V. 3 N. 3 (2024): simul-action for elevation
Articles

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

PDF (English)
  • 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

Pubblicato 2024-09-30

Parole chiave

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

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

Creative Commons License

TQuesto lavoro è fornito con la licenza Creative Commons Attribuzione 4.0 Internazionale.

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.

PDF (English)

Riferimenti bibliografici

  1. Shahim B, Kapelios CJ, Savarese G, Lund LH. Global public health burden of heart failure: an updated review. Card Fail Rev 2023;9.
  2. Jones NR, Roalfe AK, Adoki I, Hobbs FR, Taylor CJ. Survival of patients with chronic heart failure in the community: a systematic review and meta‐analysis. Eur J Heart Fail 2019;21:1306-1325.
  3. Kato M, Mori Y, Watanabe D et al. Discharge disposition and 1-year readmission in acute-phase hospitalized patients with heart failure: a retrospective observational multi-center study. Heart Vessels 2022;37:1551-1561.
  4. Brake R, Jones ID. Chronic heart failure part 1: pathophysiology, signs and symptoms. Nurs Stand 2017;31.
  5. Johansson I, Joseph P, Balasubramanian K et al. Health-related quality of life and mortality in heart failure: the global congestive heart failure study of 23 000 patients from 40 countries. Circulation 2021;143:2129-2142.
  6. Lawson CA, Benson L, Squire I et al. Changing health-related quality of life and outcomes in heart failure by age, sex and subtype. EClinicalMedicine 2023;64.
  7. Riegel B, Westland H, Iovino P et al. Characteristics of self-care interventions for patients with a chronic condition: A scoping review. Int J Nurs Stud 2021;116:103713.
  8. Green CP, Porter CB, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol 2000;35:1245-1255.
  9. Pettersen KI, Reikvam A, Rollag A, Stavem K. Reliability and validity of the Kansas City cardiomyopathy questionnaire in patients with previous myocardial infarction. Eur J Heart Fail 2005;7:235-242.
  10. Faller H, Steinbüchel T, Schowalter M, Spertus JA, Störk S, Angermann CE. The Kansas City Cardiomyopathy Questionnaire (KCCQ)--a new disease-specific quality of life measure for patients with chronic heart failure. Psychother Psychosom Med Psychol 2005;55:200-208.
  11. Spertus JA, Jones PG, Kim J, Globe D. Validity, reliability, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients. Qual Life Res 2008;17:291-298.
  12. Joseph SM, Novak E, Arnold SV et al. Comparable performance of the Kansas City Cardiomyopathy Questionnaire in patients with heart failure with preserved and reduced ejection fraction. Circ Heart Fail 2013;6:1139-1146.
  13. Creber RM, Polomano R, Farrar J, Riegel B. Psychometric properties of the Kansas City cardiomyopathy questionnaire (KCCQ). Eur J Cardiovasc Nurs 2012;11:197-206.
  14. Tucker R, Quinn JR, Chen D-GD, Chen L. Kansas City Cardiomyopathy Questionnaire administered to hospitalized patients with heart failure. J Nurs Meas 2016;24:245-257.
  15. Nave-Leal E, Pais-Ribeiro J, Oliveira MM et al. Psychometric properties of the Portuguese version of the Kansas City cardiomyopathy questionnaire in dilated cardiomyopathy with congestive heart failure. Rev Port Cardiol 2010;29:353-372.
  16. Comín-Colet J, Garin O, Lupón J, Manito N, Crespo-Leiro MG, Gómez-Bueno M. Validation of the Spanish version of the Kansas City Cardiomyopathy Questionnaire. Rev Esp Cardiol 2011;64:51-8.
  17. Patel H, Ekman I, Spertus JA, Wasserman SM, Persson L-O. Psychometric properties of a Swedish version of the Kansas City Cardiomyopathy Questionnaire in a chronic heart failure population. Eur J Cardiovasc Nurs 2008;7:214-221.
  18. Okello S, Abeya FC, Lumori BAE et al. Validation of heart failure quality of life tool and usage to predict all-cause mortality in acute heart failure in Uganda: the Mbarara heart failure registry (MAHFER). BMC Cardiovasc Disord 2018;18:1-10.
  19. Watanabe-Fujinuma E, Origasa H, Bamber L et al. Psychometric properties of the Japanese version of the Kansas City Cardiomyopathy Questionnaire in Japanese patients with chronic heart failure. Health Qual Life Outcomes 2020;18:1-11.
  20. Ortega T, Díaz-Molina B, Montoliu MA et al. The utility of a specific measure for heart transplant patients: reliability and validity of the Kansas City Cardiomyopathy Questionnaire. Transplantation 2008;86:804-810.
