MacNew Heart Disease Health-related Quality Research Articles

The Effect of Dietary Approaches to Stop Hypertension (DASH) Plan on Quality of Life in Hypertensive with Acute Coronary Syndrome Patients

Objective: The aim of the study was to evaluate the effect of Dietary Approaches to Stop Hypertension (DASH) on quality of life in hypertensive patients with acute coronary syndrome (ACS). Methods: This study was designed and conducted with 34 patients using a single-group and pre-test/post-test design in two public hospitals. Descriptive characteristics of the patients were obtained through a questionnaire. The questionnaire included socio-demographic characteristics, dietary habits, physical activity levels and quality of life using the MacNew Heart Disease Health-Related Quality of Life scale. The DASH diet plan was planned individually based on the daily energy requirement and explained to the patients. Patients were requested to achieve maximum adherence to the DASH diet plan for 12 weeks. Patients’ adherence to the DASH diet and quality of life were compared at the baseline and at study completion using SPSS 25.0 paired sample t-test. Results: Patients’ adherence to the DASH diet showed a statistically significant increase compared to the baseline (p

Assessment of patient-reported outcomes measures in heart failure: a systematic review.

Heart failure (HF) is a prevalent global disease, particularly impacting developed countries. With the world's aging population, HF's impact on the quantity and quality of life is expected to grow. This review aims to ascertain the frequency, characteristics, and properties of all patient-reported outcomes measures (PROMs) studied in HF patients. We searched Ovid/Medline and Web of Science for original articles about PROMs performed in adults with HF. Using pre-established quality criteria for measurement properties, an overall rating was assigned to evaluate and compare different instruments. The quality of evidence was assessed with the COSMIN risk of bias checklist. Of 4283 records identified, we reviewed 296 full-text documents and included 64 papers, involving 30,185 participants. Thirty different PROMs were identified, with 14 specifically designed for HF being the most commonly used. Minnesota Living with Heart Failure (MLHF) and Kansas City Cardiomyopathy Questionnaire (KCCQ) were evaluated 16 and 13 times, respectively, demonstrating good psychometric properties. The MacNew Heart Disease Health-Related Quality of Life Questionnaire, a common heart disease-specific instrument, exhibited negative performances across various psychometric measures. Evidence for generic instruments was scant and unremarkable and they proved to be less responsive in HF populations. MLHF and KCCQ emerged as the most commonly used and well-supported PROMs, with robust overall evidence. They are comprehensive and accurate instruments, particularly suitable for application in clinical practice and research. Future research should explore how computer-adapted instruments can enhance precision, reduce respondent burden, and improve communication between clinicians and patients, thereby promoting more efficient and patient-centered services.

Kinesiophobia and Associated Factors in Patients With Myocardial Infarction.

Kinesiophobia is a well-known barrier to positive clinical outcomes among patients with various diseases, but there remain few comprehensive studies of kinesiophobia among patients with myocardial infarction (MI). In this cross-sectional study, we investigated the presence of kinesiophobia and its relationship with clinical outcomes among 42 patients with MI who completed the Tampa Scale of Kinesiophobia Swedish Version for Heart (TSK-SV Heart) the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Six-Minute Walk Test (6MWT), the Hospital Anxiety and Depression Scale (HADS), the modified Medical Research Council (mMRC) Dyspnea Scale, the Charlson Comorbidity Index (CCI), and the MacNew Heart Disease Health-Related Quality of Life Questionnaire. The participants' mean TSK-SV Heart score was 39.24 (SD = 6.65), and 71.4% of these patients reported a high level of kinesiophobia. The TSK-SV Heart score demonstrated a strong correlation with the IPAQ-SF, 6MWT walking distance, and mMRC score (p < .001), and a moderate correlation with the HADS, CCI, and MacNew Heart Disease HRQoL (p < .05). Patients with a high level of kinesiophobia had lower IPAQ-SF, 6MWT walking distance, and HRQoL and higher mMRC, CCI, and HADS scores than patients with low levels of kinesiophobia (p < .05). Kinesiophobia was common and represented a considerable risk factor for physical-psychosocial dysfunctions in these patients with MI. To maintain functional independence and to increase physical activity level, clinicians should consider kinesiophobia from early to late-stage disease and should add a treatment focus that seeks to eliminate kinesiophobia in cardiac rehabilitation programs.

