Psychometric evaluation of the Sinhalese version of MacNew Heart Disease Health Related Quality of Life Questionnaire in patients with stable angina

Abstract

BackgroundA Sinhalese version of a validated, disease-specific patient-reported heart disease health related quality of life instrument is lacking. The purpose of this study was to validate the interviewer-administered Sinhalese version of the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) in patients with clinically diagnosed stable angina.MethodsThe Sinhalese translation of the MacNew was carried using standard forward- backward translation technique. In this validation study, the MacNew was administered to 200 patients with stable angina. Reliability was assessed by internal consistency and test-retest reliability. Construct validity was explored by exploratory factor analysis using principal component analysis and confirmed by confirmatory factor analysis using the robust maximum likelihood method and known group comparison. The correlation between compatible domain scores of MacNew and the World Health Organization’s quality of life –brief questionnaire was used to assess concurrent validity.ResultsThe original 3-factor model (Physical, Emotional and Social) of the MacNew with cross-loadings was confirmed: principal component analysis with 53.42 % of the explained variance and confirmatory factor analysis with adequate fit for each of the three model fit criteria considered [root mean square error of approximation = 0.044 (90 % CI = 0.031 to 0.056); comparative fit index = 0.99; χ2/df = 1.39]. Internal consistency of the MacNew was acceptable with Cronbach's α of 0.92 on the Global scale and on the domain scales ranging from 0.85–0.91. Test-retest reliability was also found to be satisfactory with intraclass correlation coefficients of >0.9 for total and domain scores. A satisfactory level of concurrent validity was demonstrated with statistically significant correlations between compatible domain scores of MacNew and the World Health Organization’s quality of life questionnaire (Pearson correlation ranging from 0.36−0.79).ConclusionsThe interviewer–administered Sinhalese MacNew is a valid and reliable patient-reported outcome measure to assess disease specific health-related quality of life among Sinhalese patients with stable angina.

Predictors of health-related quality of life in korean patients with myocardial infarction: a longitudinal observational study

“…The minimal important difference (MID) on the global MacNew and the three subscales is determined by 0.50 points as a significant change 25. The reliability of the total MacNew has been well established in a plethora of previous studies, with Cronbach's alpha coefficients ranging from 0.85 to 0.94 [27][28][29]. The Cronbach's alpha coefficient of the Korean MacNew in the current study was also high at 0.90 for the total scale, and 0.86, 0.85 and 0.88 for the emotional, physical and social subscales, respectively.…”

Reliability and Validity of the Korean Version of the MacNew Heart Disease Health-related Quality of Life Questionnaire

“…All 14 items from the emotional dimension of the original MacNew were included in the emotional dimension of the Korean version, along with one additional item (Item 11, more dependent). Item 11 was loaded onto the social dimension in the original version and the physical dimension in the Sri Lankan version [12], and was not loaded onto any of the three dimensions in the Chinese [6] and Turkish versions [27]. The factor loadings of Item 11 across studies may be attributable to the cultural differences that occur when interpreting the statements of the instrument.…”

“…The original tool has 12 items that are crossloaded onto two or more factors [13]. Furthermore, although it varies across studies, previous studies reported that at least three items are cross-loaded onto two or more factors [6,7,12,26]. The K-MacNew also features seven items that are cross-loaded onto two factors, and one item is cross-loaded onto three factors.…”

“…The K-MacNew also features seven items that are cross-loaded onto two factors, and one item is cross-loaded onto three factors. However, some researchers have questioned the validity of including all items with a factor weight > 0.40 [12,29]. This is because the results vary across studies, in which 27 items are loaded onto different factors depending on the language, and some items are loaded onto dimensions not explained in the original instrument.…”

“…The advantages of disease-speci c measures result in part from achieving speci city by measuring the frequency and severity of speci c symptoms such as chest pain in patients with CAD. The MacNew Heart Disease HRQOL questionnaire (MacNew) has been used worldwide [6,7,9,12].…”