Validation of the English Version of the HeartQoL Health-Related Quality of Life Questionnaire in Patients With Coronary Heart Disease

Oldridge, Neil; Cho, Chris; Thomas, Randal; Low, Murray; Höfer, Stefan

doi:10.1097/hcr.0000000000000248

Cited by 16 publications

(20 citation statements)

References 27 publications

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“…The German HeartQoL demonstrated adequate convergent and divergent validity as well as internal consistency reliability in the total cohort and in each diagnosis. These results are similar to other studies using the HeartQoL, e.g., the English validation study including patients with angina or MI [27] which reported strong correlations with the respective matching physical and emotional scales of the HeartQoL and SF-36 (all coefficients r > .60). In the original HeartQoL study [19], Cronbach's alpha for the physical, emotional, and global scale was .90, .81, and .91, respectively, which was confirmed with the German HeartQoL version in this study.…”

Section: Discussionsupporting

confidence: 90%

“…Although there were no HeartQoL floor effects, high ceiling effects were observed on the emotional subscale in all groups with minimal effects on the physical and global scales. These observations, consistent with the original [19] and other validation studies [27][28][29][30][31], suggest that it may be more difficult to assess improvement in emotional HRQL than either physical or global HRQL with the HeartQoL questionnaire. Responsiveness was confirmed with significant pre-post HeartQoL physical, emotional, and global scale score changes with CR and with significant physical and global scale score changes after PCI.…”

Section: Discussionsupporting

confidence: 81%

“…The psychometric properties were evaluated based on a sample of 305 patients with either angina, MI, or ischemic heart failure from Austria and Switzerland and are consistent with the original validation study [19], the English HeartQoL version based on patients in the USA [27], the EuroAspire IV study [28], and also with validation studies in patients with atrial fibrillation [29], with an implantable cardioverter defibrillator [30] or following valve surgery [31]. According to Mokken analysis, the German HeartQoL factor structure is consistent with the original two-factor structure [18] although the moderate H i coefficient loading of .48 for the eighth item in the German HeartQoL ("feeling tired, fatigued, low on energy") reflects ambiguous wording and may need substantiation in a future study as loadings in the original study [19] and the more recent English [27], Chinese [submitted], mixed European countries [28], and Danish [29,30] studies were all > .50. However, despite the weakness of the eighth item, the current Mokken analysis results suggest that subscales of physical and emotional HRQL are more substantial than the overall global scale, as some items had clearly weak H i coefficients (< .50) on the global scale.…”

Section: Discussionmentioning

confidence: 99%

“…The psychometric properties of the SF-36 [24] and the three questionnaires on which the HeartQoL is based upon (SAQ, MacNew, MLHFQ) have all been individually assessed in the German language [25,26]. Reliability, validity, and partially responsiveness of the English HeartQoL have been already demonstrated in patients with angina, myocardial infarction (MI), and ischemic heart failure in the HeartQoL Project [19], in patients with angina or MI living in the USA [27], and with reliability and validity documented in stable coronary patients in EuroAspire IV [28]. Other language versions, e.g., examining Danishspeaking patients with atrial fibrillation [29], an implantable cardioverter defibrillator [30], and valve surgery [31] or Chinese patients with angina, MI, and ischemic heart failure [submitted] demonstrated adequate psychometric properties as well.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients

Huber

Oldridge

Benzer³

et al. 2019

Qual Life Res

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Purpose The aim of this study was to evaluate psychometric properties of the core disease-specific 14-item German HeartQoL questionnaire. Methods As an extension of the international HeartQol Project, cross-sectional and longitudinal health-related quality of life (HRQL) data were collected from 305 patients with angina (N = 101), myocardial infarction (N = 123), or ischemic heart failure (N = 81) in Austria and Switzerland using German versions of the HeartQoL, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale. The underlying factor structure was examined with Mokken Scaling analysis; then convergent, divergent, and discriminative validity, internal consistency reliability, and responsiveness were assessed. Results The highest HRQL scores were reported by patients with myocardial infarction followed by ischemic heart failure and then angina. The two-factor structure was confirmed with strong physical, emotional, and global scale H coefficients (> .50). Divergent and convergent validity (from r = .04 to .78) were shown for each diagnosis; discriminative validity was verified as well (partially: age, sex, and disease severity; largely: SF-36 health status/transition; totally: anxiety and depression). Internal consistency reliability was excellent (Cronbach's alpha = .91). In terms of responsiveness, physical and global scale scores improved significantly after percutaneous coronary intervention (p < .01) while after cardiac rehabilitation all scale scores improved significantly (p < .001). Conclusions The German HeartQoL questionnaire is a valid and reliable HRQL instrument with these data supporting its potential use in clinical practice and research to assess and compare HRQL in German-speaking patients with ischemic heart disease. The shortness of the tool may prove to be helpful particularly in clinical practice.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients

Huber

Oldridge

Benzer³

et al. 2019

Qual Life Res

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“…CHD patients were proven by clinic, electrocardiogram, and selective coronary arteriography according to the diagnostic criteria for CHD [ 22 , 23 ] and the standard questionnaire [ 24 ], and the patients aged more than 18 years.…”

Section: Methodsmentioning

confidence: 99%

Antarctic Krill Oil Attenuates Oxidative Stress via the KEAP1‐NRF2 Signaling in Patients with Coronary Heart Disease

Cui

Jiang

Huang

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Background. Antarctic krill oil (AKO) has strong antioxidant activities and is effective for alleviating coronary heart disease (CHD). Kelch-like ECH-associated protein 1-NF-E2-related factor 2 (KEAP1-NRF2) axis is a crucial antioxidant signaling pathway. Thus, AKO may exert its antioxidant effects on CHD patients via KEAP1-NRF2 signaling. Methods. AKO fatty acid (FA) profiles were analyzed by using gas chromatography (GC). One hundred CHD patients were divided into the intervention (IG, AKO) and control (CG, placebo) groups. Before and after 1, 2, and 3 months of intervention, we measured serum levels of reactive oxygen species (ROS), 8-hydroxy-2-deoxyguanosine (8-OHdG), nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH), and glutathione peroxidase (GPx), and KEAP1 and NRF2 levels in peripheral blood leukocytes (PBLs). Serum FAs were measured by GC at baseline and after 3-month intervention. Results. AKO contains rich eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which is more than 27% of total FA. The levels of EPA and DHA, KEAP1, and NRF2 in the IG group were higher than those in the CG group ( p < 0.05 ). Serum levels of ROS, 8-OHdG, NO, and MDA in the IG group were lower than those in the CG group, whereas the levels of SOD, GSH, and GPx in the IG group were higher than those in the CG group ( p < 0.05 ). Serum levels of saturated fatty acids (UFA) in the IG group were higher than those in the CG group, whereas reverse results were obtained for the levels of saturated fatty acids (SFA). Serum levels of EPA and DHA had a strong negative relationship with the level of ROS, whereas the ROS level had a strong negative relationship with the levels of KEAP1-NRF2. Conclusion. AKO increases antioxidant capacities of CHD patients via the KEAP1-NRF2 signaling in the PBL.

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Power walking based outpatient cardiac rehabilitation in patients with post‐coronary angioplasty: Randomized control trial

Muthukrishnan

Malik

Gopal

et al. 2021

Physiotherapy Res Intl

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Purpose The purpose of this trial was to compare the effectiveness of standardized outpatient cardiac rehabilitation combined with treadmill power walking versus standardized outpatient cardiac rehabilitation alone on health‐related quality of life (HQoL), functional exercise capacity (FEC), left ventricular ejection fraction (LVEF) and metabolic equivalent of tasks (METs) in patients who went post coronary angioplasty (CA). Further this study evaluated the association between average numbers of steps taken with above clinical outcomes. Methods In a pragmatic sequential randomized clinical trial, 24 patients were randomized into two groups (n = 12) and participated in a standardized outpatient cardiac rehabilitation program (SOCRP) with treadmill power walking as an intervention group and SOCRP alone in control group. Scores obtained before and after 4 weeks of intervention, that is, after 12 treatment sessions were assessed using a HQoL questionnaire and 6‐min walk test (6 MWT). Average number of steps taken throughout the 4 weeks, METs and LVEF values were obtained by pedometer, exercise stress testing and echocardiogram respectively. Results Significant improvements were found in intergroup and intragroup comparison after 4 weeks of cardiac rehabilitation (p < 0.05). Scores of 6 MWT and LVEF significantly improved in the intervention group (p < 0.003) compared to the control group (p < 0.032). HQoL components that is, global and physical, MET values and average number of steps were significantly higher in the intervention group compared to the control group (p < 0.001). Conclusion SOCRP with power walking was more effective in improving HQoL, FEC, LVEF, METs and average numbers of steps than SOCRP alone although both interventions were significant after 4 weeks in patients underwent CA and completed cardiac rehabilitation program. Positive significant associations were found between the average number of steps taken with scores of METs and scores of global and physical domains of HQoL.

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Validation of the English Version of the HeartQoL Health-Related Quality of Life Questionnaire in Patients With Coronary Heart Disease

Abstract: The English HeartQoL health-related quality of life questionnaire is valid, reliable, and responsive in patients with angina and myocardial infarction allowing (1) assessment of baseline, (2) between-diagnosis comparisons, and (3) evaluation of change over time.

Cited by 16 publications

References 27 publications

Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients

Validation of the German HeartQoL: a short health-related quality of life questionnaire for cardiac patients

Antarctic Krill Oil Attenuates Oxidative Stress via the KEAP1‐NRF2 Signaling in Patients with Coronary Heart Disease

Power walking based outpatient cardiac rehabilitation in patients with post‐coronary angioplasty: Randomized control trial

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