The effect of hospital-to-home transitional care using a digital messaging application on the health outcomes of patients undergoing CABG and their family caregivers: a randomized controlled trial study protocol.

Given the increasing trend of care transition from healthcare settings to patients' own home, patients and their family caregivers should take more responsibilities for care at own home. This study is going to investigate the effect of a transitional care program from hospital to own home using a digital messaging application on patients' undergoing coronary artery bypass graft (CABG) surgery and their family caregivers' health outcomes. A parallel randomized controlled trial study will be conducted in a hospital in a metropolis located in southwestern Iran. Sampling will be performed sequentially and the eligible dyad of patients and family caregivers will be randomly assigned to intervention and control groups. The intervention group will receive a transitional care program for 8 weeks using the WhatsApp on the mobile phone based on the person-centered care approach, but the control group will receive routine care for patient's transition. Data collection will be conducted at baseline, immediately after the intervention, and two months after the intervention using demographic questionnaire, Cardiac Self-Efficacy Scale (CSES), MacNew Heart Disease Health-Related Quality of Life questionnaire (MNHD-Q), Cardiac Symptom Scale (CSS), Morisky Medication Adherence Scale, and Caregiver Burden Scale (CBS). Descriptive and inferential statistics will be used for data analysis. The results of this study will allow evaluating the effectiveness of an innovative transitional care program to patients' own home using a digital messaging application. If the transitional program is shown feasible and effective it can be incorporated into existing care programs and stimulate further studies on the use of digital solutions for improving the continuity of care in own home.

The Ozaki Procedure: Standardized Protocol Adoption of a Complex Innovative Procedure

BackgroundThe Ozaki procedure using autologous pericardium is an interesting but complex alternative for aortic valve replacement. We present a standardized approach to minimize the learning curve and confirm reproducibility. MethodsAfter careful preparation, from May 2015 to February 2021, an Ozaki procedure was performed on 46 patients age 51 ± 14 years. Seven had unicuspid (15%), 29 bicuspid (63%), and 10 tricuspid (22%) aortic valves, and 2 patients had endocarditis. Endpoints were operative learning curves, perioperative outcomes, intermediate-term valve hemodynamics, reintervention, health-related quality of life (MacNew Heart Disease Health-Related Quality of Life questionnaire), and mortality. ResultsCardiopulmonary bypass and aortic clamp times decreased from 145 to 125 ​minutes and 120 to 100 ​minutes, respectively, over the first 20 cases, reflecting the learning curve. There was no major perioperative morbidity or mortality. Median postoperative stay was 6.9 days. Aortic regurgitation was mild or less in all but 2 patients who developed moderate aortic regurgitation. Mean aortic valve gradient was 7.9 mmHg postoperatively, 9.2 mmHg by 6 months, and constant thereafter. Left ventricular ejection fraction was 58% preoperatively, 60% at 6 months, and remained stable thereafter. One patient developed infective endocarditis 7 months postoperatively, failed medical management, and underwent valve replacement at 14 months. Two-year survival was 96%, with 1 noncardiac death at 16 months. Health-related quality of life in mental, physical, and emotional domains was better than matched norms, global 6.2 vs. 5.0 (p < 0.0001). ConclusionsUsing a well-prepared standardized approach, the Ozaki procedure is reproducible with a short learning curve, excellent hemodynamic performance, and good quality of life.

