Abstract
BackgroundQuality of life (QOL) for patients with coronary heart disease (CHD) is now concerned worldwide with the specific instruments being seldom and no one developed by the modular approach.ObjectivesThis paper is aimed to develop the CHD scale of the system of Quality of Life Instruments for Chronic Diseases (QLICD-CHD) by the modular approach and validate it by both classical test theory and Generalizability Theory.MethodsThe QLICD-CHD was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pre-testing and quantitative statistical procedures. 146 inpatients with CHD were used to provide the data measuring QOL three times before and after treatments. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation analysis, factor analyses, multi-trait scaling analysis, t-tests and also G studies and D studies of Genralizability Theory analysis.ResultsMulti-trait scaling analysis, correlation and factor analyses confirmed good construct validity and criterion-related validity when using SF-36 as a criterion. The internal consistency α and test-retest reliability coefficients (Pearson r and Intra-class correlations ICC) for the overall instrument and all domains were higher than 0.70 and 0.80 respectively; The overall and all domains except for social domain had statistically significant changes after treatments with moderate effect size SRM (standardized response mea) ranging from 0.32 to 0.67. G-coefficients and index of dependability (Ф coefficients) confirmed the reliability of the scale further with more exact variance components.ConclusionsThe QLICD-CHD has good validity, reliability, and moderate responsiveness and some highlights, and can be used as the quality of life instrument for patients with CHD. However, in order to obtain better reliability, the numbers of items for social domain should be increased or the items’ quality, not quantity, should be improved.
Highlights
Quality of life (QOL) for patients with coronary heart disease (CHD) is concerned worldwide with the specific instruments being seldom and no one developed by the modular approach
An epidemiological study showed that there were about 1,300,000 new cases of CHD diagnosed in China each year [7], and the incidence of CHD is steadily increasing in China [8]
It was estimated that three-fourths of global deaths and 82% of the total disability adjusted life years lost due to CHD occurred in middle-income countries [9]
Summary
Quality of life (QOL) for patients with coronary heart disease (CHD) is concerned worldwide with the specific instruments being seldom and no one developed by the modular approach. Coronary heart disease (CHD) is worldwide the leading cause for morbidity and mortality in adults [1,2]. In the United States, CHD is the number 1 cause of death among American men and women, causes 1 of every 5 deaths, and accounted for an estimated $177 billion in direct and indirect costs in 2010 [4]. On the data from National Health and Nutrition Examination Survey 2005 to 2008, an estimated 16300 000 American adults have CHD, with the CHD prevalence for the total, men and women which larger than 20 years old being 7.0%, 8.3% and 6.1%, respectively in the United States [5]. It was estimated that three-fourths of global deaths and 82% of the total disability adjusted life years lost due to CHD occurred in middle-income countries [9]
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