Psychometric responsiveness of the health-related quality of life questionnaire (HeartQoL-P) in the Iranian post-myocardial infarction patients

Abstract

BackgroundCardiovascular diseases (CVD) as a most frequent and costly NCDs account for about 17.3 million annual deaths worldwide. About 80% of these deaths are taking place in low and middle income countries (LMIC). The survivors may experience severe disabling consequences with extensive impacts on their quality of life. The HeartQoL is a relatively new scale to measure health-related quality of life in CVD patients and was validated for use in other languages. Main aim of the present study was to validate the HeartQoL for Persian speaking populations.Design and methodsIn this cross-sectional study the participants were 557 admitted patients with acute myocardial infarction (AMI) across three specialized hospitals in Tabriz, North West of Iran from Sep 2014 to Feb 2015. Translation back-translation procedures were applied to prepare the Persian version of the HeartQol (HeartQoL-P) and the content validity of the scale was evaluated by an expert panel of 10 academic staff. Construct validity was assessed by exploratory and confirmatory factor analyses. The internal consistency was assessed based on the numeric value of Cronbach’s alpha and sensitivity of the measure according to the ceiling and floor effect’s values.ResultsThe two-factor structure of the HeartQoL-P was supported by the confirmatory factor analysis’ outputs and good internal consistency measures (total score α = 0.94) (physical subscale (10 items) α = 0.95) and emotional subscale (4items) α = 0.80)). No ceiling and floor effects were observed for the overall HeartQol-P’s score.ConclusionThe findings supported the HeartQoL-P usability as a valid instrument in studies on the Iranian or other Persian speaking patients.

Validation of the Italian HeartQoL: a short health-related quality of life questionnaire for patients with ischemic heart disease

“…The psychometric properties of the Italian version of the HeartQoL were evaluated on a sample of 472 patients with either AP, MI or IHF from five Italian centres in North-East, North-West, Central, and Southern Italy and therefore largely representative of the demographic, social, cultural, and economic characteristics of the Italian population. Further, these psychometric properties are consistent with the original validation study in patients with AP, MI or IHF, [ 13 ] the English HeartQoL version based on patients with AP or MI in the USA, [ 30 ] the German HeartQoL version in patients with AP, MI or IHF, [ 14 ] The Iranian HeartQoL version in patients with MI, [ 31 ] the EuroAspire IV study in chronic coronary syndrome patients [ 32 ] and also with validation studies in patients with atrial fibrillation, [ 16 ] implantable cardioverter defibrillator recipients [ 17 ] or following valve surgery [ 18 ]. In addition, the original two-factor structure [ 12 ], determined with Mokken scale analysis [ 27 ], was confirmed with strong physical (Hi 0.67) and emotional (Hi 0.68) domains being comparable with the original [ 13 ] and more recent validation studies.…”

Translation and evaluation of the HeartQoL in patients with coronary heart disease in Iceland

“…The problem with cross-loadings for items 8 and 9 has been reported in previous HeartQoL studies [ 14 , 32 ] and may be because they are not as clear indicators for physical and emotional attributes as the other indicators in the respective subscale. Problems with correlated errors have not been widely reported although they have been reported in the Persian HeartQoL [ 10 , 13 ] which, among other reasons, can arise from overlapping items measuring the same attribute and multidimensionality [ 25 ]. The problem with correlated errors between items 3 and 4 may be because both items measure physical efforts but at different levels.…”

Evaluation of health-related quality of life in cardiovascular research: a call for action

“…The HeartQoL questionnaire translations are available in a total of 32 languages: Azerbaijani, Bahasa Malaysia, Bulgarian, Chinese (Mandarin), Croatian, Czech, Danish, Dutch, English, Finnish, Flemish, French, German, Greek, Hmong, Hungarian, Icelandic, Italian, Korean, Latvian, Lithuanian, Norwegian, Persian, Polish, Portuguese, Romanian, Russian, Serbian, Spanish, Swedish, Turkish, and Ukrainian. Since the initial validation of the HeartQoL questionnaire in patients with angina, MI, or heart failure (5), the HeartQoL questionnaire has been validated in patients with stable coronary disease (6), atrial fibrillation (7), angina or MI (8), implantable cardioverter defibrillator (9), heart valve surgery (10), acute MI (11), and angina, MI or heart failure (12). Validation manuscripts in Chinese [Mandarin] patients and Italian patients with angina, MI or heart failure are under review.…”