Effects of physical exercise on health-related quality of life in coronary heart disease patients. a systematic review and meta-analysis

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - HEARTY-BRAIN - Effects of Exercise on Brain in Patients with Coronary Heart Disease: The Heart-Brain Connection. Andalusian Plan for Research Development and Innovation (PAIDI). University of Granada. Funding: 116.000 €. PI: F. Ortega. 2021-2021. - VASCULACTIVE. Effects of exercise on brain vascularization in coronary heart disease patients. Spanish Ministry of Economy and Competitiveness (I+D+I RETOS). University of Granada. Funding: 121.000 €. PI: F. Ortega. 2021-2023. Background Coronary heart disease (CHD) is the most prevalent type of cardiovascular disease in the world, and a leading cause of mortality and morbidity. Previous research showed that patients with CHD have a decrease in health-related quality of life (HRQoL) during the course of the disease. Physical exercise may attenuate the decline in HRQoL observed in CHD patients. Purpose To determine the effect of exercise training interventions on HRQoL in CHD patients. Methods A systematic search of controlled trials (CTs) assessing the effects of exercise training on HRQoL in CHD patients was performed in Web of Science, PubMed, Scopus, EMBASE, Cochrane Register, SportDiscus, PsycINFO and Google Scholar from inception to 30 June 2022. A meta-analysis with fixed and random effects was performed on controlled trials (comparing at least one exercise group with one non-exercise group and including a global score of HRQoL assessments before and after the interventions. All statistical analyses were performed using R-Studio. Results A total of 26 CTs met all the eligibility criteria and were included in the review (25 randomized CTs and 1 non-randomized CTs). HRQoL was mostly assessed by the SF-36 instrument (11/26) and the MacNew Heart Disease Health-Related Quality of Life questionnaire (8/26). Six out of the 26 studies reported the total score of quality of life and were included in the meta-analysis, which resulted in 8 exercise interventions and 591 participants with a mean age of 61 years, and 33% was women. There was a small (effect size 0.20) borderline overall effect of exercise on HRQoL in CHD patients (95% confidence interval: fixed effect, 0.05–0.36; random effect, -0.06-0.46. The percentage of total variability attributed to between-study heterogeneity [I2] = 44%, P=0.09 (Figure 1). Conclusions Findings from this meta-analysis suggest that supervised exercise training may cause a modest improvement in HRQoL in CHD patients. Future studies should explore which type and loads of exercise lead to larger improvements.

Which high-intensity interval training program is more effective in patients with coronary artery disease?

The aim of the study is to examine high-intensity interval training (HIIT) programs and a moderate-intensity continuous training (MICT) program, which are frequently used in cardiac rehabilitation programs in terms of their effects on the functional capacity and quality of life of patients with coronary artery disease (CAD). The study included 20 patients with CAD (mean age, 60.95 ± 5.08 years) who had undergone revascularization surgery. The participants were randomized into HIIT-short, HIIT-long, and MICT groups. All the groups participated in a 24-session exercise-based cardiac rehabilitation program. The participants' exercise capacity was evaluated using the maximal exercise test and estimated VO2max values, functional capacity using the 6-min walk test (6MWT), and quality of life using the Short Form-36 survey and MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire. It was determined that the estimated VO2max values statistically significantly improved after treatment (P < 0.05), and both HIIT groups were superior to the MICT group (P < 0.05). Only the HIIT groups achieved the minimal clinically important difference in the 6MWT distance. After treatment, only the MICT group had a statistically significant improvement in quality of life. There was no statistically significant difference between the groups in relation to the improvement in the 6MWT distance and quality of life (P > 0.05). The results of our study showed that both HIIT programs were superior to MICT in improving the maximal exercise capacity of patients with CAD, and the three programs had a similar effect on quality of life.

Evaluation of quality of life, type D personality and emotional factors in patients undergoing angioplasty- A Prospective study

