Abstract 3304: Psychometric Evaluation of Two Coronary Heart Disease HRQL Questionnaires in Chinese Patients
Objectives: To evaluate the psychometric properties of two HRQL questionnaires - Myocardial Infarction Dimensional Assessment Scale (MIDAS) and the MacNew HRQL Questionnaire (MacNew) - in Chinese patients with coronary heart disease.
Methods: Conforming to the guidelines of the Medical Outcomes Trust (2002), we examined item-internal consistency, stability, concurrent, discriminative and construct validity, and a conceptual model of the Chinese versions of the MIDAS and MacNew instruments.
Results: Data were obtained from 393 patients with either myocardial infarction (n = 131), angina (n = 165) or heart failure (n = 102), with 92 of them repeating completion of the questionnaires seven days later for testing stability. Cronbach’s alphas (MIDAS, r = 0.73 – 0.94; MacNew subscales, r = 0.88 – 0.93) supported their item-internal consistency and test-retest reliability exceeded ICC > 0.75 for both. Concurrent and construct validity for the MIDAS and MacNew subscales were supported by their moderate to high correlations with most of the Short Form 36 Health Survey subscales and the Hospital Anxiety and Depression Scale, except that the diet, medication and side effect subscales of MIDAS showed lower correlations. Discriminative validity of the MIDAS and MacNew subscales was demonstrated with poorer HRQL in female patients (p <.001), those with psychiatric morbidity (p <.001) and those with health deterioration (p <.001). Results of confirmatory factor analysis supported the original seven-factor and three-factor structure of the MIDAS and MacNew, respectively, with five items of the MacNew loading significantly on only one but not two subscales as proposed by the original version.
Conclusion: The MacNew and the MIDAS are psychometrically sound when used in Chinese patients with coronary heart disease. The problematic subscales of the MIDAS may be related to their small number of items (≤ 3) and cultural variations in perceiving disease management.