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Abstract
The psychometric properties of the core disease-specific 14-item Italian HeartQoL health-related quality of life questionnaire have been evaluated in this study. The Italian version of the HeartQoL, the MacNew questionnaire, and the Hospital Anxiety and Depression Scale were completed by 472 patients (angina, N = 183; myocardial infarction, N = 167; or ischemic heart failure, N = 122) who were recruited in five Italian centers (Florence, Veruno, Turin, Udine, and Naples) between 2015 and 2017. Patients with myocardial infarction reported significantly higher HeartQoL scores than patients with angina or ischemic heart failure. Floor and ceiling effects were always minor on the HeartQoL global scale and physical subscale with moderate ceiling effects on the emotional subscale in the total group and in patients with myocardial infarction. The bifactorial structure of the original HeartQoL questionnaire was confirmed with strong physical, emotional, and global scale H coefficients (> 0.50). The HeartQoL scales demonstrated optimal internal consistency (Cronbach’s alpha > 0.84). Convergent and divergent validity were confirmed. Discriminative validity was not confirmed for age, largely confirmed for sex, and fully confirmed for anxiety, depression, and distress. The Italian HeartQoL questionnaire demonstrated adequate key psychometric attributes of internal consistency reliability and validity in Italian-speaking patients with ischemic heart disease.
Highlights
Critical steps in improving the quality of health care include evidence-based, patient-centered, and systems-oriented care [1]
The eligibility criteria were extracted from the original cross-sectional survey phase of the HeartQoL Project [12] and included: (a) currently being treated for angina pectoris (AP) [20] with an objective measure of ischemic heart disease (IHD); or (b) had experienced a documented myocardial infarction (MI) between one to six months previously; or (c) currently being treated for ischemic heart failure (IHF) with evidence of left ventricular dysfunction and an objective measure of IHD
These psychometric properties are consistent with the original validation study in patients with AP, MI or IHF, [13] the English HeartQoL version based on patients with AP or MI in the USA, [30] the German HeartQoL version in patients with AP, MI or IHF, [14] The Iranian HeartQoL version in patients with MI, [31] the EuroAspire IV study in chronic coronary syndrome patients [32] and with validation studies in patients with atrial fibrillation, [16] implantable cardioverter defibrillator recipients [17] or following valve surgery [18]
Summary
Critical steps in improving the quality of health care include evidence-based, patient-centered, and systems-oriented care [1] Incorporating this approach has changed medicine in all areas, from everyday practice, where shared decision making has become essential and recommended by guidelines [2] to clinical trials where patients are involved in Steering Committees [3]. Internal and Emergency Medicine typically is evaluated with patient-reported outcome questionnaires through which patients may express feelings about their health condition without adulteration or interpretation by clinicians [6]. Both generic and disease-specific patient-reported outcome questionnaires can be used to evaluate and compare the health status. There is a need for core disease-specific questionnaires which permit between-diagnosis comparisons within a given disease with a single questionnaire, for example, the MacNew [11] and, more recently, the HeartQoL [12, 13] in patients with ischemic heart disease (IHD)
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