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Psychometric properties of the Minnesota Living with Heart Failure—Brazilian version—in the elderly

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Abstract

Background

Heart failure (HF) has implications for the quality of life for any age range, more so for the elderly who simultaneously present other limitations imposed by multiple co-morbidities. Although there are several instruments to measure Health Related Quality of Life (HRQL), none is specific to the elderly with HF. Among disease-specific instruments, Minnesota Living with Heart Failure(LHFQ) has not been studied extensively among the elderly with respect to its psychometric properties.

Objective

The purpose of this study was to evaluate the convergent, divergent and discriminative validity of the Brazilian version of LHFQ applied to elderly HF patients.

Method

One hundred and seventy (170) elderly were interviewed. LHFQ capacity to discriminate subjects among New York Heart Association (NYHA) Classes I, II and III/IV was analyzed. Convergent and divergent validity was evaluated through the correlation between the domains of LHFQ and the generic instrument, Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36).

Results

The LHFQ total score and physical dimension sub-scale discriminated between the three sub-groups of NYHA Classes I, II and III/IV (P < .0001). The emotional dimension discriminated NYHA Classes I and III/IV (P = .0034). The physical and emotional dimensions of the LHFQ and SF-36 were significantly correlated (coefficients from .46 to .70 for physical dimension and from .31 to .65 for emotional dimension). However, contrary to expectations, the divergent validity was not totally confirmed as there was no difference in the magnitude of the correlations between the LHFQ emotional and physical dimensions and the SF-36 role physical, social functioning and role emotional. Thus, the results suggest that LHFQ seems to be a valid tool to measure HRQL in the elderly, but new studies remain necessary to gain a better understanding of its discriminative validity for more advanced NYHA functional classes and for its divergent validity.

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References

  1. World Health Organization (1982). World Health Statistics Annual. Genebra:WHO

    Google Scholar 

  2. Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. New Jersey: Prentice-Hall.

    Google Scholar 

  3. Albanesi, F. M. (1998). Heart failure in Brazil. Arquivos Brasileiros de Cardiologia, 71(4), 561–562.

    Article  Google Scholar 

  4. Austin, J., Williams, R., Ross, L., Moseley, L., & Hutchison, S. (2005). Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. European Journal of Heart Failure, 7, 411–417.

    Article  PubMed  Google Scholar 

  5. Barreto, A. C. P., Nobre, M. R. C., Wajngarten, M., Canesin, M. F., & Ballas, D., Serro-Azul, J. B. (1998). Heart failure in a Great Tertiary Hospital in São Paulo. Arquivos Brasileiros de Cardiologia, 71(1), 15–20.

    Article  Google Scholar 

  6. Bayliss, E. A., Bayliss, M. S., Ware, J., & Steiner, J. F. (2004). Predicting declives in physical function in persons with multiple chronic medical conditions: What we can learn from the medical problem list. Health and Quality of Life Outcomes, 2, 47.

    Article  PubMed  Google Scholar 

  7. Beaton, D., Claire, B., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. SPINE 25(24), 3186–3191.

    Article  PubMed  CAS  Google Scholar 

  8. Bennett, S. J., Oldridge, N. B., Ecckert, G. J., Embree, J. L., Browing, S., & Hou, N., et al. (2002). Discriminant properties of commonly used quality of life measures in heart failure. Quality of Life Research, 11(4), 349–359.

    Article  Google Scholar 

  9. Bennett, S. J., Oldridge, N. B., Ecckert, G. J., Embree, J. L., Browing, S., & Hou, N., et al. (2003). Comparison of Quality of Life Measures in Heart Failure. Nursing Research , 52(4), 207–216.

    Article  PubMed  Google Scholar 

  10. Berry, C., & McMurray, J. A. (1999). Review of quality-of-life evaluations in patients with congestive heart failure. Pharmacoeconomics, 16(3), 247–271.

    Article  PubMed  CAS  Google Scholar 

  11. Brazier, J. E., Walters, S. J., Nicholl. J. P., Kohler, B. (1996). Using the SF-36 and Euroqol on an elderly population. Quality Life Research, 5, 195–204.

