Living With Heart Failure Questionnaire Research Articles

Interim Results of the BYHEART Observational Study: Exogenous Phosphocreatine Effect on the Quality of life of Patients with Chronic Heart Failure.

Aim Improvement of quality of life is one of the most important goals for the treatment of patients with chronic heart failure (CHF). This study searched for ways to increase the efficiency of CHF treatment based on parameters of quality of life in CHF patients during and after the treatment with exogenous phosphocreatine (EP).Material and methods The effect of a single course of EP treatment on quality of life of patients with functional class (FC) II-IV CHF with reduced or mid-range left ventricular ejection fraction was studied as a part of the all-Russia prospective observational study BYHEART. The presence of FC II-IV CHF and a left ventricular ejection fraction <50 % were confirmed by results of 6-min walk test (6MWT) and findings of echocardiography after stabilization of the background therapy.Results An interim data analysis showed that the course of EP treatment was associated with a significant improvement of quality-of-life indexes as determined by the Minnesota Living with Heart Failure Questionnaire (LHFQ) total score. These indexes significantly increased and remained at a satisfactory level for 6 mos. following completion of the treatment course. Also, the treatment significantly beneficially influenced the clinical condition of patients (heart failure severity scale), results of 6MWT, and the increase in left ventricular ejection fraction.Conclusion The conclusions based on results of the interim analysis should be confirmed by results of the completed study. Complete results are planned to be published in 2022.

Evaluation of the effect of continuous nursing in patients with chronic heart failure

Objective To explore the effect of continuous nursing in patients with chronic heart failure. Methods A total of 80 patients with chronic heart failure (NYHA Ⅱ-Ⅲ) in Department of Cardiology were randomly divided into experimental group (40 cases) and control group (40 cases). The patients in the experimental group were given continuous nursing for 6 months on the basis of routine treatment and nursing. The patients in the control group were treated with routine treatment and nursing. The self-management ability of heart failure patients was evaluated by self-management scale at discharge and 6 months after discharge, cardiac function was evaluated by 6-minute walking test, and quality of life was evaluated by Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results All 80 patients completed the study. The score of self-management ability in the experimental group was 69.51 ±4.89 after intervention, and that in the control group was 52.42 ±10.48. There was significant difference between the two groups (t value was -9.346, P< 0.05). The 6-minute walking test distance was (468.56 ±32.53) m in the experimental group and (372.95 ± 32.37) m after the intervention in the control group. There was significant difference between the two groups (t value was -13.177, P < 0.05). The MLHFQ score of the patients in the experimental group was 15.74 ± 4.66 after intervention, and that in the control group was 36.29 ± 11.67. There was significant difference between the two groups (t value was 10.343, P<0.05). Conclusion Continuous nursing intervention can significantly improve the self-management ability, cardiac function and quality of life of patients with chronic heart failure. Key words: Continuous nursing; Chronic heart failure; Self-management ability; Cardiac function; Quality of life

Effects of Pender health promotion model-based intervention plan in chronic heart failure patients

Objective To explore the effects of Pender health promotion model-based intervention plan in chronic heart failure patients. Methods From July 2018 to April 2019, this study selected 120 heart failure patients in Cardiovascular Medicine of a ClassⅢ Grade A general hospital in Harbin as subjects by convenience sampling. All of patients were divided into control group (n=60, from July 2018 to November 2018) and experimental group (n=60, from December 2018 to April 2019) according to admission time. Finally, a total of 52 patients completed the study in control group and 57 patients in experimental group. Control group carried out routine health education, while experimental group implemented the intervention based on Pender health promotion model. The intervention effects were evaluated with the Self-management Scale of Heart Failure Patients and Minnesota Living with Heart Failure Questionnaire (MLHFQ) . Results After intervention, the dimension scores of self-management of patients in experimental group were higher than those in control group with statistical differences (P 0.05) . Conclusions Pender health promotion model-based intervention plan can improve the self-management and quality of life among chronic heart failure patients which is worthy of popularization and application. Key words: Heart failure; Pender health promotion model; Self-management; Quality of life

