Abstract 9812: The Symptom Status Questionnaire is a Reliable and Valid Symptom Instrument for Patients With Heart Failure

Abstract

Background and Purpose: Patients with heart failure (HF) experience physical symptoms, poor health-related quality of life (HRQOL), and high rates of hospitalization. Physical symptoms are associated with HRQOL and are major antecedents of hospitalization. However, reliable and valid physical symptom instruments have not been established for use in patients with HF. This study, therefore, examined the psychometric properties of the Symptom Status Questionnaire-Heart Failure (SSQ-HF) in patients with HF. Method: Data on symptoms were collected from 249 Patients (age 61, 67% male, 45% in New York Heart Association functional class III/IV). Internal consistency reliability was assessed using Cronbach’s alpha. Item homogeneity was assessed using item-total and inter-item correlations. Construct validity was assessed using factor analysis and testing hypotheses on known relationships. The SSQ-HF is a 7-item questionnaire asking about the presence, frequency, severity, and distress of common HF symptoms during the past 4 weeks. Data on depressive symptoms (using the Beck Depression Inventory II), HRQOL (using the Minnesota Living with Heart Failure Questionnaire), and event-free survival were collected to test known relationships. Event-free survival was defined as the time from enrollment to the first event of all-cause hospitalization, emergency department visit, or death. Results: Cronbach’s alpha was .80, supporting internal consistency reliability. Item-total correlation coefficients and inter-item correlation coefficients were acceptable. One factor was extracted, and all the items demonstrated moderate to strong loadings (> .40), indicating acceptable construct validity. As hypothesized, more severe symptoms were associated with more depressive symptoms, poorer HRQOL, and shorter event-free survival, providing further evidence for the construct validity of the SSQ-HF. Conclusions: The findings of this study support the reliability and validity of the SSQ-HF. Clinicians and researchers can use this instrument to assess physical symptoms in patients with HF.