Vol. 3 No. 3 (2024): simul-action for elevation
Articles

New insights into validity, reliability, and measurement invariance of the Kansas City Cardiomyopathy Questionnaire 23

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  • Hamilton Dollaku,
  • Paolo Iovino,
  • Gianluca Pucciarelli,
  • Laura Rasero,
  • Izabella Uchmanowicz,
  • Rosaria Alvaro,
  • Ercole Vellone
Hamilton Dollaku
MS, RN, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy; Fondazione Don Carlo Gnocchi, Florence, Italy;
Paolo Iovino
PHD, RN, Assistant Professor, Health Sciences Department, University of Florence, Italy
Gianluca Pucciarelli
PHD, RN, FAHA, Assistant Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
Laura Rasero
RN, MSN, Associate Professor, Health Sciences Department, University of Florence, Italy
Izabella Uchmanowicz
RN, PhD, FESC, FHFA, Professor, Faculty of Health Sciences, Department of Nursing and Obstetrics, Wroclaw Medical University, Poland
Rosaria Alvaro
MSN, RN, FAAN, FESC, Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
Ercole Vellone
PhD, RN, FAAN, FESC, Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy - Faculty of Health Sciences, Department of Nursing and Obstetrics, Wroclaw Medical University, Poland
DOI: https://doi.org/10.36253/if-2957

Published 2024-09-30

Keywords

  • Psychometric properties;,
  • Validation Study,
  • Quality of Life,
  • Instrument,
  • Heart Failure,
  • Health Status,
  • Reliability
    • ...More
    Less

Copyright (c) 2024 Hamilton Dollaku, Paolo Iovino, Gianluca Pucciarelli, Laura Rasero, Izabella Uchmanowicz, Rosaria Alvaro, Ercole Vellone

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background: People affected by heart failure (HF) often exhibit a poor health status, which places a great deal of burden on the healthcare systems. The Kansas City Cardiomyopathy Questionnaire (KCCQ) 23 is the most used tool to measure the health status in this population; however, its psychometric properties have not been thoroughly established.
Objective: To evaluate the psychometric properties of the KCCQ-23 in a European cohort of HF patients.
Methods: 510 patients (median age 74 years, IQR=18, 58% males) completed the KCCQ-23 along with clinical and psychosocial measures. Factorial validity was established with confirmatory factor analysis (CFA); omega and model-based internal consistency indexes were computed to examine the internal consistency of the scale. Convergent validity was established by correlating the KCCQ-23 scores with clinical and psychosocial measures. Measurement invariance tests across those with preserved vs reduced ejection fraction were conducted within a multigroup framework.
Results: Two CFA solutions were tested, which confirmed the theoretical and empirical models postulated by the original author. The internal consistency coefficients for the latent dimensions were adequate (Omega range =0.77-0.93; internal consistency coefficient =0.89-96). KCCQ-23 scores were found to be correlated with ejection fraction, NYHA levels, quality of life, self-care confidence, anxiety and depression, and symptom burden, supporting its convergent validity. Finally, the KCCQ-23 was invariant across ejection fraction levels, both in the theoretical and empirical factor solution.
Conclusion: Overall, this study provides evidence of satisfactory psychometric properties of the KCCQ-23, promoting its use in clinical settings and research fields.

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