Influence of extended nursing based on WeChat platform on sleep and quality of life of patients with chronic heart failure

Objective To explore the effects of extended nursing intervention based on WeChat platform on sleep and quality of life of chronic heart faliure(CHF) patients. Methods Totally 124 CHF patients were randomly divided into control group and experimental group.Control group accepted usual discharge nursing, while the experimental group accepted extended nursing based on WeChat platform for 3 months.In front of the hospital nursing intervention and intervention for 3 months after the Pittsburgh Sleep Quality Index scale (PSQI) and Minnesota Living with Heart Failure Questionnaire (MLWHFQ) Questionnaire survey was carried out on the patient. Results After 3 months of nursing intervention, the sleep quality and life quality of patients in the observation group were better than those in the control group, and the differences were statistically significant (P<0.05). Conclusions Extended nursing intervention based on WeChat platform can improve the sleep quality and life quality of patients, which is worthy of clinical promotion. Key words: WeChat platform; Chronic heart failure; Extended nursing

Effects of integrated nursing in heart failure patients with Vitacamphorae injection

Objective To explore the effects of integrated nursing in heart failure patients with Vitacamphorae injection. Methods From December 2016 to December 2017, we selected 160 heart failure patients with Vitacamphorae injection of Cardiovascular Department in Sino-Japanese Friendship Hospital of Jilin University as subjects by convenience sampling. All of the patients were divided into control group and experimental group with the random numbers, 80 cases in each group. Control group received routine nursing, while experimental group carried out integrated nursing. We compared the scores of European Heart Failure Self Care Behavior Scale (EHFSCB) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) between two groups before and after intervention. Results After intervention, the scores of EHFSCB and MLHFQ of experimental group were lower than those of control group with statistical differences (P<0.05) . Conclusions Application of integrated nursing in heart failure patients with Vitacamphorae injection can improve their self-care ability and quality of life. Key words: Heart failure; Integrated nursing; Vitacamphorae injection; Adverse reaction

Application of Information-Motivation-Behavioral skills model on the improvement of life quality for patients with chronic heart failure

Objective To explore the effects of applying Information-Motivation-Behavioral skills model (IMB) on the improvement of life quality for patients with chronic heart failure (CHF) . Methods Totally 90 patients with CHF were selected by convenient sampling and divided into two groups based on random number table with 45 cases in each group. The control group received routine nursing care, while the experiment group received the nursing invention guided by the IMB besides the routine nursing care. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate the CHF patients' improvment status of their life quality before and after intervention. Results Before intervention, there were not statistical differences between the experimental group (65.11±11.31) and control group (66.05±14.72) in terms of their life quality (P>0.05) . After intervention, the score from MLHFQ in the experiment group (50.99±14.56) was lower than the control group (58.57±12.95) with statistical significance (P<0.05) . Conclusions The application of IMB model can effectively improve life quality of CHF patients. Key words: Heart failure; Quality of life; Health education; Information-Motivation-Behavioral skills model

The application in patients with chronic heart failure based on the "Internet plus" three entities double track interactive continuity nursing

