ABSTRACT
BACKGROUND: Assessment of health-related quality of life (HRQL) using generic measures may not be optimally responsive to treatment interventions. The disease-specific instrument, MacNew heart disease HRQL questionnaire (MacNew), is designed specifically to evaluate HRQL among heart patients. AIMS: To validate the Hebrew version of MacNew, and to report HRQL of Israeli chronic cardiac patients. METHODS: The generic SF-36 and the MacNew HRQL questionnaires were administered to 221 Hebrew speaking heart patients treated in the outpatient clinic of the Sheba Medical Center. RESULTS: According to the SF-36, HRQL is relatively low in the cardiac patients compared to Israeli norms, and comparable to norms of American heart patients according to the MacNew. Heart-failure patients have the lowest HRQL scores in all three dimensions (physical, mental, social) and the total score identified for the MacNew. Confirmatory factor analysis verified good model fit for physical/emotional domain items, supporting structural validity. Spearman coefficients correlating MacNew with parallel SF-36 domains were moderate-high (r=0.63-0.89, p<0.01), supported convergent validity. Cronbach's alpha was > 0.9 (total MacNew score, dimensions), supporting internal reliability, as was the test-retest reliability, examined 1.5 months later among 11 patients. The different scales discriminated between heart failure, angina pectoris, and other heart patients, supporting criterion validity. A multilinear regression model showed significant correlation between heart failure, past myocardial infarction (MI), years of schooling, duration of heart disease and HRQL. CONCLUSIONS: Among patients with heart disease, the MacNew is highly acceptable and maintains good psychometric properties, comparing favorably with SF-36. DISCUSSION AND CONCLUSION: These findings suggest MacNew's utility for measuring disease-specific HRQL in Israeli heart patients.