Development and psychometric properties of the 'Assessment of Burden of Chronic Conditions (ABCC) tool' for people with chronic heart failure (CHF): a mixed methods approach

Fam Med Community Health. 2026 Feb 24;14(1):e003781. doi: 10.1136/fmch-2025-003781.

Abstract

Objective: To develop a chronic heart failure (CHF) module for the Assessment of Burden of Chronic Conditions (ABCC) tool and evaluate its psychometric properties.

Design: Mixed methods study.

Setting: The study was conducted in the Netherlands.

Participants: Healthcare providers (ie, general practitioners (GPs), practice nurses, cardiologists, heart failure nurse practitioners, heart failure specialist nurses) and patients with CHF were involved in the developmental phase. In the psychometric evaluation, patients with CHF were included.

Results: The ABCC-CHF module comprised 26 items across CHF-specific domains, accompanied by associated advice. It demonstrated high convergent validity with the Kansas City Cardiomyopathy Questionnaire (KCCQ) (97%) and successfully differentiated most known-groups. Internal consistency yielded a Cronbach's α of 0.92 for the total scale, while test-retest reliability showed an intraclass correlation coefficient (ICC) of 0.97.

Conclusion: The CHF-specific module is developed and validated. It aims to integrate disease burden into routine healthcare, supporting person-centred care for people with CHF and multimorbidity.

Keywords: chronic disease; multiple chronic conditions; patient-centered care; primary health care; quality of health care.

MeSH terms

  • Aged
  • Chronic Disease
  • Cost of Illness*
  • Female
  • Heart Failure* / psychology
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires / standards