Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Qual Life Res. 2020 Apr;29(4):1093-1105. doi: 10.1007/s11136-019-02384-6. Epub 2019 Dec 12.
The aim of this study was to evaluate psychometric properties of the core disease-specific 14-item German HeartQoL questionnaire.
As an extension of the international HeartQol Project, cross-sectional and longitudinal health-related quality of life (HRQL) data were collected from 305 patients with angina (N = 101), myocardial infarction (N = 123), or ischemic heart failure (N = 81) in Austria and Switzerland using German versions of the HeartQoL, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale. The underlying factor structure was examined with Mokken Scaling analysis; then convergent, divergent, and discriminative validity, internal consistency reliability, and responsiveness were assessed.
The highest HRQL scores were reported by patients with myocardial infarction followed by ischemic heart failure and then angina. The two-factor structure was confirmed with strong physical, emotional, and global scale H coefficients (> .50). Divergent and convergent validity (from r = .04 to .78) were shown for each diagnosis; discriminative validity was verified as well (partially: age, sex, and disease severity; largely: SF-36 health status/transition; totally: anxiety and depression). Internal consistency reliability was excellent (Cronbach's alpha = .91). In terms of responsiveness, physical and global scale scores improved significantly after percutaneous coronary intervention (p < .01) while after cardiac rehabilitation all scale scores improved significantly (p < .001).
The German HeartQoL questionnaire is a valid and reliable HRQL instrument with these data supporting its potential use in clinical practice and research to assess and compare HRQL in German-speaking patients with ischemic heart disease. The shortness of the tool may prove to be helpful particularly in clinical practice.
本研究旨在评估核心疾病特异性的 14 项德国心脏生活质量问卷的心理测量学特性。
作为国际心脏生活质量项目的延伸，使用德国心脏生活质量问卷、健康调查简表 36 项（SF-36）和医院焦虑抑郁量表，从奥地利和瑞士的 305 名心绞痛（n=101）、心肌梗死（n=123）或缺血性心力衰竭（n=81）患者中收集横断面和纵向健康相关生活质量（HRQL）数据。采用 Mokken 尺度分析检验潜在的因子结构；然后评估了聚合、发散和区分效度、内部一致性信度和反应性。
心肌梗死患者报告的 HRQL 评分最高，其次是缺血性心力衰竭，然后是心绞痛。通过具有强物理、情感和全球量表 H 系数（>.50），证实了双因素结构。对于每种诊断，均显示出发散和聚合效度（从 r=.04 到.78）；也验证了区分效度（部分：年龄、性别和疾病严重程度；大部分：SF-36 健康状况/转换；全部：焦虑和抑郁）。内部一致性信度极好（克朗巴赫α=.91）。在反应性方面，经皮冠状动脉介入治疗后物理和全球量表评分显著改善（p<.01），而心脏康复后所有量表评分均显著改善（p<.001）。
德国心脏生活质量问卷是一种有效的 HRQL 工具，这些数据支持其在临床实践和研究中评估和比较德国缺血性心脏病患者 HRQL 的潜在用途。该工具的简短性在临床实践中可能特别有用。
