Keywords
Heart failure
quality of life
validation studies
quality of life
validation studies
How to Cite
Rojas, L. Z., Hernández, J. A., Trujillo caceres, S. J., Roa, Z. M., Jurado, A. M., Echeverría, L. E., Muka, T., & Franco, O. H. (2018). Psychometric properties of the Minnesota Living with Chronic Heart Failure Questionnaire in a Colombian population. Salud UIS, 51(1), 11–22. https://doi.org/10.18273/revsal.v51n1-2019002
Abstract
Introduction: Although the Minnesota Living with Heart Failure Questionnaire (MLHF-Q) is one of the most widely used tools to assess Health-Related Quality of Life (HRQoL) in patients with chronic heart failure (CHF), it has not been validated in Latin American Spanish-speaking populations. Objective: We evaluated internal consistency and construct validity of the MLHF-Q in patients with CHF from Colombia. Methods: The Spanish version of the MLHF-Q was given to 200 patients. Cronbach’s alpha was used to evaluate internal consistency. Confirmatory factorial Principal Component Analysis (PCA) and Rasch analysis were used to evaluate construct validity. The discriminative capacity was measured using the Mann-Whitney U test. Results: Median age was 64 years, 63% of the patients included in the study were men, and 79.5% had a left ventricular ejection fraction (LVEF) ≤ 45%. The median of the total score of HRQoL was 40 points (Q1=20; Q3=55), physical dimension 11 points (Q1=4; Q3=23) and emotional dimension 7 points (Q1=3; Q3=13). Global internal consistency of MLHF-Q was 0.91 (95% CI 0.89 - 0.93). In the PCA, the three dimensions explained 47.7% and 54.0% in Rasch analysis, in which five items presented misfit. Worse HRQoL was observed among women than men in the emotional dimension (p=0.047). Discriminative capacity for the overall score of the MLHF-Q and their subscales was observed in age and New York Heart Association (NYHA) functional class (p<0.05). Conclusions: Our findings confirmed the three-factor structure of the MLHF-Q, and satisfactory level for internal consistency. Additionally, these results suggest that the questionnaire adequately reflects the severity of the disease. However, further studies are required to validate these findings in Colombian population and to evaluate the sensitivity to change of the MLHF-Q in longitudinal designs.
References
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14. Garin O, Herdman M, Vilagut G, Ferrer M, Ribera A, Rajmil L, et al. Assessing health-related quality of life in patients with heart failure: a systematic, standardized comparison of available measures. Heart Fail Rev. 2014;19(3): 359-367. doi: 10.1007/s10741-013-9394-7.
15. Middel B, Bouma J, de Jongste M, van Sonderen E, Niemeijer MG, Crijns H, et al. Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHF-Q). Clin Rehabil. 2001;15(5): 489-500. doi: 10.1191/026921501680425216.
16. Zanolla L, Zardini P. Selection of endpoints for heart failure clinical trials. Eur J Heart Fail. 2003; 5(6): 717-723.
17. Garin O, Ferrer M, Pont A, Rue M, Kotzeva A, Wiklund I, et al. Disease-specific health-related quality of life questionnaires for heart failure: a systematic review with meta-analyses. Qual Life Res. 2009; 18(1): 71-85. doi: 10.1007/s11136-008-9416-4.
18. Saccomann IC, Cintra FA, Gallani MC. Psychometric properties of the Minnesota Living with Heart Failure--Brazilian version--in the elderly. Qual Life Res. 2007; 16(6): 997-1005. doi: 10.1007/s11136-007-9170-z.
19. Ho CC, Clochesy JM, Madigan E, Liu CC. Psychometric evaluation of the Chinese version of the Minnesota Living with Heart Failure Questionnaire. Nurs Res. 2007; 56(6): 441-448. doi: 10.1097/01.NNR.0000299849.21935.c4.
20. Cronbach L. Coefficient alpha and the internal structure of test. Psychometrika. 1951; 16(3): 297-334.
21. Káiser H. An index of factorial simplicity. Psychometrika. 1974; 39: 32-36.
22. Bartlett M. Test of significance in factor analysis. Psychology. 1950; 3: 77-85.
23. Garin O, Ferrer M, Pont A, Wiklund I, Van Ganse E, Vilagut G, et al. Evidence on the global measurement model of the Minnesota Living with Heart Failure Questionnaire. Qual Life Res. 2013; 22(10): 2675-2684. doi: 10.1007/s11136-013-0383-z.
24. Bilbao A, Escobar A, Garcia-Perez L, Navarro G, Quiros R. The Minnesota living with heart failure questionnaire: comparison of different factor structures. Health Qual Life Outcomes. 2016; 14: 23. doi: 10.1186/s12955-016-0425-7.
25. Tesio L. Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research. J Rehabil Med. 2003; 35(3): 105-115.
26. Mogle J, Buck H, Zambroski C, Alvaro R, Vellone E. Cross-Validation of the Minnesota Living With Heart Failure Questionnaire. J Nurs Scholarsh. 2017; 49(5): 513-520. doi: 10.1111/jnu.12318.
