Psychometric responsiveness of the health-related quality of life questionnaire (HeartQoL-P) in the Iranian post-myocardial infarction patients

BACKGROUND: Cardiovascular diseases (CVD) as a most frequent and costly NCDs account for about 17.3 million annual deaths worldwide. About 80% of these deaths are taking place in low and middle income countries (LMIC). The survivors may experience severe disabling consequences with extensive impacts on their quality of life. The HeartQoL is a relatively new scale to measure health-related quality of life in CVD patients and was validated for use in other languages. Main aim of the present study was to validate the HeartQoL for Persian speaking populations. DESIGN AND METHODS: In this cross-sectional study the participants were 557 admitted patients with acute myocardial infarction (AMI) across three specialized hospitals in Tabriz, North West of Iran from Sep 2014 to Feb 2015. Translation back-translation procedures were applied to prepare the Persian version of the HeartQol (HeartQoL-P) and the content validity of the scale was evaluated by an expert panel of 10 academic staff. Construct validity was assessed by exploratory and confirmatory factor analyses. The internal consistency was assessed based on the numeric value of Cronbach’s alpha and sensitivity of the measure according to the ceiling and floor effect’s values. RESULTS: The two-factor structure of the HeartQoL-P was supported by the confirmatory factor analysis’ outputs and good internal consistency measures (total score α = 0.94) (physical subscale (10 items) α = 0.95) and emotional subscale (4items) α = 0.80)). No ceiling and floor effects were observed for the overall HeartQol-P’s score. CONCLUSION: The findings supported the HeartQoL-P usability as a valid instrument in studies on the Iranian or other Persian speaking patients.