  21. Barbaranelli C, Lee CS, Vellone E, Riegel B. The problem with Cronbach's alpha: comment on Sijtsma and van der Ark (2015). Nurs Res 2015;64:140.
  22. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health 2018;6:149.
  23. Hancock GR, Mueller RO, Stapleton LM. The reviewer's guide to quantitative methods in the social sciences. Routledge, 2010.
  24. Kline R. Principles and practice of structural equation modeling. 2010.
  25. Roberson III RB, Elliott TR, Chang JE, Hill JN. Exploratory factor analysis in Rehabilitation Psychology: A content analysis. Rehabil Psychol 2014;59:429.
  26. Vellone E, Paturzo M, D'Agostino F et al. MOTIVATional intErviewing to improve self-care in Heart Failure patients (MOTIVATE-HF): Study protocol of a three-arm multicenter randomized controlled trial. Contemp Clin Trials 2017;55:34-38.
  27. Ponikowski P, Voors AA, Anker SD et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Kardiol Pol 2016;74:1037-1147.
  28. Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care 2002;40:771-81.
  29. Bennett JA, Riegel B, Bittner V, Nichols J. Validity and reliability of the NYHA classes for measuring research outcomes in patients with cardiac disease. Heart Lung 2002;31:262-270.
  30. Vellone E, Riegel B, Cocchieri A et al. Psychometric testing of the Self-Care of Heart Failure Index Version 6.2. Res Nurs Health 2013;36:500-11.
  31. Ware J, Jr., Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220-33.
  32. De Smedt D, Clays E, Doyle F et al. Validity and reliability of three commonly used quality of life measures in a large European population of coronary heart disease patients. Int J Cardiol 2013;167:2294-2299.
  33. Christensen AV, Dixon JK, Juel K et al. Psychometric properties of the Danish Hospital Anxiety and Depression Scale in patients with cardiac disease: results from the DenHeart survey. Health Qual Life Outcomes 2020;18:1-13.
  34. Jurgens CY, Lee CS, Riegel B. Psychometric analysis of the heart failure somatic perception scale as a measure of patient symptom perception. J Cardiovasc Nurs 2017;32:140.
  35. Pucciarelli G, Greco A, Paturzo M et al. Psychometric evaluation of the Heart Failure Somatic Perception Scale in a European heart failure population. Eur J Cardiovasc Nurs 2019;18:484-491.
  36. Vellone E, Rebora P, Ausili D et al. Motivational interviewing to improve self-care in heart failure patients (MOTIVATE-HF): a randomized controlled trial. ESC Heart Fail 2020;7:1309-1318.
  37. George D, Mallery P. IBM SPSS Statistics 25 Step by Step: A Simple Guide and Reference. Routledge, 2018.
  38. Muthén LK, Muthén BO. Mplus user‘s guide. 1998–2010. Muthén and Muthén; 2010.
  39. Spertus JA, Jones PG, Sandhu AT, Arnold SV. Interpreting the Kansas City Cardiomyopathy Questionnaire in clinical trials and clinical care: JACC state-of-the-art review. J Am Coll Cardiol 2020;76:2379-2390.
  40. Tanaka JS. Multifaceted conceptions of fit in structural equation models. Testing structural equation models. 1993;154:10.
  41. Hair JF. Multivariate data analysis. 2009.
  42. Cohen J. Statistical power analysis for the behavioral sciences. Academic Press, 2013.
  43. Fernandes SL, Carvalho RR, Santos LG et al. Pathophysiology and treatment of heart failure with preserved ejection fraction: state of the art and prospects for the future. Arq Bras Cardiol 2019;114:120-129.
  44. Meredith W. Measurement invariance, factor analysis and factorial invariance. Psychometrika 1993;58:525-543.
  45. Nunnally JC. Psychometric theory—25 years ago and now. Educ Res 1975;4:7-21.
  46. Spertus JA, Jones PG. Development and validation of a short version of the Kansas City Cardiomyopathy Questionnaire. Circ Cardiovasc Qual Outcomes 2015;8:469-476.
  47. Salyer J, Flattery M, Lyon DE. Heart failure symptom clusters and quality of life. Heart Lung 2019;48:366-372.
  48. Chen C, Fang W, An Y, Wang L, Fan X. The multiple mediating effects of illness perceptions and coping strategies on the relationship between physical symptoms and depressive symptoms in patients with heart failure. Eur J Cardiovasc Nurs 2020;19:125-133.
  49. Gallagher AM, Lucas R, Cowie MR. Assessing health‐related quality of life in heart failure patients attending an outpatient clinic: a pragmatic approach. ESC Heart Fail 2019;6:3-9.
  50. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Adv Behav Res Ther 1978;1:139-161.