Psychometric properties of MacNew Heart Disease Health-related Quality of Life Questionnaire: Brazilian version

Title. Psychometric properties of MacNew Heart Disease Health‐related Quality of Life Questionnaire: Brazilian version. Aim. This paper is a report of a study to test the psychometric properties of the Brazilian Version of the MacNew Heart Disease Health‐related Quality of Life Questionnaire. Background. Evidence of acceptable psychometric properties of the original MacNew questionnaire has been reported. However, the psychometric performance of the Brazilian version has not been extensively studied. Method. Between November 2004 and June 2005, 159 patients with myocardial infarction completed the Brazilian version of the instrument. Reliability was determined with Cronbach’s alpha coefficient; convergent validity with Pearson’s correlation between the Brazilian MacNew questionnaire and the SF‐36; and the ‘known‐group’ approach was used to test discriminant validity. Ceiling and floor effects and practicality were analyzed. Findings. It took an average of 8·9 minutes to complete the instrument. A ceiling effect was detected in the subscales and global scores, with no floor effect. Cronbach’s alpha coefficient ranged from 0·87 to 0·92. Scores on similar domains of the SF‐36 and the MacNew questionnaire were correlated (r = 0·66; 0·78 and 0·53 for the physical, emotional, and social domains). Correlation between the dissimilar SF‐36 mental health and MacNew physical domains was lower at 0·45; correlation between the dissimilar SF‐36 physical functioning and MacNew emotional domain was 0·64. Individuals without regional ventricular dysfunction or symptoms had statistically significantly higher scores than those with regional ventricular dysfunction or symptoms. Conclusion. The Brazilian version of the MacNew questionnaire has acceptable levels of validity, reliability and practicality. Further studies are advisable to confirm its divergent validity and to test its responsiveness.     

Psychometric testing of the Chinese Mandarin version of the Mental Health Inventory among Chinese patients with coronary heart disease in Mainland China

This study aimed to develop a Chinese Mandarin version of the Mental Health Inventory (CM:MHI). The English version MHI was translated into Chinese (simple Chinese character) using the forward‐backward translation method while establishing the semantic equivalence and content validity. A convenience sample of 204 coronary heart disease (CHD) patients was recruited to evaluate the internal consistency, concurrent validity and construct validity of the CM:MHI. Forty patients completed the CM:MHI to evaluate the test–retest reliability after 2 weeks. The CM:MHI demonstrated good semantic equivalent rate (92%) and satisfactory content validity index (0.91). The internal consistency was acceptable for total and all subscales with Cronbach's alpha greater than 0.70, with the exception of the subscale of Emotional Ties (Cronbach's alpha = 0.64). The test–retest reliability was also satisfactory with intraclass correlation coefficients higher than 0.75. The concurrent validity was acceptable with significantly strong correlations between the CM:MHI and the Chinese Mandarin versions of Short Form 36 Health survey and Hospital Anxiety and Depression Scale. Confirmatory factor analysis further supported the five‐factor structure of the CM:MHI. The CM:MHI demonstrated to be a valid and reliable measure for assessing psychological distress and well‐being in Chinese‐speaking CHD patients.     

Construct and criterion validity of the SF‐12 health questionnaire in patients with acute myocardial infarction and unstable angina

Background The aim of the study was to determine the construct and criterion validity of the 12‐item short‐form questionnaire (SF‐12) in coronary patients with either acute myocardial infarction or unstable angina in Spain. Method A total of 186 patients hospitalized with coronary heart disease have been studied. The construct validity has been analysed by means of the association between the SF‐12v.1 and sociodemographic and clinical variables; and the criterion validity was tested by the correlations between 36‐item short‐form question (SF‐36) and SF‐12 summary scores. The equivalence between both health questionnaires was examined by means of the proportion of variance in the SF‐36 physical and mental component summary (PCS‐36 and MCS‐36) scores explained by the 12 items adjusted by age and sex. Results The validation result was as expected: female patients and those with poor education level, worse mental health, unstable angina, cardiovascular risk factor and co‐morbidity obtained a lower score in the SF‐12. The correlations between SF‐36 and SF‐12 summary scores were high. The equivalence between the SF‐12 and SF‐36 was good, because the models explained 87% of the variation in PCS‐36 score and 93% of the variation in MCS‐36. Conclusion The SF‐12 is a valid tool in studies assessing health‐related quality of life in coronary patients. The use of the SF‐12 may be especially useful in patients where the clinical situation make difficult the application of the longer instrument.     

