Validation of The Fluid Intake Appraisal Inventory; a self-efficacy scale for managing fluid allowance among patients on haemodialysis in Denmark

Background
Many haemodialysis patients have problems limiting their fluid intake, and this might be influenced by their self-efficacy (SE). Thus interventions to improve patients’ SE might lead to an improvement in their managing of fluid allowance. The Fluid Intake Appraisal Inventory (FIAI) evaluates patients’ SE with regard to fluid intake. FIAI was developed in Sweden and can be used as a screening instrument or as evaluation tool.

Objectives
The aim of this study was to translate and validate the FIAI for use in Denmark.

Methods
Following the steps of forward and backward translation the Swedish version of FIAI was translated into Danish. Conceptual and semantic equivalence were established by the translators in the forward and reverse translation procedure. Experiential and idiomatic equivalence was discussed by the researchers. Four patients completed the first version of the FIAI and were asked to evaluate the appropriateness and were asked to make suggestions for clarity. The second part of the assessment relates to construct validity and internal consistency of the revised scale. FIAI has been tested in a survey among haemodialysis patients in Danish dialysis centres during May and June 2015.

Results
Four translators and two experts participated in evaluation of the conceptual and semantic equivalence of FIAI. Two concepts (“myrekryb” (=cramping) and “fest” (=party)) had different meanings in Swedish and Danish and needed further clarification. 225 patients from four dialysis centre (including four satellite units) completed the Danish FIAI. Analysis of construct validity and internal consistency is ongoing.

Conclusions
Primarily findings indicate that the Danish FIAI can be used in clinical practice as a screening instrument for SE and evaluation tool among adult haemodialysis patients with restricted fluid allowance.