Health related quality of life: Comparison of properties in three questionnaires in a diverse population of persons with chronic heart failure
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BACKGROUND. A number of health related quality of life (HRQoL) questionnaires are available to measure outcomes in persons with chronic heart failure (CHF). The purpose of this study was to determine the psychometric properties, internal consistency and test-retest reliability, sensitivity and responsiveness of three HRQoL questionnaires in a diverse population of persons with CHF undertaking an exercise programme. METHODS. Consecutive persons with CHF referred to an eight-week exercise programme were recruited into a prospective study measuring HRQoL on three occasions (pre-screening Time 1, prior to entry into exercise programme Time 2 and at programme exit Time 3). Internal consistency, test-retest reliability, sensitivity and responsiveness were tested for the Short Form-36 (SF-36), Minnesota Living with Heart Failure (MLwHF) and Kansas City Cardiomyopathy (KCC) questionnaires. A retrospective global rating of change (RGRC) and the incremental shuttle walk test (ISWT) served as external criteria for testing responsiveness. RESULTS. Twenty-three participants were recruited of which most were younger adults (M = 49; SD = 13.7; range 26-79 years) with adequate female (n = 9; 39%) and minority ethnicity (n = 13; 56.5%) representation. The majority of participants (n = 21; 91%) had one or more co-morbidities. With the exception of one domain (self-efficacy α = 0.46 within the KCC questionnaire), domains and summary scores demonstrated adequate internal consistency reliability (n = 22; α > .7). No HRQoL questionnaire, across all domains and summary scores demonstrated adequate test-retest reliability or sensitivity and responsiveness to either of the external criteria on completion of the exercise programme. CONCLUSIONS. This study identifies that the majority of domain and summary scores across three HRQoL questionnaires had adequate internal consistency to be used as outcome measures within a diverse population of persons with CHF. Due to an underpowered study there is inconclusive evidence whether any of the HRQoL questionnaires has adequate test- eliability, sensitivity or responsiveness to detect change post exercise intervention.