Background: Percutaneous coronary intervention (PCI) has been effective in increasing the longevity of patients with cardiovascular disease. Notwithstanding paucity of Indian studies on the psychological effects of PCI, there have been conflicting evidences with regard to improvement of quality of life in patients undergoing angioplasty. Aim: To evaluate change in the quality of life and emotional factors like depression, stress, and anxiety in patients undergoing angioplasty. Methods: This prospective longitudinal study was carried out at a tertiary care hospital and research centre in the western part of Maharashtra in a semi-urban location on 70 consecutive patients undergoing angioplasty from July 2019 to July 2021. Besides sociodemographic data patients were assessed with Type D Scale-14 (DS14), Depression Anxiety Stress Scale, and The MacNew heart disease health-related quality of life Questionnaire. After 15 days of the procedure, patients were re-evaluated with the same scales. Results: Mean age of our study population was 58.67 years of which 77.14% were men. The prevalence of Type D personality was 28.57%. There was a significant reduction in anxiety and stress scores and significant improvement in emotional and physical sub scales of Quality of life post angioplasty. On multiple regression analysis, anxiety and social inhibition emerged as predictors of depression. Conclusion: Angioplasty is associated with significant improvement in anxiety, stress, and emotional and physical subscales of Quality of life. Social inhibition, which is a component of Type D personality, anxiety, and loss of libido are significant predictors of depression in patients undergoing angioplasty.

Reliability and validity of the Korean version of the MacNew heart disease Health-related Quality of Life questionnaire

BackgroundMyocardial infarction and unstable angina are prevalent in Korea. The MacNew Heart Disease health-related quality of life questionnaire is a widely used patient-reported outcome measure for patients with heart disease in several countries. In this study, we tested the validity and reliability of the Korean version of the MacNew (K-MacNew).MethodsParticipants were 200 patients who had experienced unstable angina or myocardial infarction, and were recruited from a tertiary hospital in Korea. The K-MacNew was developed using forward–backward translation techniques. Construct validity (including discriminative validity), concurrent validity, and internal consistency reliability of the K-MacNew were assessed. Discriminative validity was assessed by examining the between-group differences in the K-MacNew scores according to functional capacity, anxiety, and depression levels. Concurrent validity was examined by correlating the K-MacNew dimensions with the physical and mental health domains of the 36-item Short Form Health Survey Instrument (SF-36).ResultsFactor analysis results of the K-MacNew demonstrated a three-factor structure (emotional, physical, and social) that explained 57.92% of the variance. Significant differences in the K-MacNew scores were observed according to patients’ functional capacity, anxiety, and depression levels. The SF-36 physical health domain score showed a moderate positive correlation with the physical dimension score of the K-MacNew (r = 0.517, P < 0.001), and the SF-36 mental health domain score showed a strong positive correlation with the emotional dimension of K-MacNew (r = 0.745, P < 0.001). The K-MacNew showed good internal consistency, with a Cronbach’s α of 0.947 for the global scale.ConclusionThe K-MacNew demonstrated good reliability and validity for use as a patient-reported outcome measure and is ready for the assessment of the health-related quality of life of patients with coronary artery disease in Korea. To establish the clinical validity of the K-MacNew, additional studies should be conducted to verify the validity and reliability of the K-MacNew in a number of participants, including those with various types of coronary artery disease.

Development of a preference-based heart disease-specific health state classification system using MacNew heart disease-related quality of life instrument.

The MacNew Heart Disease Health-Related Quality of Life Instrument (MacNew) is a validated, clinically sensitive, 27-item disease-specific questionnaire. This study aimed to develop a new heart disease-specific classification system for the MacNew amenable for use in health state valuation. Patients with heart disease attending outpatient clinics and inpatient wards in Brisbane, Australia, completed MacNew. The development of the new disease-specific classification system included three stages. First, a principal component analysis (PCA) established dimensionality. Second, Rasch analysis was used to select items for each dimension. Third, Rasch analysis was used to explore response-level reduction. In addition, clinician and patient judgement informed item selection. Participants included 685 patients (acute coronary 6%, stable coronary 41%, chronic heart failure 20%). The PCA identified 4 dimensions (restriction, emotion, perception of others, and symptoms). The restriction dimension was divided into physical and social dimensions. One item was selected from each to be included in the classification system. Three items from the emotional dimension and two symptom items were also selected. The final classification system had seven dimensions with four severity levels in each: physical restriction; excluded from doing things with other people; worn out or low in energy; frustrated, impatient or angry; unsure and lacking in self-confidence; shortness of breath; and chest pain. This study generated a brief heart disease-specific classification system, consisting of seven dimensions with four severity levels in each. The classification system is amenable to valuation to enable the generation of utility value sets to be developed for use in economic evaluation.

