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

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Abstract

Purpose

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.

Design

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

Methods

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)].

Results

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.

Conclusions

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.

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Acknowledgements

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

Funding

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.

Author information

Authors and Affiliations

  1. Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Charlotte N. Grønset

  2. National Institute of Public Health, University of Southern Denmark, Odense, Denmark

    Lau C. Thygesen & Marie S. Kristensen

  3. The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Odense, Denmark

    Selina Kikkenborg Berg

  4. The Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), Odense University Hospital, Odense, Denmark

    Graziella Zangger & Ann-Dorthe Zwisler

  5. University of Southern Denmark, Odense, Denmark

    Graziella Zangger & Ann-Dorthe Zwisler

  6. Department of Internal Medicine, Section of Cardiology, Hvidovre University Hospital, Hvidovre, Denmark

    Kirstine L. Sibilitz

  7. Department of Psychology, University of Southern Denmark, Odense, Denmark

    Susanne S. Pedersen

  8. Department of Cardiology, Odense University Hospital, Odense, Denmark

    Susanne S. Pedersen

  9. College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA

    Neil B. Oldridge

Authors
  1. Charlotte N. Grønset
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Corresponding author

Correspondence to Charlotte N. Grønset.

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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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Grønset, C.N., Thygesen, L.C., Berg, S.K. et al. Measuring HRQoL following heart valve surgery: the HeartQoL questionnaire is a valid and reliable core heart disease instrument. Qual Life Res 28, 1245–1253 (2019). https://doi.org/10.1007/s11136-018-02098-1

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