27. Heo S, Moser DK, Riegel B, Hall LA, Christman N. Testing the psychometric properties of the Minnesota Living with Heart Failure questionnaire. Nurs Res. 2005; 54(4): 265-272.
28. Moon JR, Jung YY, Jeon ES, Choi JO, Hwang JM, Lee SC. Reliability and validity of the Korean version of the Minnesota Living with Heart Failure Questionnaire. Heart Lung. 2012; 41(1): 57-66. doi: 10.1016/j.hrtlng.2011.09.011.
29. Breidthardt T, Irfan A, Klima T, Drexler B, Balmelli C, Arenja N, et al. Pathophysiology of lower extremity edema in acute heart failure revisited. Am J Med. 2012; 125(11): 1124 e1- e8. doi: 10.1016/j.amjmed.2011.12.015.
30. Kataoka H. Clinical characteristics of lower-extremity edema in stage A cardiovascular disease status defined by the ACC/AHA 2001 Chronic Heart Failure Guidelines. Clin Cardiol. 2013; 36(9): 555-559. doi: 10.1002/clc.22159.
31. Sztajzel J. Chronic heart failure and its consequences on the partner relationship. Rev Med Suisse. 2015; 11(498): 2313-2315.
32. Kitzman DW, Hundley WG, Brubaker PH, Morgan TM, Moore JB, Stewart KP, et al. A randomized double-blind trial of enalapril in older patients with heart failure and preserved ejection fraction: effects on exercise tolerance and arterial distensibility. Circ Heart Fail. 2010; 3(4): 477-485. doi: 10.1161/CIRCHEARTFAILURE.109.898916.
33. Rector TS, Carson PE, Anand IS, McMurray JJ, Zile MR, McKelvie RS, et al. Assessment of long-term effects of irbesartan on heart failure with preserved ejection fraction as measured by the minnesota living with heart failure questionnaire in the irbesartan in heart failure with preserved systolic function (I-PRESERVE) trial. Circ Heart Fail. 2012; 5(2): 217-225. doi: 10.1161/CIRCHEARTFAILURE.111.964221.
34. Edelmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, Kamke W, et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013;309(8): 781-791. doi: 10.1001/jama.2013.905.
2. Ciapponi A, Alcaraz A, Calderon M, Matta MG, Chaparro M, Soto N, et al. Burden of heart failure in Latin América: a systematic review and meta-analysis. Rev Esp Cardiol (Engl Ed). 2016; 69(11): 1051-1060. doi: 10.1016/j.rec.2016.04.054.
3. Escobar A, Garcia-Perez L, Navarro G, Bilbao A, Quiros R, group C-HS. A one-year mortality clinical prediction rule for patients with heart failure. Eur J Intern Med. 2017. doi: 10.1016/j.ejim.2017.06.013.
4. Jaarsma T, Johansson P, Agren S, Stromberg A. Quality of life and symptoms of depression in advanced heart failure patients and their partners. Curr Opin Support Palliat Care. 2010; 4(4): 233-237. doi: 10.1097/SPC.0b013e328340744d.
5. Juenger J, Schellberg D, Kraemer S, Haunstetter A, Zugck C, Herzog W, et al. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart. 2002; 87(3): 235-241.
6. Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, et al. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2012; 125(15): 1928-1952. doi: 10.1161/CIR.0b013e31824f2173.
7. Berry C, McMurray J. A review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics. 1999; 16(3): 247-271. doi: 10.2165/00019053-199916030-00003.
8. Rector TS, Cohn JN. Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan. Pimobendan Multicenter Research Group. Am Heart J. 1992; 124(4): 1017-1025.
9. Lambrinou E, Kalogirou F, Lamnisos D, Middleton N, Sourtzi P, Lemonidou C, et al. Evaluation of the psychometric properties of the Greek version of the Minnesota Living With Heart Failure questionnaire. J Cardiopulm Rehabil Prev. 2013; 33(4): 229-233. doi: 10.1097/HCR.0b013e3182930cbb.
10. Munyombwe T, Hofer S, Fitzsimons D, Thompson DR, Lane D, Smith K, et al. An evaluation of the Minnesota Living with Heart Failure Questionnaire using Rasch analysis. Qual Life Res. 2014; 23(6): 1753-1765. doi: 10.1007/s11136-013-0617-0.
11. Garin O, Soriano N, Ribera A, Ferrer M, Pont A, Alonso J, et al. Validation of the Spanish version of the Minnesota Living with Heart Failure Questionnarie. Rev Esp Cardiol. 2008; 61(3): 251-259.
12. Parajon T, Lupon J, Gonzalez B, Urrutia A, Altimir S, Coll R, et al. Use of the Minnesota Living With Heart Failure Quality of Life Questionnaire in Spain. Rev Esp Cardiol. 2004; 57(2): 155-160.
13. Naveiro-Rilo JC, Diez-Juarez DM, Romero Blanco A, Rebollo-Gutierrez F, Rodriguez-Martinez A, Rodriguez-Garcia MA. Validation of the Minnesota living with heart failure questionnaire in primary care. Rev Esp Cardiol. 2010; 63(12): 1419-1427.