Mapping MacNew Heart Disease Quality of Life Questionnaire onto country-specific EQ-5D-5L utility scores: a comparison of traditional regression models with a machine learning technique.

This study aims to derive country-specific EQ-5D-5L health status utility (HSU) from the MacNew Heart Disease Health-related Quality of Life questionnaire (MacNew) using both traditional regression analyses, as well as a machine learning technique. Data were drawn from the Multi-Instrument Comparison (MIC) survey. The EQ-5D-5L was scored using 4 country-specific tariffs (United States, United Kingdom, Germany, and Canada). The traditional regression techniques, as well as a machine learning technique, deep neural network (DNN), were adopted to directly predict country-specific EQ-5D-5L HSUs (i.e. a direct mapping approach). An indirect response mapping was undertaken additionally. The optimal algorithm was identified based on three goodness-of-fit tests, namely, the mean absolute error (MAE), mean error (ME) and root mean square error (RMSE), with the first being the primary criteria. Internal validation was undertaken. Indirect response mapping and direct mapping (via betamix with MacNew items as the key predictors) were found to produce the optimal mapping algorithms with the lowest MAE when EQ-5D-5L were scored using three country-specific tariffs (United Kingdom, Canada, and Germany for the former and United Kingdom, United States, Canada and Germany for the latter approach). DNN approach generated the lowest MAE and RMSE when using the Germany-specific tariff. Among different approaches been explored, there is not a conclusive conclusion regarding the optimal method for developing mapping algorithms. A machine learning approach represents an alternative mapping approach that should be explored further. The reported algorithms from response mapping have the potential to be more widely used; however, the performance needs to be externally validated.

Impact of Training Based on Orem's Theory on Self-Care Agency and Quality of Life in Patients With Coronary Artery Disease.

ABSTRACTBackgroundCoronary artery disease (CAD) is a primary cause of death worldwide. CAD negatively affects individuals because it reduces their functional skills and self-care abilities and disrupts quality of life.PurposeThis study was designed to assess the impact of a training program based on Orem's self-care deficit nursing theory (SCDNT) on self-care abilities and quality of life in patients with CAD.MethodsThis study was conducted using a randomized, controlled, pretest/posttest experimental design. One hundred two patients with CAD were divided evenly into either the intervention or control group, with sample randomization based on gender, age, low-density lipoprotein cholesterol level, and Self-Care Agency Scale scores. For both groups, interviews were conducted in two sessions held, respectively, at the hospital and at home. Study data were collected using the patient information form, Self-Care Agency Scale, MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew), Quality of Life Questionnaire (15D), and training booklet.ResultsA highly significant difference was found between the two groups in terms of the average posttest scores on the Self-Care Agency Scale, MacNew, and 15D. For the intervention group, the posttest scores on the Self-Care Agency Scale, MacNew, and 15D were significantly higher than the pretest scores, whereas average pretest and posttest scores on these measures were similar for the control group.ConclusionsThe training program developed in this study based on Orem's SCDNT improved self-care agency as well as disease-specific and overall quality of life in patients with CAD. Nurses should pay attention to the CAD-related educational level of patients when teaching them how to live with their disease. Moreover, nurses should use Orem's SCDNT to strengthen the self-care agency of these patients to increase quality of life and the effectiveness of related education efforts. Finally, medical institutions and governments should develop appropriate education policies for patients at risk of CAD and for those with CAD.

A Behavioral Change Smartphone App and Program (ToDo-CR) to Decrease Sedentary Behavior in Cardiac Rehabilitation Participants: Prospective Feasibility Cohort Study.

