Quality of Life Research

, Volume 28, Issue 5, pp 1245–1253 | Cite as

Measuring HRQoL following heart valve surgery: the HeartQoL questionnaire is a valid and reliable core heart disease instrument

  • Charlotte N. GrønsetEmail author
  • Lau C. Thygesen
  • Selina Kikkenborg Berg
  • Graziella Zangger
  • Marie S. Kristensen
  • Kirstine L. Sibilitz
  • Susanne S. Pedersen
  • Neil B. Oldridge
  • Ann-Dorthe Zwisler



Patient-reported health-related quality of life is a complementary healthcare outcome and important when assessing treatment efficacy. Using COSMIN methodological recommendations, this study evaluates the validity and reliability of a core heart disease-specific health-related quality of life questionnaire, the HeartQoL questionnaire (Danish version) in a sample of patients following heart valve surgery.


This project involved a cross-sectional validity study and a test–retest reliability study.


Eligible patients completed the HeartQoL, the SF-36 health survey questionnaire, and the Hospital Anxiety and Depression Scale following heart valve surgery. Construct validity was tested using a priori hypotheses. Internal consistency reliability was assessed with Cronbach’s alpha. An independent sample of patients participated in the test–retest study and reproducibility was determined with relative [intra-class correlation coefficient (ICC)] and absolute reliability [standard error of measurement (SEM) and smallest detectable change (SDC)].


Internal consistency was high with Cronbach’s alpha ≥ 0.87. ICC was 0.86–0.92. SEM ranged from 0.17 to 0.26 points and SDC ranged from 0.5 to 0.7 points. Construct validity was confirmed with 87% of all a priori hypotheses for predicted variables.


The HeartQoL questionnaire demonstrates acceptable construct validity, internal consistency, and test–retest reproducibility in patients following heart valve surgery. Future studies should focus on assessing the responsiveness of the HeartQoL questionnaire over time and following heart valve surgery.


Heart valve surgery Health-related quality of life questionnaires HeartQoL Measurement properties 



The authors thank the respondents for their participation and Jamal Uddin for assisting in data entry.


The study was financially supported by The Danish Council for Strategic Research (10-092790), The Danish Heart Foundation, Edith and Olfert Dines Hansen Foundation (8868MT/IV), and the Research Council of the Region Zealand (12–000095/jun2014). The funding agencies had no influence on the interpretation of results.

Compliance with ethical standards

Conflict of interest

Professor Neil Oldridge is a co-developer of the HeartQoL with no competing interest to report by the other authors.

Ethical approval

The Danish Data Protection Agency approved the survey data (File Number: 2013-41-1643) and all local confidentiality and privacy requirements were met.

Informed consent

Danish laws for register-based research do not require signed informed consent.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Charlotte N. Grønset
    • 1
    Email author
  • Lau C. Thygesen
    • 2
  • Selina Kikkenborg Berg
    • 3
  • Graziella Zangger
    • 4
    • 5
  • Marie S. Kristensen
    • 2
  • Kirstine L. Sibilitz
    • 6
  • Susanne S. Pedersen
    • 7
    • 8
  • Neil B. Oldridge
    • 9
  • Ann-Dorthe Zwisler
    • 4
    • 5
  1. 1.Department of Occupational Therapy and PhysiotherapyCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
  2. 2.National Institute of Public HealthUniversity of Southern DenmarkOdenseDenmark
  3. 3.The Heart CentreCopenhagen University Hospital, RigshospitaletOdenseDenmark
  4. 4.The Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA)Odense University HospitalOdenseDenmark
  5. 5.University of Southern DenmarkOdenseDenmark
  6. 6.Department of Internal Medicine, Section of CardiologyHvidovre University HospitalHvidovreDenmark
  7. 7.Department of PsychologyUniversity of Southern DenmarkOdenseDenmark
  8. 8.Department of CardiologyOdense University HospitalOdenseDenmark
  9. 9.College of Health SciencesUniversity of Wisconsin-MilwaukeeMilwaukeeUSA

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