Objective To explore the application effect of Interactive continuing nursing intervention model with three subjects and two tracks, which is based on internet and applied to chronic heart failure patients. Methods During January 1 to December 30, 2017, 110 chronic heart failure patients, who were going to discharge from the Second People′s Hospital of Guangdong Province, were selected for this research. Participants were equally divided into control group and observation group with random number table with 55 cases each. Participants were adopted conventional medication and traditional care, while patients in control group were given extra interactive continuing nursing intervention with three subjects and two tracks, which was relied on internet-based cardiovascular disease management platform. Comparing patients′ scores of life quality, self-care ability, anxiety and depression degree before intervention and that in 6 months after intervention with Minnesota Living with Heart Failure Questionnaire (MLHFQ), Self Care of Heart Failure Index (SCHFI), Self-rating Anxiety Scale(SAS) and Hamilton Depression Scale (HAMD) respectively. Moreover, 6 minute walk test was conducted, simultaneously, the incidence of cardiovascular events was calculated respectively before intervention, 3 months after intervention and 6 months after intervention. Results It showed that total scores of MLHFQ, SCHFI, SAS and HAMD for patients in observation group before intervention were (49.05 ± 4.39), (101.57 ± 21.04), (58.3 ± 5.2) and (40.1 ± 3.5) points respectively while that for patients in observation group after 6 months intervention were (43.03 ± 6.85), (123.17 ± 18.23), (42.3 ± 4.2) and (24.4 ± 4.3) points respectively. The difference was statistically significant (t=5.49-20.60, all P <0.01). In comparison, intervention effect of observation group was better than that of control group, although, the SAS scores of the control group were statistically significant. Furthermore, after intervention, the difference of MLHFQ, SCHFI, SAS and HAMD scores were statistically significant(t=3.48-17.79, all P <0.01). Moreover, 6 months after intervention, 6 minute walk test evaluation showed that there was statistical significance between observation group and control group (χ2=8.11, P <0.05). Besides, The death rate in observation group was lower than that in control group after 6 months intervention (χ2= 6.30, P <0.05). Meanwhile, readmission rate after 3 months and 6 months indicates that there was statistical significance between observation group and control group(χ2=5.25, 6.30, P <0.05). Conclusions Interactive nursing intervention model with three subjects and two tracks which based on internet is able to enhance chronic heart failure patients′ self-care ability and life quality, decrease the incidence of cardiovascular events and negative emotion of patients. Key words: Internet; Interactive nursing intervention model with three subjects and two tracks; Cardiac failure; Quality of life; Self-care ability; Depression

Correlations between self-management and quality of life in elderly patients with chronic heart failure in Xinjiang Uygur Autonomous Region

Objective To explore the correlations between self-management and quality of life in elderly patients with chronic heart failure (CHF) in Xinjiang Uygur Autonomous Region, so as to provide effective measures to improve quality of life of them. Methods A total of 750 elderly patients with CHF were selected as the research subjects by convenience sampling method from 5 regions of Xinjiang Uygur Autonomous Region from February to August 2015. General Data Questionnaire, Heart Failure Self-Management Scale and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were applied in the investigation to analyze the correlation between self-management and quality of life. Results A total of 750 questionnaires were distributed and 704 valid questionnaires were collected, with an effective recovery rate of 94.1%. The total score of self-management and MLHFQ in the 704 CHF patients was (47.6±11.1) and (57.1±18.5) respectively. Pearson correlation analysis showed that patients' self-management was positively correlated with quality of life (r=0.114, P<0.05) . Conclusions The overall level of self-management and quality of life in elderly patients with chronic heart failure in Xinjiang Region is mid-to-low. Nursing intervention can give full play to the initiative of self-management behavior in accordance with patients' cultural background, so as to improve their quality of life. Key words: Aged; Quality of life; Chronic heart failure; Self-management

Effects of exercise on activity tolerance and life quality after heart failure for patients with a preserved ejection fraction

Objective To observe the effect of individualized exercise programs on the activity tolerance and life quality of heart failure patients with a preserved ejection fraction. Methods Heart failure patients with a preserved left ventricular ejection fraction (LVEF) were randomized to an exercise training group (n=55) or a control group (n=53). Both groups were given optimized heart failure drug therapy, while the exercise training group was additionally provided with individualized exercise training. The LVEFs, 6-minute walking distances (6MWDs), Minnesota living with heart failure questionnaire (MLHFQ) scores and adverse events were noted before the experiment and after 12 months of the intervention. Results After one year, no significant differences were found in the groups′ average LVEFs or in the incidence of adverse events, while the average 6MWD and the average MLHFQ score of the exercise training group were significantly better than those of the control group. The average MLHFQ score decrease (7.8 points) was statistically and practically significant. Conclusion Individualized exercise training can significantly improve the activity tolerance and quality of life of patients with a preserved ejection fraction. It is safe, but the impacts on the ejection fraction are small. Key words: Exercise; Heart failure; Activity tolerance; Quality of life

