Comparative Evaluation of Health-Related Quality of Life Questionnaires in Patients With Heart Failure Undergoing Cardiac Rehabilitation: A Psychometric Study

Objective: To compare the psychometric properties of 2 heart failure (HF)-specific quality of life questionnaires and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) in patients with HF. Design: A methodological study based on 3-month follow-up data for evaluating psychometric properties of health-related quality of life (HRQOL) questionnaires. Setting: Cardiac rehabilitation center at a cardiovascular research institute. Participants: Eligible patients with HF (N=60). Interventions: Exercise training in cardiac rehabilitation. Main Outcome Measures: The SF-36, the MacNew Heart Disease questionnaire, and the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and New York Heart Association functional classification. Results: Items from the MLHFQ and the MacNew questionnaire had acceptable correlations (r>.30, P<.05). Internal consistency and test-retest reliability were adequate at >0.7 for the MLHFQ subscales. Correlations for the MLHFQ and the MacNew with SF-36 similar items ranged from .28 to .50 and from .26 to .60, respectively. Similar scales from the MacNew and MLHFQ showed strong correlations at baseline and follow-up, supporting the convergent validity. Improvement in HRQOL was significant for all MLHFQ subscales (P<.001) and the MacNew emotional (P<.05) and social (P<.001) subscales. The MLHFQ demonstrated the most responsiveness to changes and discriminated disease severity the best. The follow-up scores for all MLHFQ and 2 MacNew subscales were significantly greater in patients who improved compared with those who showed no change or deteriorated. Conclusions: The MLHFQ was more responsive to changes of HRQOL than the MacNew questionnaire over time in patients with HF. The MacNew questionnaire was more responsive to changes than the SF-36. (C) 2016 by the American Congress of Rehabilitation Medicine