Höfer Stefan, Schmid Jean-Paul, Frick Matthias, Benzer Werner, Laimer Herbert, Oldridge Neil, Saner Hugo
Department of Medical Psychology and Psychotherapy, Medical University Innsbruck, Austria.
J Eval Clin Pract. 2008 Aug;14(4):500-6. doi: 10.1111/j.1365-2753.2007.00905.x. Epub 2008 May 2.
RATIONALE, AIMS AND OBJECTIVES: Heart failure (HF) is a severe chronic disease and impairs health-related quality of life (HRQL). While validated specific HRQL instruments are required for evaluation of treatment and rehabilitation in patients with HF, a single validated measure to document changes in HRQL for patients with different heart disease diagnoses would be invaluable. The purpose of this analysis was the psychometric analysis of the German MacNew Heart Disease Questionnaire (MacNew) in HF patients, which has previously been shown to be reliable and valid in patients with myocardial infarction, angina pectoris and arrhythmia.
We recruited 89 patients (61.7+/-11.5 years; 84.3% male) in two Austrian and one Swiss cardiology department with documented HF (effect sizes 28.9+/-10.1%). The self-administered MacNew, the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale were completed. Internal consistency reliability (Cronbach's alpha), discriminative and evaluative validity were assessed.
Cronbach's alpha exceeded 0.80. Each MacNew scale differentiated between patients with and without anxiety (3.9+/-1.0 vs. 5.3+/-0.8, all P<0.001), with and without depression (4.2+/-1.2 vs. 5.2+/-0.9 all P<0.03) and by the SF-36 health transition item (deteriorate=4.39, no change=4.95, improve=5.45, all P<0.02). Evaluative validity was demonstrated with effect sizes >0.70 for a subsample attending a 12-week outpatient rehabilitation programme.
The German language version of the MacNew demonstrates consistently acceptable psychometric properties of reliability, validity and responsiveness in patients with documented HF. Together with previous documentation of reliability, validity and responsive, these findings strengthen the argument for the MacNew as a potential 'core' HRQL measure, at least in the German language.
原理、目的和目标：心力衰竭（HF）是一种严重的慢性疾病，会损害健康相关生活质量（HRQL）。虽然评估HF患者的治疗和康复需要经过验证的特定HRQL工具，但对于记录不同心脏病诊断患者HRQL变化的单一经过验证的测量方法将非常宝贵。本分析的目的是对德国版MacNew心脏病问卷（MacNew）在HF患者中进行心理测量分析，该问卷先前已证明在心肌梗死、心绞痛和心律失常患者中可靠且有效。
我们在奥地利的两个和瑞士的一个心脏病科招募了89名患者（61.7±11.5岁；84.3%为男性），这些患者有HF记录（效应量28.9±10.1%）。完成了自我管理的MacNew、简短形式36（SF - 36）和医院焦虑抑郁量表。评估了内部一致性信度（Cronbach's α）、区分效度和评价效度。
Cronbach's α超过0.80。MacNew的每个量表都能区分有无焦虑的患者（分别为3.9±1.0和5.3±0.8，所有P<0.001）、有无抑郁的患者（分别为4.2±1.2和5.2±0.9，所有P<0.03）以及SF - 36健康转变项目（恶化 = 4.39，无变化 = 4.95，改善 = 5.45，所有P<0.02）。对于参加为期12周门诊康复项目的子样本，效应量>0.70证明了评价效度。
MacNew德语版在有HF记录的患者中表现出始终如一的、可接受的信度、效度和反应度的心理测量特性。连同先前关于信度、效度和反应度的记录，这些发现强化了MacNew作为潜在“核心”HRQL测量方法的论据，至少在德语方面是如此。