    Article  PubMed  CAS  Google Scholar 

  12. Calvert, M. J., Freemantle, N., & Cleland, J. G. F. (2005). The impact of chronic heart failure on health-related quality of life data acquired in the baseline phase of the CARE-HF study. European Journal of Heart Failure 7, 243–251.

    Article  PubMed  Google Scholar 

  13. Campbel, D. T., & Fiske, D. W. (1959). Convergent and discriminant validity by the multitrait-multimethod matrix. Psychological Bulletin , 56, 81–105.

    Article  Google Scholar 

  14. Carrara, D. (2001). Quality of life prospective evaluation in patients with dilated myocardiopathy subjected to a left partial ventriclectomy. [‘PhD thesis’]. São Paulo,(S.P): São Paulo University

  15. Cicconelli, R. M., Ferraz, M. B., Santos, W., Meinão, I., & Marina, R. Q. (1999). Translation to the Portuguese Language and general questionnaire of quality of life SF-36 evaluation (Brasil SF-36). Revista Brasileira de Reumatología , 39, 143–150.

    Google Scholar 

  16. Clarke, K. W., Gray, D., & Hampton, J. R. (1995). How common is heart failure? Evidence from PACT (Prescribing Analysis and Cost) data in Nottingham. Journal of Public Health Medicine , 17, 459–464.

    PubMed  CAS  Google Scholar 

  17. Cowie, M. R., Wood, D. A., Coats, A. J. S., Thompson, S. G., Poole-Wilson, P. A., Suresh, V., & Sutton, G. C. (1999). Incidence and aetiology of heart failure: A population-based study. European Heart Journal , 20, 421–428.

    Article  PubMed  CAS  Google Scholar 

  18. Datasus-Tabnet: Brazil Health Statistics Scenary (2001). Health Ministry. Available in: http://www.datasus.gov.br. Access on: June 20 2004

  19. Ekman, I., Fagerberg, B., & Lundmen, B. (2002). Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls. Heart & Lung, 31,94–101.

    Article  Google Scholar 

  20. Fayers, P. M., & Machini, D. (1998). Quality of life: Assessment, Analysis, and Interpretation. Chischester: John Wiley & Sons.

    Google Scholar 

  21. Grigioni, F., Carigi, S., Grandi, S., Potena, L., Bacchi-Reggiani, L., & Magnani, G., et al. (2003). Distance between patients’ subjective perceptions and objectively evaluated disease severity on chronic heart failure.Psychotherapy and Psychosomatics , 72(3), 166–170.

    Article  PubMed  Google Scholar 

  22. Guyatt, G. H. (1993). Measurement health-related quality of life in heart failure. Journal of the American College of Cardiology , 4, 185A–191A.

    Article  Google Scholar 

  23. Guyatt, G. H., Naylor, D., Juniper, E., Heyland, D. K., Jaeschke, R., & Cook, D. J. (1997). Users’ guides to the medical literature. XII. How to use articles about health-related quality of life. JAMA 277(15), 1232–1237.

    Article  PubMed  CAS  Google Scholar 

  24. Hak, T., Willems, D., Wal, G., & Visser, F. (2004). A qualitative validation of the Minnesota Living with Heart Failure Questionnaire. Quality Life Research, 13, 417–426.

    Article  Google Scholar 

  25. Havranek, E. P., Masoudi, F. A., Westfall, K. A., Wolfe, P., Ordin, D. L., & Krumholz H. M. (2002). Spectrum of heart failure in older patients: Results from the National Heart Failure Project. American Heart Journal , 143(3), 412–417.

    Article  PubMed  Google Scholar 

  26. Hayes, V., Morris, J., Wolfe, C., & Morgan, M. (1995). The SF-36 Health Survey Questionnaire: Is it Suitable for use with Older Adults? Age and Ageing, 24, 120–125.

    Article  PubMed  CAS  Google Scholar 

  27. Heo, S., Moser, D. K., Riegel, B., May, L. A., & Christman, N. (2005). Testing the psycometric properties of the Minnesota Living With Heart Failure Questionnaire. Nursing Research, 54(4), 265–272.