BackgroundCardiac rehabilitation participants are encouraged to meet physical activity guidelines to reduce the risk of repeat cardiac events. However, previous studies have found that physical activity levels are low and sedentary behavior is high, both during and after cardiac rehabilitation. There is potential for smartphone apps to be effective in reducing sedentary behavior, although among the few studies that have investigated smartphone apps in cardiac rehabilitation, none targeted sedentary behavior.ObjectiveThis study aims to evaluate the feasibility of a behavioral smartphone app (Vire) and a web-based behavior change program (ToDo-CR) to decrease sedentary behavior in cardiac rehabilitation participants.MethodsUsing a single-center, pre-post design, participants were recruited by nursing staff on admission to cardiac rehabilitation. All eligible participants installed the Vire app, were given a Fitbit Flex, and received the 6-week ToDo-CR program while attending cardiac rehabilitation. The ToDo-CR program uses personalized analytics to interpret important behavioral aspects (physical activity, variety, and social opportunity) and real-time information for generating and suggesting context-specific actionable microbehavioral alternatives (Do’s). Do’s were delivered via the app, with participants receiving 14 to 19 Do’s during the 6-week intervention period. Outcome measures were collected at 0, 6, and 16 weeks. The assessors were not blinded. Feasibility outcomes included recruitment and follow-up rates, resource requirements, app usability (Unified Theory of Acceptance and Use of Technology 2 [UTAUT2] questionnaire), and objectively measured daily minutes of sedentary behavior (ActiGraph) for sample size estimation. Secondary outcomes included functional aerobic capacity (6-min walk test), quality of life (MacNew Heart Disease Health-Related Quality of Life Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale questionnaire), BMI, waist circumference, waist-to-hip ratio, and blood pressure.ResultsBetween January and May 2019, 20 participants were recruited consecutively. One-third of people who commenced cardiac rehabilitation were eligible to participate. Other than declining to take part in the study (15/40, 38%), not having a smartphone was a major reason for exclusion (11/40, 28%). Those excluded without a smartphone were significantly older than participants with a smartphone (mean difference 20 [SD 5] years; P<.001). Participants were, on average, aged 54 (SD 13) years, mostly male (17/20, 85%), and working (12/20, 67%). At 6 weeks, 95% (19/20) of participants were assessed, and 60% (12/20) of participants were assessed at 16 weeks. Participants were relatively satisfied with the usability of the app (UTAUT2 questionnaire). Overall, participants spent 11 to 12 hours per day sitting. There was a medium effect size (Cohen d=0.54) for the reduction in sedentary behavior (minutes per day) over 16 weeks.ConclusionsThe use of a behavioral smartphone app to decrease sitting time appears to be feasible in cardiac rehabilitation. A larger randomized controlled trial is warranted to determine the effectiveness of the app.

Association Between Exercise Capacity and Health-Related Quality of Life During and After Cardiac Rehabilitation in Acute Coronary Syndrome Patients: A Substudy of the OPTICARE Randomized Controlled Trial

ObjectiveTo examine the strength of the association between exercise capacity and health-related quality of life (HRQOL) during and after cardiac rehabilitation (CR) in patients with acute coronary syndrome (ACS) who completed CR. DesignProspective cohort study. SettingOutpatient CR center. ParticipantsPatients (N=607) with ACS who completed CR. InterventionsMultidisciplinary 12-week exercise-based CR program. Main Outcome MeasuresAt baseline (pre-CR), the 6-Minute Walk Test (6MWT) was performed to determine exercise capacity, and the MacNew Heart Disease Health-related Quality of Life questionnaire was used to assess HRQOL. Measurements were repeated immediately after completion of CR (post-CR): at 12 months and 18 months follow-up. Multivariable linear regression, including an interaction term for time and exercise capacity, was applied to study the association between exercise capacity and HRQOL at different time points relative to CR, whereas model parameters were estimated by methods that accounted for dependency of repeated observations within individuals. ResultsMean age in years ± SD was 58±8.9 and 82% of participants were male. Baseline mean 6MWT distance in meters ± SD was 563±77 and median (25th-75th percentile) global HRQOL was 5.5 (4.6-6.1) points. Mean 6MWT distance (P<.001) and the global (P<.001), physical (P<.001), emotional (P<.001) and social (P<.001) domains of HRQOL improved significantly during CR and continued to improve during follow-up post-CR. Independent of the timing relative to CR (ie, pre-CR, post-CR, or during follow-up), a difference of 10 m 6MWT distance was associated with a mean difference in the global HRQOL domain of 0.007 (95% confidence interval [CI], 0.001-0.014) points (P=.029) and a mean difference in the physical domain of 0.009 (95% CI, 0.001-0.017) points (P=.023). ConclusionsBetter exercise capacity was significantly associated with higher scores on the global and physical domains of HRQOL, irrespective of the timing relative to CR, albeit these associations were weak. Hence, CR programs in secondary prevention should continue to aim at enhancing both HRQOL and exercise capacity.

