Reliability and validity of Chinese version of MLHFQ scale in evaluating the quality of life of patients with chronic Keshan disease / 中华地方病学杂志

Objective:To evaluate the reliability and validity of Chinese version of Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale among patients with chronic Keshan disease.Methods:The patients with chronic Keshan disease diagnosed in Keshan disease area of Gansu Province from August 2018 to April 2020 were selected as the survey subjects to analyze the reliability and validity of the Chinese version of MLHFQ scale in evaluating the quality of life of patients with chronic Keshan disease. To evaluate the reliability of MLHFQ scale, the Cronbach's α coefficient was used, and when the Cronbach's α coefficient > 0.8 indicated that the consistency reliability of the scale was good. Kaider-Meyer-Olkin(KMO) statistic and Barlett's sphericity test were used to evaluate whether the scale was suitable for factor analysis (applicable when KMO > 0.6 and Barlett's sphericity test P < 0.05). The principal component analysis and maximum variance method of exploratory factor analysis were used to extract common factors, and the structural validity of the scale was evaluated. The discrimination validity of the scale was evaluated by New York Heart Association (NYHA) cardiac function classification and analysis of variance. Pearson correlation analysis was used to evaluate the content validity of the scale. Results:A total of 333 questionnaires were collected, of which 329 were valid. There were 180 males and 149 females, aged (59.52 ± 9.26) years. The Cronbach's α coefficient of the Chinese version of MLHFQ scale was 0.95 ( > 0.8). Among them, the Cronbach's α coefficients in the physical domain, emotional domain and other domains were 0.93, 0.91 and 0.86, respectively ( > 0.8). The KMO value of the Chinese version of MLHFQ scale was 0.95 ( > 0.6), and Barlett's sphericity test rejected the hypothesis (χ 2 = 5 222.01, P < 0.05). Principal component analysis and maximum variance method were used to extract 3 common factors, which were named kinetic energy of life, physical condition and emotional condition, respectively. The cumulative contribution rate of principal components was 66.22% ( > 50%). Compared with patients with NYHA cardiac function grade Ⅱ and patients with grade Ⅲ and Ⅳ, there were significant differences in the physical domain, other domain and total score ( P < 0.001). The Pearson correlation coefficients between the physical, emotional, and other domains and their respective items ranged from 0.74 to 0.88, 0.78 to 0.90, and 0.56 to 0.80, respectively, and the correlation coefficients between each item and its domain were all > 0.5 ( P < 0.001). Conclusion:The Chinese version of MLHFQ scale has good reliability and validity in patients with chronic Keshan disease in Gansu Province, and can be used to evaluate the quality of life of patients with chronic Keshan disease.

Validación del Minnesota Living with Heart Failure questionnaire (MLFHQ) en pacientes con falla cardíaca en Colombia / Validation of the Minnesota Living with Heart Failure questionnaire in patients with heart failure in Colombia

Resumen Objetivo: Validar el cuestionario de calidad de vida `` Minnesota Living with Heart Failure'' en pacientes con falla cardíaca para su uso en población colombiana. Materiales y métodos: Estudio observacional de validación de una escala, prospectivo en tres momentos: en el primero se hizo la traducción, la retrotraducción y la adaptación cultural; en el segundo se hizo la evaluación de la validez de contenido, constructo, criterio convergente y divergente con el SF36, WHODASII y DASI, y se evaluó la consistencia interna y la fiabilidad intra e interobservador, y en el tercero, longitudinal, se evaluó la sensibilidad al cambio. Resultados: Se incluyeron 134 pacientes, con clase funcional I-IV de la NYHA, fracción de eyección ≤ 50%. El análisis confirmatorio se ajustó a las tres dimensiones de la escala original. Hubo mejor calidad de vida en quienes tuvieron mejor capacidad física de acuerdo con los MET alcanzados. La validez de criterio convergente fue superior a 0,6 y la divergente menor a 0,4 con el SF36, WHODAS II y DASI. Se encontraron diferencias estadísticamente significativas entre el inicio, el primero, el tercero y el sexto mes. El mínimo cambio detectable (MCD) fue para la dimensión física de 6,0, para la dimensión emocional de 4,8 y para el total de 12,6. Conclusiones: La escala de "Minnesota Living with Heart Failure" (MLHFQ) es válida, confiable y tiene una buena sensibilidad al cambio para ser utilizada en las personas con falla cardiaca en Colombia.

