[EuroQol-5D FOR quality of life assessment in cardiac rehabilitation].
EuroQol-5D (EQ-5D) is a well-known generic instrument measuring quality of life in different diseases; it includes 5 dimensions (mobility, self-care, daily activities, pain-discomfort, anxiety and depression) and a Visual Analogue Scale that evaluates patients' perceived health status. The aim of this study was to verify the utility of the EQ-5D in the Italian Cardiac Rehabilitation setting. The study population consisted of 248 consecutive cardiac rehabilitation inpatients (176 males and 72 females, aged 65.3 +/- 10.75 years), 200 of whom had recently undergone cardiac surgery (aortocoronary by-pass and/or valve replacement). Patients filled in the EQ-5D and A-D schedule (on anxiety and depression) on their second day in hospital. Exploratory and Confirmatory Factor Analysis confirmed the robust nature of the EQ-5D and its mono-factorial structure (EFA: Total Variance 50.39% - CFA: chi2 = 3.596; p approximately equal .60; RMSEA = 00; CFI = 1.00; RMR = .007). The instrument showed a good internal consistency (a .73) despite the limited number of items. T test and ANOVA showed the independence of the EQ-5D dimensions and VAS evaluation with respect to patients' education level, but an influence of age and sex. In general, females reported a lower quality of life than males, and older patients a lower quality of life than younger. Furthermore, cardiac-surgery patients reported more problems in self-care and pain-discomfort than ischemic/heart failure patients, and patients in NYHA Classes III and IV reported more difficulties in mobility than patients in lower NYHA classes. In 15% of patients, of heterogeneous socio-demographic and clinical characteristics, no problems in any of the 5 EQ-5D dimensions were reported: this group was characterised by scores under the clinical cut-off on anxiety and depression and showed a better quality of life on the VAS. Results confirm the robustness of the EuroQol-SD psychometric properties and the instrument's utility for the routine assessment of quality of life in the Italian Cardiac Rehabilitation setting.
Servizio di Psicologia, Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Veruno. gianluigi.balestroni@fsm.it
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D000203:Activities of Daily Living; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005060:Europe; D005260:Female; D006331:Heart Diseases / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016138:Walking