Health‐related quality of life and its promotion among multiple sclerosis patients in Finland

Heiskanen S, Vickrey B, Pietilä A‐M. International Journal of Nursing Practice 2011; 17 : 187–194 Health‐related quality of life and its promotion among multiple sclerosis patients in Finland The aim of this study was to measure the health‐related quality of life (HRQOL) of Finnish multiple sclerosis (MS) patients and importance and adequacy of existing psychosocial services as reported by MS patients. Data were collected with a structured questionnaire of 100 adults in Finland diagnosed with MS 2–4 years earlier. Response rate was 81%. The data were analysed using statistical analyses. Results show the need for psychosocial support related significant reduction in HRQOL at an early stage of MS. In addition, results indicated considerable gaps between MS patients' perceptions of the importance and perceived adequacy of support.     

Health‐related quality of life among adult patients with moderate and severe von Willebrand disease

Summary. Background: von Willebrand Disease (VWD) is the most frequent inherited bleeding disorder. It is unknown how this disorder affects quality of life. Objectives: This nationwide multicenter cross‐sectional study determined health‐related quality of life (HR‐QoL) in adult patients with moderate or severe VWD, and assessed whether bleeding severity and type of VWD are associated with HR‐QoL. Methods: HR‐QoL was assessed using the Short Form (SF)‐36, and bleeding severity was measured using the Bleeding Score (BS). Results: Five hundred and nine patients participated; 192 males and 317 females, median age and range 45 (16–87) and 47 (16–84) years, respectively. Compared with the general population, HR‐QoL in VWD patients was lower in the vitality domain (61 vs. 66 P < 0.001 for females, 67 vs. 72 P < 0.001 for males). Patients with the most severe bleeding phenotype (highest quartile BS, BS > 17) had a lower HR‐QoL in eight domains than patients with a less severe bleeding type (lowest quartile BS, BS < 7) in the univariate analysis. After adjustment for age, gender, co‐morbidity and employment/educational status, a more severe bleeding phenotype was associated with lower scores on the domains of physical functioning, role limitations due to physical functioning, bodily pain, general health, social functioning and physical component summary. Conclusions: HR‐QoL is lower in VWD patients compared with the general population. HR‐QoL is strongly associated with bleeding phenotype.     

Changes in hope and health‐related quality of life in couples following acute myocardial infarction: a quantitative longitudinal study

Scand J Caring Sci; 2013; 27; 295–302 Changes in hope and health‐related quality of life in couples following acute myocardial infarction: a quantitative longitudinal study Background: Acute myocardial infarction (AMI) is a life‐changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period. Aims: To compare self‐rated scores of hope and health‐related quality of life (HRQoL) 1, 7, 13 and 25 months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners. Design: Explorative and longitudinal study. Methods: In this nonrandomized study, Short Form 36 Health Questionnaire (SF‐36) and Herth Hope Index‐Swedish (HHI‐S) questionnaires were completed by thirteen post‐AMI patients and their partners. Data were collected on four occasions. Results: In general, hope as well as HRQoL scores increased over time. A 2 (groups) × 4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC‐index) for HHI‐S and SF‐36 revealed that scores between data collection points were not stable. Conclusion: Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI‐S nor SF‐36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation. Relevance to clinical practice: These results can be used in the training of nursing staff to enhance their understanding of the significance of a family‐centred approach after an AMI.     