Abstract Objective: To validate the "Minnesota Living with Heart Failure" quality of life questionnaire in patients with heart failure, for its use in a Colombian population. Materials and methods: An observational, prospective study with validation of a scale at three points was conducted. First of all, a translation, back-translation, and cultural adaptation were performed. This was followed by the evaluation of the content validity, construct, convergent and divergent criteria with the SF36, WHODAS II and DAS I questionnaires, as well as the assessment of internal consistency and the within- and between-observer reliability. Finally, a longitudinal study was carried out to evaluate the sensitivity to change. Results: The study included a total of 134 patients, with NYHA functional class I-IV, and an ejection fraction ≤ 50%. The confirmatory analysis was adjusted to the three dimensions of the original scale. There was a better quality of life in those that had a better physical capacity according to the MET achieved. The validity of the convergent criteria was greater than 0.6, with the divergent being less than 0.4 with the SF36, WHODAS II and DASI. Statistically significant differences were found between the beginning and the first, third, and sixth month. The minimum detectable change was for the physical dimension, 0.6, for the emotional dimension, 4.8, and for the total, 12.6. Conclusions: The "Minnesota Living with Heart Failure" scale is valid and reliable, and has a good sensitivity to change, in order to be used in the populations with heart failure in Colombia.

Health-related quality of life in patients with Chagas disease / Qualidade de vida relacionada à saúde na doença de Chagas

INTRODUCTION: Chagas disease (ChD) is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL) of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL) profile of ChD patients and compare this with a non-ChD (NChD) group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD and 21 NChD individuals using the Medical Outcomes Study 36-item Short-Form (SF-36) and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ). Patients were submitted to a standard protocol that included clinical examination, ECG, Holter monitoring, Doppler echocardiogram and autonomic function tests. RESULTS: HRQoL scores were significantly worse among the ChD group compared to the NChD group in the SF-36 domains of physical functioning and role-emotional and in the MLWHFQ scale. For the ChD group, univariate analysis showed that HRQoL score quartiles were associated with level of education, sex, marital status, use of medication, functional classification and cardiovascular and gastrointestinal symptoms. In the multivariate analysis, female sex, fewer years of education, single status, worst functional classification, presence of cardiovascular and gastrointestinal symptoms, associated illnesses, Doppler echocardiographic abnormalities and ventricular arrhythmia detected during Holter monitoring were predictors of lower HRQoL scores. CONCLUSIONS: ChD patients showed worse HRQoL scores compared to NChD. For the ChD group, sociodemographic and clinical variables were associated with worst scores.

INTRODUÇÃO: A doença de Chagas (DCh) é associada à morbidade e mortalidade significativas e que pode afetar a qualidade de vida (QV) dos pacientes infectados. Entretanto, encontramos poucos estudos sobre a QV na DCh. Os objetivos deste estudo são definir o perfil de qualidade de vida relacionada à saúde (QVRS) em pacientes com DCh, compará-lo com indivíduos sem a doença de Chagas (NDCh) e encontrar os fatores associados com os piores escores de QV para aqueles com DCh. MÉTODOS: A QVRS foi investigada em 125 pacientes com DCh e 21 NDCh aplicando-se os questionários Medical Outcomes Study 36-item short-Form (SF36) e Minnesota Living With Heart Failure Questionanaire (MLWHFQ). Os pacientes foram submetidos a exame clínico, ECG, monitorização por Holter, Doppler ecocardiograma e testes de função autonômicas. RESULTADOS: Os escores de QVRS nos domínios capacidade física e aspecto emocional do SF36 e na escala de MLWHFQ foram significativamente piores entre os pacientes com DCh. A análise univariada mostrou associação dos escores QVRS e nível de formação, gênero, situação conjugal, uso de medicamentos, classe funcional e sintomas cardiovasculares e gastrointestinais. Na análise multivariada, sexo feminino, poucos anos de estudos, situação conjugal de solteiro, pior classificação funcional, presença de sintomas cardiovasculares e gastrointestinais, doenças associadas, alteração ao Doppler ecocardiograma e arritmia ventricular ao Holter foram preditores de pior QVRS. CONCLUSÕES: Pacientes com DCh apresentaram piores escores de QVRS quando comparados com NDCh. Para o grupo com DCh, variáveis sociodemográficas e clínicas se associaram aos piores escores.