Development and validation of a patient-centered health-related quality-of-life measure: the chronic heart failure assessment tool.
OBJECTIVE
Despite the importance of health-related quality of life (HRQL) as an outcome measure in chronic heart failure (CHF), instruments currently available have been developed by clinicians or researchers; none have been derived from the patient's perspective. The purpose of this study was to develop and validate a patient-derived, disease-specific HRQL measure.


METHODS
The psychometric testing of the Chronic Heart Failure Assessment Tool (CHAT) followed 2 phases: testing the psychometric properties (n = 223) of the 51-item version of the CHAT in a postal survey and validation of the CHAT (n = 68) using the Medical Outcomes Study 36-Item Short-Form Health Survey and the Minnesota Living With Heart Failure questionnaire.


RESULTS
The CHAT contains questions measuring 7 themes of HRQL: physical ability, emotional state, self-perception, relationships, coping with symptoms, maintaining social/lifestyle status, and cognitive aspects in respect to CHF. Factor analysis was used to analyze these themes. Four domains emerged: symptoms, activity levels, psychosocial aspects, and emotions.


CONCLUSIONS
The CHAT comprises dimensions of HRQL identified by patients in the study population that may more appropriately reflect the concerns of patients. Further work is recommended to develop this tool for use as an HRQL measure in a CHF population.
Dunderdale
Karen
K
Cardiac Rehabilitation, Scunthorpe General Hospital, Scunthorpe, United Kingdom. karen.dunderdale@nlg.nhs.uk
Thompson
David R
DR
Beer
Stephen F
SF
Furze
Gill
G
Miles
Jeremy N V
JN
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D004644:Emotions; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000451:nursing / Q000523:psychology*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D018802:Patient-Centered Care; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires / Q000592:standards*; D006113:United Kingdom