Introduction and Validation of DoloTest®: A New Health‐Related Quality of Life Tool Used in Pain Patients

Purpose: The aim of the publication is to introduce DoloTest^® and to document the validation of DoloTest^®. DoloTest^® is a health‐related quality of life (HRQoL) tool for pain patients with low‐time burden involving the patient in interpretation of the test result by creating a graphic presentation of the test result in a DoloTest^® Profile and therefore, suitable use in clinical setting. Methods: Validation against SF‐36, 246 participants in four pain clinics. Main Outcome Measures: Face validity (domains) cognitive interviewing (time and patient's perception), factor analysis (factors and eigenvalues), construct validity (correlation coefficients), Reliability: Intern consistency (Cronbach's alpha), test–retest stability (correlation coefficients). Results: Face validation: the eight domains most important for assessment of the patients with persistent pain were selected. The factor analysis shows equal relevance and weighting of all domains. Construct validation against SF‐36? shows positive correlation within each domain; correlation coefficients were between 0.47 and 0.69. Reliability was tested with Cronbach's alpha and test–retest. Cronbach's alpha values were 0.615 to 0.715. Correlation coefficients for linear regressions of test and retest for the DoloTest^® and SF‐36 were all positive. Introduction and Validation of DoloTest^®: A new HRQoL tool used in pain patients.     

行经皮冠状动脉介入术急性心肌梗死患者生活质量及其影响因素

急性心肌梗死（acute myocardial infarction,AMI）是指在冠状动脉病变的基础上,发生冠状动脉血供急剧减少或中断,使相应的心肌严重而持久地急性缺血,导致心肌缺血性坏死。AMI是冠心病死亡的主要原因,特别是对伴有ST段抬高的AMI,应尽早、充分、持续地开通梗死相关血管,     

Health‐related quality of life among Danish patients 3 and 12 months after TIA or mild stroke

Scand J Caring Sci; 2010; 24; 211–218
Health‐related quality of life among Danish patients 3 and 12 months after TIA or mild stroke Aim: This paper aimed to describe health related quality of life three and 12 months after mild stroke or transient ischemic attack, TIA, to describe the perceived changes from pre to post stroke status and to examine sociodemographic determinants for health related quality of life. Methods: 105 patients with mild stroke or TIA delivered self reported data on health related quality of life using the Stroke Specific Quality of Life Scale Danish Version, SSQOL‐DK. The main outcome was perceived change in over all quality of life from pre to post stroke status. Non‐parametric tests were used to examine change over time and differences between groupings of gender, age and life conditions. Logistic regression was used to model the change of all over quality of life changed at 12 months compared to pre stroke status. Results: Fifty seven percent (57%) of the patients felt that their pre stroke status concerning quality of life was regained. Those that rated all over quality of life deteriorated 12 months post stroke were more often working (48.9% vs. 31.7%), fewer had a diagnosis of TIA (13.3% vs. 30%), functional level was lower and the consumption of antidepressive medication was more frequent. In the regression model male sex (OR 3.77), working outside home (OR 2.84) and less than 5.00 (maximum score) on the domains Mood and Work/productivity at three months were significant predictors for rating health related quality of life deteriorated after stroke. Conclusion: Rehabilitation efforts should include employment alternatives of a less demanding nature for male patients.     

Health‐related quality of life,anxiety and depression related to mammography screening in Norway

Aim and objectives. To measure health‐related quality of life, anxiety and depression ahead of mammography screening and to assess any differences in health‐related quality of life compared to reference population. Background. The study of health‐related quality of life among attendees prior to mammography screening has received little attention, and increased knowledge is needed to better understand the overall health benefits of participation. Design. A two‐group cross‐sectional comparative study was performed. Methods. The samples comprised 4,249 attendees to mammography screening and a comparison group of 943 women. We used the SF‐36 Health Survey to assess health‐related quality of life. Linear regression was used to study any differences between the groups with adjustment for age, level of education, occupation, having children and smoking status. Other normative data were also used. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Results. Attendees scored statistically significant higher on the SF‐36 than the comparison group but were in line with normative data. Attendees had anxiety mean 4 · 1 and depression mean 2 · 6. Conclusions. The majority of the attendees have a high health‐related quality of life, low anxiety and depression ahead of screening. Anxiety and depression were less than shown in normative data from Norway. Despite a high health‐related quality of life, low anxiety and depression among the majority, healthcare workers should pay special attention to the few women who are anxious and depressed, and have a lower health‐related quality of life. Omitted from mammography screening may be women who are unemployed, have lower socioeconomic status, are anxious and are depressed. Further research should be performed with non‐attendees and subgroups to improve the screening programme. Relevance to clinical practice. It is important to identify which patients have the greatest need for support and caring in an organised mammography screening and who may be overlooked.     