    Article  PubMed  Google Scholar 

  28. Hulley, S. B., & Cummings S. R. (1988) Designing Clinical Research (Baltimore: Williams & Wilkins)

  29. Hunt, S. M., Baker, D. W., Chin, M. H., Cinquegrani, M. P., Feldman, A. M., & Francis, G. S., et al. (2001). ACC/AHA Guidelines for evaluation and management of chronic heart failure in the adult: Executive summary. Circulation, 104, 2296–3007.

    Article  Google Scholar 

  30. van Jaarsveld, C. H. M., Sanderman, R., Miedema, I., Ranchor, A. V., & Kempen, G. I. J. M. (2001). Changes in health-related quality of life in older patients with acute myocardial infarction or congestive heart failure: a prospective study. Journal of the American Geriatrics Society , 49(8), 1052–1058.

    Article  PubMed  Google Scholar 

  31. Johansson, P., Agnebrink, M., Dahlström, U., & Broström, A. (2004). Measurement of health-related quality of life in chronic heart failure, from a nursing perspective – a review of the literature. European Journal of Cardiovascular Nursing, 3(1), 7–20.

    Article  PubMed  Google Scholar 

  32. Juenger, J., Schellberg, D., Haunstetter, A., Zugek, C., & Herzog W. (2002). Health related quality of life in patients with congestive to functional variables. Heart, 87, 235–241.

    Article  PubMed  CAS  Google Scholar 

  33. Kamel, C. S., Siguera Filho, A., Barreto, L. F. M., & Benchimol, M. (1999). Correlation among the functional class, the systolic function and the diastolic function in the heart failure. Revista da Sociedade de Cardiologia do Estado do Rio de Janeiro, 12(2), 523–531.

    Google Scholar 

  34. Lessa, I. (2001). Systemic Arterial Hypertension and Heart Failure Epidemiology in Brazil. Revista Brasileira de Hipertensão, 8(4), 383–392.

    Google Scholar 

  35. Lewis, E. F., Johnson, P. A., Johnson, W., Collins, C., Grifffin, L., & Stevenson, L. W. (2001). Quality of life. Preferences for quality of life or survival expressed by patients with heart failure. The Journal of Heart and Lung Transplantation 20(9), 1016–1024.

    Article  PubMed  CAS  Google Scholar 

  36. Lobiondo-Wood, G., & Haber, J. (1994). Nursing Research: methods, critical appraisal and utilization, (3rd Ed.). St Loius: Mosby-Year-Book.

    Google Scholar 

  37. Maratanz, P. R., Tobin, J. N., & Wassertheil-Smoller, S., et al. (1988). The relationship between left ventricular systolic function and congestive heart failure diagnosed by clinical criteria. Circulation 77(3), 607–612.

    Google Scholar 

  38. Masoudi, F. A., Havranek, E. P., & Krumholz, H. M. (2002). The burden of chronic congestive heart failure in older persons: Magnitude and implications for policy and research. Heart Failure Reviews, 7(1), 9–16.

    Article  PubMed  Google Scholar 

  39. Mesquita, E. T. (1998). Heart Failure Clinic—The New Paradigm. Revista da Sociedade de Cardiologia do Estado do Rio de Janeiro, 11(3), 262–265.

    Google Scholar 

  40. Middel, B., Bouma, J., Jongste, M., Sonderen, E., Niemeijer, M. G., Crijns, H., & Heuvel, W. (2001). Psychometric properties of the Minnesota Living with Heart Failure Questionnaire (MLHF-Q). Clinical Rehabilitation , 15, 489–500.

    Article  PubMed  CAS  Google Scholar 

  41. Mitani, H., Hashimoto, H., Isshiki, T., Kurokawa, S., Ogawa, K., & Matsumoto, K., et al. (2003) Health-related quality of life of Japanese patients UIT chronic heart failure—assessment using the medical outcome study Short Form 36. Circulation Journal, 67, 215–220.

    Article  PubMed  Google Scholar 

  42. O’Mahony, M. S., Sim, M. F. V., Ho, S. F., Steward, J. A., Buchalter, M., & Burr, M. (2003). Diastolic heart failure in older people. Age and Ageing, 32(5), 519–524.

