL) and to examine its reliability and validity. METHODS AND RESULTS: A draft SAT-TDL was developed and validated by experts. A modified version was then developed through patient interviews and acceptability assessment, and its reliability and validity were evaluated through exploratory and confirmatory factor analyses. Construct validity was tested using the standard version of the 12-item Short Form Health Survey (SF-12v2). The initial 56-item SAT-TDL draft was modified into a 28-item pilot version and then into a 27-item version based on feedback from seven patients who had undergone cardiac surgery. From 340 valid responses, the 27-item SAT-TDL yielded four domains through item and factor (exploratory and confirmatory) analyses. Cronbach's alpha coefficient for the entire tool was 0.95. Hypothesis testing revealed significant correlations between the psychological aspects of the SF-12v2 and 'psychological transitions' domain of the SAT-TDL, and between the social aspects of the SF-12v2 and 'continuation of self-management' and 'meeting care needs' domains of the SAT-TDL. The final model fit was generally good (CMIN/DF = 3.3285, GFI = 0.809, AGFI = 0.771, CFI = 0.883, and RMSEA = 0.083). CONCLUSION: The SAT-TDL is a reliable and valid self-assessment tool. Sharing information on patients' post-discharge transitions and care needs with medical staff may support smoother recovery and improve the quality of life after cardiac surgery.