Effects of dietary approaches to stop hypertension on the quality of life and re-hospitalization rate in patients with chronic heart failure

Objective To explore the effects of dietary approaches to stop hypertension (DASH) on the quality of life and re-hospitalization rate in patients with chronic heart failure (CHF) . Methods A total of 163 patients with CHF receiving standard medical therapy in the Cardiology Department of the First Affiliated Hospital of Zhengzhou University from February to September 2014 were selected and divided into experimental group (n=85) and control group (n=78) randomly. Low salt, low fat diet was applied in the control group, while DASH was adopted in the experimental group. Patients' body mess index (BMI) , blood pressure, blood glucose, blood lipid, ejection fraction, cardiac function, the score of Minnesota Living with Heart Failure Questionnaire (MLHFQ) and re-hospitalization rate were compared before and after intervention. Results There were no statistical differences in BMI, blood pressure, blood glucose, blood lipid, cardiac function and the score of MLHFQ before intervention (P>0.05) . Patients' BMI, systolic pressure, cholesterol and triglyceride of the experimental group paitents were all lower than those of the control group 12 months after intervention, with statistical significance (P<0.05) . 12 months after intervention, patients' quality of life of the experimental group was higher than that of the control group (P<0.05) , and the re-hospitalization rate was lower than that of the control group (P<0.05) . Conclusions DASH can improve the quality of life in patients with CHF, reduce readmission rate, thus improving the prognosis of heart failure. Key words: Quality of life; Chronic heart failure; DASH diet; Re-hospitalization rate

Effects of type D personality and related psychosocial factors on quality of life in patients with chronic heart failure

Objective To explore the effects of type D personality and related psychosocial factors on quality of life in patients with chronic heart failure(CHF). Methods According to the type D personality scale(DS14), 150 patients with CHF were divided into the type D personality group and the non-type D personality group.All patients were investigated with the general healthy questionnaire, minnesota living with heart failure questionnaire(MLHFQ), Zung’s self-rating anxiety scale(SAS), Zung’s self-rating depression scale(SDS) and Social support rating scale(SSRS) before receiving treatment. Results (1)The scores of SAS, SDS in the type D personality group were higher than those in the non-type D personality group(52.16±8.86 vs 43.56±7.33, 56.82±10.29 vs 46.59±10.07, separately)(P<0.01). The score of SSRS in the type D personality group was lower than that in the non-type D personality group(34.00±7.18 vs 41.57±7.61, P<0.01). The type D personality, negative affectivity(NA) and social inhibition(SI) were positively correlated with anxiety and depression(r=0.452, 0.521, 0.230; 0.458, 0.477, 0.296, separately)(P<0.01), and the type D personality, NA and SI were negatively correlated with social support level(r=-0.336, -0.271, 0.316, P<0.01). (2)The score of MLHFQ in the type D personality group was significantly higher than that in the non-type D personality group(58.61±17.12 vs 36.67±17.63, P<0.01). (3)Multiple stepwise regression analysis showed that type D personality, anxiety, depression, social support level and NYHA class entered the quality of life regression equation(β=-9.074, 0.418, 0.512, -0.519, 6.584, P<0.05). Conclusion The type D personality of CHF is closely related to anxiety, depression and social support level, and type D personality and related psychosocial factors affect the quality of life of CHF. Key words: Type D personality; Heart failure; Quality of life; Dysthymic disorder; Social support

Effect of nursing intervention on the quality of life of patients with heart failure based on the ;transtheoretical model

