Measuring dispositional optimism in patients with chronic heart failure and their healthcare providers: The validity of the Life Orientation Test-Revised

The Life Orientation Test-Revised (LOT-R) measures dispositional optimism (DO) – an individual difference promoting physical and psychological well-being in healthy adults (HAs) as well as in patients with chronic heart failure (CHF) and healthcare providers (HPs). Controversy has arisen regarding the dimensionality of the LOT-R. Whereas DO was originally defined as a one-dimensional construct, empirical evidence suggests two correlated factors in the LOT-R. This study was the first attempt to identify the best factor structure of the LOT-R in patients with CHF and HPs and to evaluate its measurement invariance among subsamples of patients with CHF, HPs, and a normative sample of HAs. Its validity was also evaluated in patients with CHF. The sample comprised 543 participants (34% HAs; 34% HPs; and 32% CHF patients). Congeneric, two correlated factor, and two orthogonal factor models for the LOT-R were compared by performing confirmatory factor analysis (CFA). Measurement invariance was evaluated by considering differential item functioning (DIF) among subsamples of HPs, patients with CHF, and HAs. In patients with CHF, validity was assessed by considering associations with anxiety and depression. The CFA demonstrated the superior fit of the two orthogonal factor model. Moreover, across patients with CHF, HPs, and HAs, the results highlighted a minimal DIF with only trivial consequences. Finally, negative but weak correlations of DO with anxiety and depression confirmed the validity of the LOT-R in patients with CHF. In summary, these findings supported the validity and suitability of the LOT-R for the assessment of DO in patients with CHF, HPs, and HAs.