    Article  PubMed  Google Scholar 

  43. Owen, A., & Croucher, L. (2000). Effect of an exercise programme for elderly patients with heart failure. European Journal of Heart Failure , 2, 65–70.

    Article  PubMed  CAS  Google Scholar 

  44. Paul, S., & Sneed, N. (2002). Patient Perceptions of Quality of Life and Treatment in an Outpatient Congestive Heart Failure Clinic. Congestive Heart Failure 8,(2), 74–77.

    Google Scholar 

  45. Rector, T. S., & Cohn, J. N. (1992). Assessment of patients outcome with the Minnesota Living with Heart Failure questionnaire: Reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan. American Heart Journal , 124, 1017–1025.

    Article  PubMed  CAS  Google Scholar 

  46. Rector, T. S., Kubo, S. H., & Cohn, J. (1987). Patient’s self-assessment of their congestive heart failure part 2: Content, reliability and validity of a new measure, the Minnesota Living with Heart Failure Questionnaire. Heart Failure, 3, 198–209.

    Google Scholar 

  47. Riegel, B., Moser, D. K., Glaser, D., Carlson, B., Deaton, C., & Armola, R., et al. (2002) The Minnesota Living with Heart Failure Questionnaire: Sensitivity to differences and responsiveness to intervention intensity in a clinical population. Nursing Research 51(4), 209–218.

    Article  PubMed  Google Scholar 

  48. Savonitti, B. H. R. A. (2000) Quality of life institutionalized elderly people. São Paulo (Essay— Master’s Degree—Nursing School from Universidade de São Paulo)

  49. Shively, M., Kodiath, M., Smith, T. L., Kelly, A., Bone, P., & Fetterly, L., et al. (2005). Effect of behavioral management on quality of life in mild heart failure: a randomized controlled trial. Patient Education and Counseling 58, 27–34.

    Article  PubMed  Google Scholar 

  50. Sneed, N. V., Paul, S., Michel, Y., Vanbakel, A., & Hendrix, G. (2001). Evaluation of 3 quality of life measurement tools in patients with chronic heart failure. Heart & Lung, 30, 332–340.

    Article  CAS  Google Scholar 

  51. Standnyk, K., Calder, J., & Rockwood, K. (1998). Testing the measurement properties of the Short Form-36 Health Survey in a frail elderly population. Journal of Clinical Epidemiology , 51(10), 827–835.

    Article  Google Scholar 

  52. Ware, J. E. (1993). Measuring patients’ views: the optimum outcome measure. a valid, reliable assessment of health form the patient’s point of view. BMJ, 306, 1429–1430.

    Article  PubMed  CAS  Google Scholar 

  53. Ware, J. E., Gandek, B., the IQOLA Project Group (1994). The SF-36 health survey: Development and use in mental health research and the IQOLA Project. International Journal of Mental Health , 23, 49–73.

    Google Scholar 

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Acknowledgments

We are grateful to the Statistics Service of the Research Commission, Faculty of Medical Sciences—UNICAMP for their assistance in data analysis, to the Canada Research Chair on Behaviour and Health—Laval University for the support in discussion and English revision, and to the anonymous reviews for the helpful comments.

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Authors and Affiliations

  1. Nursing Department, Medical and Biological Sciences Center, PUC-SP, Sorocaba, Sao Paulo, Brazil

    Izabel C. R. S. Saccomann

  2. Nursing Department, FCM-UNICAMP, Campinas, Sao Paulo, Brazil

    Fernanda A. Cintra & Maria Cecília B. J. Gallani

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  1. Izabel C. R. S. Saccomann
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  2. Fernanda A. Cintra
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  3. Maria Cecília B. J. Gallani
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Correspondence to Izabel C. R. S. Saccomann.

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Saccomann, I.C.R.S., Cintra, F.A. & Gallani, M.C.B.J. Psychometric properties of the Minnesota Living with Heart Failure—Brazilian version—in the elderly. Qual Life Res 16, 997–1005 (2007). https://doi.org/10.1007/s11136-007-9170-z

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