Quality of Life in Heart Patients / Quality of Life after Myocardial Infarction Questionnaire

Abstract

The Kwaliteit van Leven bij Hartpatiënten (KvL-H), or Quality of Life after Myocardial Infarction Questionnaire, is the validated Dutch translation of the MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew or QLMI-2). This psychometric instrument is designed primarily to assess the efficacy and outcomes of a cardiac rehabilitation program.

The questionnaire requires clients who have experienced heart problems, such as myocardial infarction, to report on the specific problems and feelings they experience as a result of their condition. The original Quality of Life after Myocardial Infarction Questionnaire (QLMI) was initially administered in an interview format but was later converted into a self-administered questionnaire. The MacNew/KvL-H version consists of 27 items and measures three key health-related quality of life domains: emotional, physical, and social functioning.

Keywords

Quality of Life, Myocardial Infarction, MacNew, KvL-H, Cardiac Rehabilitation, Cardiovascular Disease, Psychometric Scale, Health-Related Quality of Life, QLMI, Self-Report.

Authors

The original QLMI/MacNew was developed by Oldridge N, et al. (1991). The Dutch validated version (KvL-H) was developed by van Elderen T, et al. (2000).

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Purpose

The primary purpose of the KvL-H is to provide a standardized, patient-reported measure of the impact of heart disease on daily functioning and well-being. By quantifying the perceived problems and feelings associated with heart conditions, the scale offers an objective assessment tool.

Specifically, the instrument is used in clinical and research settings to evaluate the short-term and long-term effectiveness of therapeutic interventions, particularly comprehensive cardiac rehabilitation programs. It allows clinicians to track changes in a patient’s health status across critical domains following a significant cardiac event.

Construct

The KvL-H measures Health-Related Quality of Life (HRQoL) specifically within the context of heart disease. HRQoL is a multi-dimensional construct encompassing an individual’s subjective perception of their physical and mental health status and how it affects their ability to function in daily life.

The MacNew/KvL-H operationalizes this construct through three established subscales or domains:

• Emotional Domain: Measures feelings related to the heart condition, such as anxiety, depression, anger, or general well-being.
• Physical Domain: Assesses physical limitations, symptoms (like shortness of breath or chest pain), and restrictions on physical activity imposed by the heart problem.
• Social Domain: Evaluates the impact of the condition on social interactions, relationships, hobbies, and leisure activities.

Validity

The KvL-H is reported to be a validated instrument, derived from the internationally recognized MacNew scale (QLMI-2). The original 26-item QLMI was subject to initial validation procedures, establishing its relevance and reliability for assessing the quality of life in post-myocardial infarction patients.

The transition to the 27-item MacNew/KvL-H version maintained and improved upon the scale’s psychometric integrity. Validation studies typically confirm the scale’s content validity (items accurately reflect the construct), criterion validity (correlation with other relevant health measures), and construct validity (the three-factor structure accurately represents the theoretical domains).

Reliability

While specific reliability coefficients (such as Cronbach’s alpha) are detailed in the full manual, the MacNew scale upon which the KvL-H is based is generally accepted as having high internal consistency across its subscales, particularly in large cohorts of patients recovering from myocardial infarction or undergoing cardiac procedures. Test-retest reliability is typically strong, suggesting stability of scores over short periods when the patient’s underlying health status remains unchanged.

Factor Analysis

The structure of the MacNew/KvL-H is supported by factor analytical studies which confirm the existence of the three primary, yet distinct, factors: Emotional, Physical, and Social Quality of Life. These three domains together account for a significant portion of the variance in health-related quality of life among cardiac patients. The initial QLMI adaptation, which had 26 items, was refined to the 27-item MacNew version (QLMI-2) through factor analysis to ensure optimal domain separation and item clarity.

Instrument

Test Type: Questionnaire

Format: Originally an interview (QLMI), later converted into a self-administered questionnaire (KvL-H/MacNew).

Language Available: Dutch (KvL-H), English (MacNew), and various other translations.

Population Group: Patients diagnosed with heart and vascular diseases (Cardiovascular Disease).

Age Group: Adults, Elderly.

Population Details: Primarily used with patients post-myocardial infarction or those participating in structured cardiac rehabilitation programs.

Test Methodology: Self-report scale consisting of 27 items (MacNew/KvL-H). Patients rate their experiences and feelings based on a defined Likert-type response scale, yielding scores for the three domains and a total score for overall HRQoL.

Keywords

Health Status Assessment, Heart Disease, QLMI-2, MacNew, Patient-Reported Outcome Measures (PROMs), Psychometrics, Cardiac Rehabilitation Outcome, Domain Specific Measurement, Self-Report.

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Authors

Author ORCID Identifier: Not specified in source content.

Affiliation Email addresses: Not specified in source content.

Correspondence Address: Not specified in source content.

Permissions & Fee and Test Year

The original QLMI was published in 1991 (Oldridge N, et al.). The Dutch validated version (KvL-H) was published in 2000 (van Elderen T, et al.). Specific details regarding current licensing fees and permissions should be sought directly from the copyright holders of the MacNew instrument.

The original explanatory form (Toelichtingsformulier) for the KvL-H can be found here: KvL-H-form.pdf

The original measurement instrument (Meetinstrument) can be found here: KvL-H-meetinstr.pdf

The original manual (Handleiding) can be found here: KVL-H-handl..pdf

Reference’s

Primary references for the development and validation of the scale include:

• Oldridge N, Guyatt G, Jones N, et al. (1991). Effects of cardiac rehabilitation on health-related quality of life after acute myocardial infarction. Journal of the American Medical Association (JAMA).
• Van Elderen T, Maes S, Maes S. (2000). De Kwaliteit van Leven bij Hartpatiënten (KvL-H): Nederlandse vertaling en validatie. (Validation and Dutch translation of the Quality of Life after Myocardial Infarction Questionnaire).
• MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew or QLMI-2) official documentation.

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Items of the Kwaliteit van Leven bij Hartpatiënten / Quality of Life after Myocardial Infarction Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

[Insert the original scale items from the source content here.]

Note: The specific text of the 27 scale items was not provided in the source content, only the links to the accompanying documents. Users must consult the provided PDF link for the full list of items: KvL-H-meetinstr.pdf