The validity and reliability of the Turkish version of the Seattle Angina Questionnaire.

The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.

Adaptation of MacNew Heart Disease Health-Related Quality of Life Instrument in Indonesian Myocardial Infarction Patients

Abstract Lack of adapted health-related quality of life measurement in Bahasa Indonesia may create difficulties in concluding the effects of heart disease and its treatment on a patient's health-related quality of life in Indonesia. MacNew heart disease health-related quality of life questionnaire (MacNew) has been proven a valid and reliable health-related quality of life measurement. It also has been adapted in several languages. This study aimed at translating and assessing the Indonesian version of MacNew questionnaire validity evidence based on the relation with other variables on and internal consistency. Validity evidence based on the relation with other variables was assessed by correlating the Indonesian version of the MacNew questionnaire score with cardiac anxiety, gender, age, education level, left ventricular ejection fraction score, and comorbidity. Two hundred thirty-six patients diagnosed with myocardial infarction (MI) filled out the questionnaire at a one-time intake. Results from confirmatory factor analysis revealed three domains of health-related quality of life, namely emotional, physical, and social. The three-domain explained 42.31% of the health-related quality of life total variance. The internal consistency of the questionnaire was good (0.816-0.900). Health-related quality of life was negatively correlated with cardiac anxiety. Male patients had a higher health-related quality of life compare to female patients. However, there was no significant correlation between health-related quality of life and left ventricular ejection fraction and comorbidity. The Indonesian version of MacNew questionnaire demonstrated satisfactory psychometric properties and can be recommended to measure HRQOL in heart patients in Indonesia. Keywords: Health-related quality of life , MacNew Heart Disease HRQOL instrument, instrument adaptation

Validation of the Korean Version of the MacNew Heart Disease Health-Related Quality of Life Questionnaire.

Health-related quality of life (HRQoL) is an important concept in patients with cardiac diseases, including myocardial infarction (MI). Disease-specific tools offer valuable insights into the impact of a disease on various aspects of a patient's life. The aim of this study was to assess the psychometric properties of the Korean version of the MacNew Heart Disease HRQoL Questionnaire (Korean MacNew). One hundred thirty-six patients who had experienced MI about 3 months earlier were recruited from two tertiary hospitalsin South Korea. The internal consistency and various types of validity of the Korean MacNew were assessed. Exploratory factor analysis with varimax rotation was performed to identify a better structure for this instrument. The internal consistency of the Korean MacNew was established with Cronbach's alpha coefficients ranging from .88 to .93. Face validity and construct validity (both discriminant and concurrent) of the Korean MacNew were established. Strong positive correlations were found between the total Korean MacNew and the single-item global QoL scale (r = .73, p < .001). As expected, the total Korean MacNew also had strong negative correlations with the Depression Anxiety and Stress Scale 21 (r = -.81, p < .001) and the single-item fatigue scale (r = -.51, p < .001). The outcomes of exploratory factor analysis showed a better result with the five-factor structure in the Korean MacNew. The Korean MacNew showed consistently acceptable psychometric properties of reliability and validity in patients with MI. Therefore, this instrument may be recommended for assessing the HRQoL of patients with MI in Korea. However, caution should be taken in using the subscale scores.