Objective To evaluate the effect of nursing intervention on the quality of life of patients with heart failure based on the transtheoretical model （ TTM）.Methods Totals of 100 heart failure patients were divided into the control group and the intervention group , 50 cases each .The control group was treated with conventional health education .The intervention group was treated with the nursing intervention based on TTM . We evaluated the quality of life in the time of before intervention , 1 month and 3 months after the intervention , respectively , by the Minnesota living with heart failure questionnaire （ MLHFQ） , and compared the differences . Results 1 month and 3 months after discharge , 2 cases were died and 5 cases were lost during the follow-up in＆amp;nbsp;the intervention group , and 43 cases finished the investigation .3 cases were died and 7 cases were lost during the follow-up in the control group , and 40 cases finished the investigation .Before the intervention , 1 month and 3 months after the intervention, the total score of MLHFQ were （40.14 ±17.59）, （59.98 ±17.44）, （52.28 ±16.46） in the intervention group, and （38.45 ±16.00）, （45.25 ±14.80）, （41.30 ±14.40） in the control group .Before the intervention , there was no statistically difference between the two groups （ P〈0.05）.After the intervention for 1month and 3 months, the differences were significant （ t =3.29, 3.22, respectively;P〈0.05）.Conclusions Comparing with the conventional healthy education , the method based on TTM is one of the most effective ways , which can improve the quality of life of patients with heart failure . Thus, it is worthy of getting widely promoted in hospital . Key words: Heart failure; Quality of life; Transtheoretical model

DAILY-BASED SELF-MANAGEMENT FOR NON-HOSPITALISED HEART FAILURE PATIENTS IMPROVE PROGNOSIS

ObjectivesOur study focused on the method of monitoring, and integrated a variety methods of follow-up. We expected to establish a new management model which relies on patients themselves, that is...

Comparison of cardiac and pulmonary-specific quality-of-life measures in pulmonary arterial hypertension

Studies systematically comparing the performance of health-related quality-of-life (HRQoL) instruments in pulmonary arterial hypertension (PAH) are lacking. We sought to address this by comparing cardiac and respiratory-specific measures of HRQoL in PAH. We prospectively assessed HRQoL in 128 patients with catheterisation-confirmed PAH at baseline and at 6, 12 and post-24 month follow-up visits. Cardiac-specific HRQoL was assessed using the Minnesota Living with Heart Failure Questionnaire (LHFQ); respiratory-specific HRQoL was assessed using the Airways Questionnaire 20 (AQ20); and general health status was assessed using the 36-item Short Form physical component summary (SF-36 PCS). The LHFQ and AQ20 were highly intercorrelated. Both demonstrated strong internal consistency and converged with the SF-36 PCS. Both discriminated patients based on World Health Organization (WHO) functional class, 6-min walking distance (6MWD) and Borg dyspnoea index (BDI), with the exception of a potential floor effect associated with low 6MWD. The LHFQ was more responsive than the AQ20 to changes over time in WHO functional class, 6MWD and BDI. In multivariate analyses, the LHFQ and AQ20 were each longitudinal predictors of general health status, independent of functional class, 6MWD and BDI. In conclusion, both cardiac-specific and respiratory-specific measures appropriately assess HRQoL in most patients with PAH. Overall, the LHFQ demonstrates stronger performance characteristics than the AQ20.

