Measurement Properties of English and Chinese Versions of HeartQoL in a Multiethnic Asian Cohort With Cardiovascular Disease

Abstract

Objectives To evaluate the measurement properties of the HeartQoL questionnaire in assessing health-related quality of life (HRQoL) among multiethnic Asian patients with cardiovascular diseases (CVDs). Methods A cross-sectional survey was conducted among 556 CVD patients from 2 tertiary hospitals in Singapore. Patients self-assessed HRQoL using HeartQoL (a heart-disease-specific measure) and EuroQol 5-Dimension 5-Level (EQ-5D-5L) (a generic measure). HeartQoL includes a global scale and 2 subscales (physical and emotional), with higher values indicating better HRQoL. Measurement properties of HeartQoL were evaluated through convergent validity (Spearman’s ρ), internal consistency (Cronbach’s α), discriminative validity, and language equivalence between English and Chinese (Mandarin) versions. Results The mean age of recruited patients was 57.7 years (SD 11.5). 72.2% were male, and 461 (82.9%) responded to the survey in English. Cronbach’s α for the HeartQoL emotional, physical, and global scales were 0.86, 0.88, and 0.89, respectively. All scales were significantly positively correlated with relevant EQ-5D-5L items (r ≥ 0.4, P < .01) and negatively associated with CVD functional classification ( P for trend < .01). Among Chinese ethnic patients, the 90% confidence interval for mean differences in HeartQoL scales between English and Mandarin versions was within ±0.5 SD, confirming measurement equivalence between the 2 language versions. Conclusions The HeartQoL demonstrated robust measurement properties in Asian CVD patients. The finding supports its use in clinical practice and research to assess and compare HRQoL among patients with CVDs.