Psychometric validation of the Taiwan Chinese version of the 25‐Item National Eye Institute Visual Functioning Questionnaire

Objectives To evaluate the reliability and construct validity of a Taiwan Chinese version of the 25‐Item National Eye Institute Visual Functioning Questionnaire (NEI‐VFQ 25) in patients with visual impairment. Methods The NEI‐VFQ 25 was translated and adapted into the Taiwan Chinese version. In total, 222 patients responded to the questionnaire. To examine reliability, Cronbach's alpha for each subscale was used as an index of internal consistency. Test–retest reliability was evaluated with intraclass correlation coefficients. Regarding construct validity, both convergent and discriminant validities were calculated by means of multi‐trait analysis. Clinical validity was examined by correlation of clinical measurements and subscale scores and known‐groups comparison. Finally, correlation between different subscales was examined to evaluate hypothetical relationship between subscales. Results Five patient groups were studied, each including participants with a single cause of visual impairment. Group 1 consisted of 53 cataract patients; group 2 included 51 subjects with glaucoma; group 3 included 36 subjects with age‐related macular degeneration (ARMD); and group 4 included 48 subjects with diabetic retinopathy. Thirty‐four individuals with uncorrected refractive error comprised the control group. NEI‐VFQ scores (mean ± SD) for the cataract, glaucoma, ARMD, diabetic retinopathy and control groups were: 73.5 ± 17.1, 69.2 ± 20.4, 62.3 ± 23.7, 63.7 ± 20.8 and 80.7 ± 12.0, respectively. Item analysis revealed moderate data skewing. Cronbach's alpha coefficients of subscales ranged from 0.956 (mental health) to 0.964 (near activities). Intraclass correlation coefficients ranged from 0.41 (driving) to 0.846 (distance activities). All items passed the convergent and discriminant validity tests. Moderate correlations were detected between visual acuity and the ‘general vision’, ‘distance activities’ and ‘near activities’ subscales. Significant correlations were detected between visual field deficits and the vision associated subscales. Conclusion This study revealed that the Taiwan Chinese version of the NEI‐VFQ 25 is a valid and reliable instrument to measure vision‐related quality of life in patients with visual impairment.     

Validation of the Chinese version of the MacNew heart disease health-related quality of life questionnaire

Rationale Patient‐reported outcomes such as health‐related quality of life (HRQL) describe or characterize what patients have experienced as a result of their health care. However, treatment outcome comparisons among different pure or mixed populations of patients with myocardial infarction, angina or heart failure cannot be made using existing coronary heart disease (CHD)‐specific HRQL instruments. Aims and objectives The aim of this study was to evaluate the psychometric properties of the Chinese version of the MacNew in a cohort of Hong Kong patients diagnosed with CHD. Methods Chinese translations of a CHD‐specific HRQL instrument, the MacNew Heart Disease HRQL questionnaire (MacNew), the Short‐form 36 Health Survey and the Hospital Anxiety and Depression Scale were administered to 365 Chinese‐speaking patients with CHD at baseline and again 3 months later (n = 363). The Medical Outcomes Trust Scientific Advisory Committee criteria were used to examine the psychometric properties of the Chinese MacNew Heart Disease HRQL questionnaire. Results The results warrant recommending the use of the MacNew as an outcome measure to enhance treatment evaluation in Chinese patients with CHD and a diagnosis of myocardial infarction, angina or heart failure, substantiating previous psychometric data on the MacNew in a number of different studies in patients speaking seven different languages. Conclusion The MacNew questionnaire may have value as a core CHD questionnaire for treatment outcome comparisons among pure or mixed populations of patients with myocardial infarction, angina or heart failure.