Dunderdale Karen, Thompson David R, Beer Stephen F, Furze Gill, Miles Jeremy N V
Cardiac Rehabilitation, Scunthorpe General Hospital, Scunthorpe, United Kingdom.
J Cardiovasc Nurs. 2008 Jul-Aug;23(4):364-70. doi: 10.1097/01.JCN.0000317439.82704.e8.
Despite the importance of health-related quality of life (HRQL) as an outcome measure in chronic heart failure (CHF), instruments currently available have been developed by clinicians or researchers; none have been derived from the patient's perspective. The purpose of this study was to develop and validate a patient-derived, disease-specific HRQL measure.
The psychometric testing of the Chronic Heart Failure Assessment Tool (CHAT) followed 2 phases: testing the psychometric properties (n = 223) of the 51-item version of the CHAT in a postal survey and validation of the CHAT (n = 68) using the Medical Outcomes Study 36-Item Short-Form Health Survey and the Minnesota Living With Heart Failure questionnaire.
The CHAT contains questions measuring 7 themes of HRQL: physical ability, emotional state, self-perception, relationships, coping with symptoms, maintaining social/lifestyle status, and cognitive aspects in respect to CHF. Factor analysis was used to analyze these themes. Four domains emerged: symptoms, activity levels, psychosocial aspects, and emotions.
The CHAT comprises dimensions of HRQL identified by patients in the study population that may more appropriately reflect the concerns of patients. Further work is recommended to develop this tool for use as an HRQL measure in a CHF population.
尽管健康相关生活质量（HRQL）作为慢性心力衰竭（CHF）的一项结局指标很重要，但目前可用的测评工具都是由临床医生或研究人员开发的；没有一个是从患者的角度得出的。本研究的目的是开发并验证一种源自患者、针对特定疾病的HRQL测评工具。
慢性心力衰竭评估工具（CHAT）的心理测量测试分两个阶段进行：在一项邮寄调查中测试CHAT 51项版本的心理测量特性（n = 223），并使用医学结局研究36项简短健康调查和明尼苏达心力衰竭生活问卷对CHAT进行验证（n = 68）。
CHAT包含测量HRQL七个主题的问题：身体能力、情绪状态、自我认知、人际关系、应对症状、维持社会/生活方式状态以及与CHF相关的认知方面。采用因子分析来分析这些主题。出现了四个领域：症状、活动水平、心理社会方面和情绪。
CHAT包含了研究人群中患者所确定的HRQL维度，可能更恰当地反映患者的关注点。建议进一步开展工作，开发该工具以用作CHF人群的HRQL测评工具。