Evaluation of the Health Utilities Index Mark-3 in Heart Failure

Background The purpose of this study was to evaluate the reliability, validity, and responsiveness to change of the Health Utilities Index Mark-3 (HUI-3) in heart failure (HF) for use in cost-effectiveness studies. Methods and Results Two hundred eleven patients with HF recruited from outpatient clinics were enrolled; 165 completed the 26-week study. Patients completed 4 health-related quality of life questionnaires (baseline and 4, 8, and 26 weeks), including the HUI-3, the Medical Outcomes Study Short-form 12 (SF-12), the Minnesota Living with Heart Failure Questionnaire (LHFQ), and the Chronic Heart Failure Questionnaire (CHQ). The HUI-3 indicated moderate or fair health-related quality of life overall; the attributes most impaired were pain, ambulation, cognition, and emotion. Internal consistency reliability (Cronbach’s alpha = 0.51) was low and test-retest reliability (intraclass correlation coefficient = 0.68) was adequate. The HUI-3 total score was significantly associated with the SF-12, LHFQ, and CHQ total scores. It discriminated among patients with varying New York Heart Association class ( P < .001) and varying perceived health ( P < .001). The HUI-3 was less responsive to perceived change in health condition than the LHFQ or the CHQ. Conclusions The HUI-3 demonstrated satisfactory reliability and validity in this sample supporting its use in cost-effectiveness studies.

The translating,editing and testing of the Minnesota living With heart failure questionnaire of Chinese version

Objective To edit Chinese version of the Minnesota living with heart failure questionnaire (MLHFQ) and to estimate its reliability and validity.Metheds Translated and edited the Chinese version of MLHFQ according to the standard procedures,and tested 83 inpatients which were recruited from three polyclinics of Beijing district in China.Results Cronbach's alpha consistency was>0.80 for the three MLHFQ scores.Reproducibility ranged from 0.48 to 0.84 for items of weighted kappa coefficient and from 0.88 to 0.94 for three do-mains of Spearman's correlation coefficient.MLHFQ scores varied significantly with NYHA functional class(P<0.05),and there were intermediate-to-high correlations with the assumed corresponding SF-36 domains(-0.73 to -0.59).Factor analysis revealed three-factor structure explained 49.34% of the total variance.The MLHFQ scores before and after the treatment combined TCM and western medicine were significant (physical domain (26.15±7.15,17.63±8.50),emotional domain (8.96±5.73,6.8l±5.31),overall score(56.38±16.88,39.77±15.69) all P<0.01).Conclusions The Chinese version of MLHFQ is translated and edited according to the standard procedures.Its reliability and validity is good,and could be used as a clinical outcome measurement. Key words: MLHFQ; Chinese version; Reliability; Validity

Optimização da programação da terapêutica de ressincronização cardíaca por ecocardiograma: avaliação do impacto sobre a capacidade funcional

Background: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with severe heart failure and left bundle branch block, left ventricular (LV) dilatation and severely compromised LV systolic function. Since 25-35% of those patients conventionally treated with CRT do not improve, new strategies for CRT optimization should been investigated. Objectives: To evaluate the impact of the echoguided CRT reprogramming in patients chronically treated with biventricular (BiV) pacemaker and under stable pharmacological therapeutic. Methods: A convenient sample of clinically stable patients treated with BiV pacemaker for at least 12 months was submitted to echo-guided CRT reprogramming. Maximum and minimum atrioventricular (AV) delay limits to test were identified by pulsed-wave Doppler evaluation of transmitral flow, under progressive 10 ms increments, and the optimal AV delay was identified by the greatest velocity-time integral (VTI) at LV outflow tract (LVOT). The best ventricular stimulation pattern (LV-only, simultaneous BiV and sequential BiV pacing) and optimal VV delay were also determined by the highest LVOT VTI, using progressive 20 ms increments (from -60ms to +60ms). New York Heart Association (NYHA) functional class, NTproBNP, Quality of life score assessed by the Minnesota Living with Heart Failure Questionnaire (LHFQ), 6-min walk test, LV ejection fraction, LV stroke volume and cardiac output were assessed at the initial evaluation and 1 and 3 months after CRT reprogramming. During the investigation period no change in the pharmacological therapeutic was allowed. Results: 10 patients were studied (7 men, 63±8 years old), with an ejection fraction of 29±12%. After CRT reprogramming, none of the patients worsened. NYHA functional class (p=0,039) and LHFQ score (p=0,011) significantly improved in the first month after CRT optimization and remained stable thereafter. The systolic volume (p=0,025) and cardiac output (p=0,025) also significantly improved. Nonetheless, NT-proBNP (p=0,066) and distance in 6-min walking test (p=0,678) did not significantly improved. Conclusion: Although the reduced number of patients evaluated demands caution in extracting conclusions, these results suggest that echo-guided CRT reprogramming can induce additional clinical improvements (particularly in quality of life parameters), even in those patients that were considered “responders” to CRT.