Evaluation of life quality in patients with postinfarction cardiosclehrosis on the background of metabolitic therapy

Aim of research – to estimate the dynamics of life quality indices in patients with postinfarction cardiosclerosis on the background of the metabolic therapy using the questionnaire MacNew Heart Disease Health-related Quality of Life.Materials and methods: in the research took part 99 patients (71 % of men and 29 % of women) with postinfarction cardiosclerosis, stable angina of effort of ІІ-ІІІ functional class. Patients of the group of comparison (n=49) continued to take the basis therapy of the ischemic heart disease, whereas patients of the main group (n=50) additionally took glutargin. All groups were representative by age and sex. The patients’ life quality estimation was realized by the questionnaire MacNew.Results: The determination of the life quality was carried out using the questionnaire MacNew Heart Disease Health-related Quality of Life, most effective for patients with the ischemic heart disease. At the comparative analysis of initial life quality indices by the questionnaire MacNew in both groups, all patients with postinfarction cardiosclerosis demonstrated the decrease of all indices of scales and didn’t differ statistically. It was established, that on the background of glutargin treatment took place the statistically reliable increment of the physical activity (from 4,3±1,0 to 5,2±0,9 points, p&lt;0,05) and reliable increase of the routine activity, limited by the pain influence (from 4,6±0,8 to 5,9±0,9 points, p&lt;0,05).Conclusions: All patients with postinfarction cardiosclerosis demonstrated the essential decrease of life quality indices in physical, emotional and social spheres. Glutargin inclusion into the standard therapy of patients with the ischemic heart disease allows to improve the life quality of patients with postinfarction cardiosclerosis essentially

THE QUALITY OF LIFE AND HOME CARE NEEDS OF PATIENTS TREATED FOR HEART FAILURE

Objective: To identify the quality of life and need for home care of patientstreated for heart failure and the socio demographic and disease-related featuresthat affect them. Methodology: This cross sectional study included patients treated at theCardiology-Coronary Intensive Care Unit of Ondokuz Mayis University, Turkey.Data was collected from patients who were willing to participate in the study fromDecember 2010 to June 2012. The data collection tools were the Katz Daily LivingActivities Scale and the MacNew Heart Disease Health-related Quality of LifeQuestionnaire. The data collected was analyzed using the SPSS 16.0, and thedescriptive statistics were analyzed using the t-test, Spearman's correlationanalysis, the Mann-Whitney U test and the Chi-square test. Results: About 180 patients were included. It was found that in participatingpatients, when their level of need for home care increased their quality of lifedecreased. Research reveals that the activities with which patients with heartfailure need the most home care assistance are cleaning, cooking, eating,bathing, and using the toilet. Conclusion: It was found that the more patients with heart failure need homecare, the more their quality of life falls.

Sex differences in the quality of life of patients with acute coronary syndrome treated with percutaneous coronary intervention after a 3-year follow-up.

BackgroundThe aims of this study were to analyze the dynamics of quality of life (QoL) changes after 36 months from the percutaneous coronary intervention (PCI) depending on sex and identify baseline predictors of the follow-up QoL of patients hospitalized for acute coronary syndrome (ACS) and subjected to PCI.Methods and resultsThe study included 137 patients, females (n=67) and males (n=70), with ACS who underwent PCI. The QoL was assessed using the MacNew Heart Disease Health-Related Quality of Life questionnaire. The group of females scored lower in all the domains of the MacNew Heart Disease Health-Related Quality of Life questionnaire in the initial measurement (B1), in the measurement after 6 months (B2), and in the long-term follow-up measurement (36 months – B3). Despite the fact that both groups achieved improved QoL, its values were higher in the males. The average growth rate of the QoL score in the period from the sixth month to 36th month was higher in females than in males. In the univariate and multivariate analyses, significant independent predictors with a negative influence on the long-term QoL score included female sex (ρ=−0.190, β=−0.21), age >60 years (ρ=−0.255, β=−0.186), and diabetes (ρ=−0.216, β=−0.216).ConclusionIn a 36-month follow-up of ACS patients treated with PCI, there were no statistically significant differences in QoL between sexes. In the entire cohort, there was improvement in QoL, which was higher in the case of the females studied. For the entire group, significant independent determinants of lower QoL 3 years after ACS included female sex, age >60 years, and diabetes.