14. Garin O, Herdman M, Vilagut G, Ferrer M, Ribera A, Rajmil L, et al. Assessing health-related quality of life in patients with heart failure: a systematic, standardized comparison of available measures. Heart Fail Rev. 2014;19(3): 359-367. doi: 10.1007/s10741-013-9394-7.
15. Middel B, Bouma J, de Jongste M, van Sonderen E, Niemeijer MG, Crijns H, et al. Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHF-Q). Clin Rehabil. 2001;15(5): 489-500. doi: 10.1191/026921501680425216.
16. Zanolla L, Zardini P. Selection of endpoints for heart failure clinical trials. Eur J Heart Fail. 2003; 5(6): 717-723.
17. Garin O, Ferrer M, Pont A, Rue M, Kotzeva A, Wiklund I, et al. Disease-specific health-related quality of life questionnaires for heart failure: a systematic review with meta-analyses. Qual Life Res. 2009; 18(1): 71-85. doi: 10.1007/s11136-008-9416-4.
18. Saccomann IC, Cintra FA, Gallani MC. Psychometric properties of the Minnesota Living with Heart Failure--Brazilian version--in the elderly. Qual Life Res. 2007; 16(6): 997-1005. doi: 10.1007/s11136-007-9170-z.
19. Ho CC, Clochesy JM, Madigan E, Liu CC. Psychometric evaluation of the Chinese version of the Minnesota Living with Heart Failure Questionnaire. Nurs Res. 2007; 56(6): 441-448. doi: 10.1097/01.NNR.0000299849.21935.c4.
20. Cronbach L. Coefficient alpha and the internal structure of test. Psychometrika. 1951; 16(3): 297-334.
21. Káiser H. An index of factorial simplicity. Psychometrika. 1974; 39: 32-36.
22. Bartlett M. Test of significance in factor analysis. Psychology. 1950; 3: 77-85.
23. Garin O, Ferrer M, Pont A, Wiklund I, Van Ganse E, Vilagut G, et al. Evidence on the global measurement model of the Minnesota Living with Heart Failure Questionnaire. Qual Life Res. 2013; 22(10): 2675-2684. doi: 10.1007/s11136-013-0383-z.
24. Bilbao A, Escobar A, Garcia-Perez L, Navarro G, Quiros R. The Minnesota living with heart failure questionnaire: comparison of different factor structures. Health Qual Life Outcomes. 2016; 14: 23. doi: 10.1186/s12955-016-0425-7.
25. Tesio L. Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research. J Rehabil Med. 2003; 35(3): 105-115.
26. Mogle J, Buck H, Zambroski C, Alvaro R, Vellone E. Cross-Validation of the Minnesota Living With Heart Failure Questionnaire. J Nurs Scholarsh. 2017; 49(5): 513-520. doi: 10.1111/jnu.12318.
27. Heo S, Moser DK, Riegel B, Hall LA, Christman N. Testing the psychometric properties of the Minnesota Living with Heart Failure questionnaire. Nurs Res. 2005; 54(4): 265-272.
28. Moon JR, Jung YY, Jeon ES, Choi JO, Hwang JM, Lee SC. Reliability and validity of the Korean version of the Minnesota Living with Heart Failure Questionnaire. Heart Lung. 2012; 41(1): 57-66. doi: 10.1016/j.hrtlng.2011.09.011.
29. Breidthardt T, Irfan A, Klima T, Drexler B, Balmelli C, Arenja N, et al. Pathophysiology of lower extremity edema in acute heart failure revisited. Am J Med. 2012; 125(11): 1124 e1- e8. doi: 10.1016/j.amjmed.2011.12.015.
30. Kataoka H. Clinical characteristics of lower-extremity edema in stage A cardiovascular disease status defined by the ACC/AHA 2001 Chronic Heart Failure Guidelines. Clin Cardiol. 2013; 36(9): 555-559. doi: 10.1002/clc.22159.
31. Sztajzel J. Chronic heart failure and its consequences on the partner relationship. Rev Med Suisse. 2015; 11(498): 2313-2315.
32. Kitzman DW, Hundley WG, Brubaker PH, Morgan TM, Moore JB, Stewart KP, et al. A randomized double-blind trial of enalapril in older patients with heart failure and preserved ejection fraction: effects on exercise tolerance and arterial distensibility. Circ Heart Fail. 2010; 3(4): 477-485. doi: 10.1161/CIRCHEARTFAILURE.109.898916.
33. Rector TS, Carson PE, Anand IS, McMurray JJ, Zile MR, McKelvie RS, et al. Assessment of long-term effects of irbesartan on heart failure with preserved ejection fraction as measured by the minnesota living with heart failure questionnaire in the irbesartan in heart failure with preserved systolic function (I-PRESERVE) trial. Circ Heart Fail. 2012; 5(2): 217-225. doi: 10.1161/CIRCHEARTFAILURE.111.964221.
34. Edelmann F, Wachter R, Schmidt AG, Kraigher-Krainer E, Colantonio C, Kamke W, et al. Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA. 2013;309(8): 781-791. doi: 10.1001/jama.2013.905.
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