Impact of Chronic Heart Failure on Elderly Persons' Daily Life: A Validation Study

Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons. To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population. The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used. A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbach's alpha for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%). The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.

Testing the Psychometric Properties of the Minnesota Living With Heart Failure Questionnaire

Health-related quality of life (HRQOL) is an important outcome in patients with heart failure. One of the most commonly used instruments to measure HRQOL in this population is the Minnesota Living With Heart Failure Questionnaire (LHFQ). Although the psychometric properties of the LHFQ have been tested, the results do not definitively support the psychometric soundness of the instrument. To examine the psychometric properties of the LHFQ. Data from 638 patients with heart failure were used to assess the reliability, homogeneity, representativeness, discriminative ability, and construct validity of the LHFQ before and after deletion of 5 items that showed lack of representativeness and contributed to inadequate factor structure. Cronbach's alphas for the LHFQ Total and subscales were greater than .80. Interitem correlation coefficients in 17 of the 21 items, item-total correlation coefficients in 20 items, and discriminative ability in all items were acceptable. The total and both subscales of the LHFQ differentiated New York Heart Association functional groups. The Physical subscale was moderately related to the physical measures (the Specific Activity Scale and symptom status), whereas the emotional subscale was weakly related to the measures. The results of item p level testing and factor analysis demonstrated that 7 items were consistently problematic and 5 items were recommended to be deleted. The results of the reliability, homogeneity, and construct validity after deletion of these items demonstrated that the psychometric properties of the LHFQ were improved as a result. The initial results provided additional support for the reliability and substantial evidence for the validity of the LHFQ. However, the results of item and factor analyses did not fully support the psychometric soundness of several items. The psychometric properties of the LHFQ after deleting these items were improved. These results could provide researchers and clinicians a more useful measure of HRQOL.

Activity questionnaires; a useful tool in accessing heart failure patients

Aim The aim of the study was to correlate the score derived from Specific Activity Questionnaire (SAQ), Left Ventricular Dysfunction 36 (LVD 36) and the Minnesota Living with Heart Failure Questionnaire (LIhFE) with peak oxygen consumption measured during maximal treadmill exercise spirometry in patients with heart failure. Methods We prospectively studied 106 patients, average age 47 ± 15.5 (mean ± SD), with symptomatic heart failure. All were asked to answer the questions of the above mentioned questionnaires. Subsequently patients underwent treadmill exercise spirometry to measure peak oxygen consumption (VO 2 peak ml/kg/min) using the Dargie protocol and to derive functional class according to the Weber classification system. Results SAQ had a very high performance in classifying patients with a VO 2 peak < 20 ml/kg/min and those with a VO 2 peak < 14 ml/kg/min. The correlation between VO 2 peak achieved and the METs corresponding to the score derived from SAQ according to the given answers was r = 0.77 ( p < 0.01). The correlation between VO 2 peak achieved and the score from LVD 36 was r = −0.74 ( p < 0.01). The correlation between VO 2 peak achieved and the score from LIhFE was r = −0.71 ( p < 0.01). Conclusion The Specific Activity Questionnaire, the Left Ventricular Dysfunction and the Minnesota Living with Heart Failure Questionnaire were used to predict aerobic capacity and all correlated significantly with peak VO 2 achieved from exercise spirometry. The above questionnaires represent a useful method to access heart failure patients and are valuable for those unable to undergo a treadmill test.