The HeartQoL: Part II. Validation of a new core health-related quality of life questionnaire for patients with ischemic heart disease

Abstract

Background:Evaluation of health-related quality of life (HRQL) is important in improving the quality of patient care. The aim of this study was to determine the psychometric properties of the HeartQoL in patients with ischemic heart disease (IHD), specifically angina, myocardial infarction (MI), or ischemic heart failure. Methods:Data for the interim validation of the HeartQoL questionnaire were collected in (a) a cross-sectional survey and (b) a prospective substudy of patients undergoing either a percutaneous coronary intervention (PCI) or referred to cardiac rehabilitation (CR) and were then analyzed to determine the reliability, validity, and responsiveness of the HeartQoL questionnaire. Results:We enrolled 6384 patients (angina, n = 2111, 33.1%; MI, n = 2351, 36.8%; heart failure, n = 1922, 30.1%) across 22 countries speaking 15 languages in the cross-sectional study and 730 patients with IHD in the prospective substudy. The HeartQoL questionnaire comprises 14-items with physical and emotional subscales and a global score (range 0–3 (poor to better HRQL). Cronbach’s α was consistently ≥0.80; convergent validity correlations between similar HeartQoL and SF-36 subscales were significant (r ≥ 0.60, p < 0.001); discriminative validity was confirmed with predictor variables: health transition, anxiety, depression, and functional status. HeartQoL score changes following either PCI or CR were significant (p < 0.001) with effect sizes ranging from 0.37–0.64. Conclusion:The HeartQoL questionnaire is reliable, valid, and responsive to change allowing clinicians and researchers to (a) assess baseline HRQL, (b) make between-diagnosis comparisons of HRQL, and (c) evaluate change in HRQL in patients with angina, MI, or heart failure with a single IHD-specific HRQL instrument.

The HeartQoL: Part I. Development of a new core health-related quality of life questionnaire for patients with ischemic heart disease

“…Guidelines for key psychometric attributes of HRQL instruments such as the HeartQoL include the conceptual and measurement model, reliability, validity, responsiveness, and respondent and administrative burden 27 and these are the focus of a separate manuscript 11 .…”

“…The study was conducted in two phases: 1) a cross-sectional survey phase with three validated IHD-specific HRQL questionnaires to identify items for inclusion in the HeartQoL questionnaire and described in this manuscript; 2) a second phase to test the questionnaire's psychometric properties (described in a separate manuscript 11 ).…”

Unplanned Inpatient and Observation Rehospitalizations After Acute Myocardial Infarction

“…Interest in quality of life for patients with ischemic heart disease is growing, as evidenced by the development of a new quality-of-life score specific to this population. 27,28 In addition to poor quality of life, depression may negatively affect cardiac outcomes. 29 The prevalence of depression in patients with cardiovascular disease ranges from 17% to 47%, 30 and interventions to treat depression after MI may reduce cardiac morbidity.…”

Psychological Aspects of Cardiac Care and Rehabilitation: Time to Wake Up to Sleep?

“…Therefore, comparison of HRQoL among subgroups has become an important focus. Two HRQoL questionnaires have recently been shown to allow for comparison among different diagnostic groups -the HeartQol and the MacNew [130][131][132]. The HeartQol, in particular, has demonstrated validity across 22 countries and several languages and has been shown to predict 5-year mortality and cardiac readmissions in patients with ischaemic heart disease [133].…”