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Development and Validation of an Arrhythmia-Specific Scale in Tachycardia and Arrhythmia With Focus on Health-Related Quality of Life

Ulla, Walfridsson PhD, RN; Anna, Strömberg PhD, RN; Årestedt, Kristofer PhD, RN

Journal of Cardiovascular Nursing:
doi: 10.1097/JCN.0000000000000149
Articles
Abstract

Background: Arrhythmias can cause a profoundly negative impact on a person’s daily life, leading to impaired health-related quality of life (HRQOL). Assessment of HRQOL can provide valuable information before, during, and after healthcare interventions for arrhythmias.

Objective: The aim was to develop and validate a disease-specific scale evaluating HRQOL in patients with different forms of arrhythmia.

Methods: The Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA HRQOL) was developed from a literature review, patient interviews, and expert panel evaluations. This version was then psychometrically evaluated in patients treated with radiofrequency catheter ablation because of different forms of arrhythmias and patients who sought emergency care because of atrial fibrillation. Construct validity was evaluated with item-total correlations, confirmatory factor analyses, and convergent and discriminant validity. Internal consistency was evaluated using Cronbach’s α.

Results: All items reached the expected level of item-total correlations of greater than 0.3 for the total scale. The content validity index was sufficient for all items, as was the total scale (0.86–1.0). The 2-factor confirmatory factor analysis model that included the physical and mental factors showed a better fit between model and data than the 1-factor model did (P < .001). Convergent and discriminant validities were evaluated in the correlation analyses between the ASTA HRQOL subscales and SF-36 physical and mental dimensions. A strong correlation was found between the hypothesized physical and mental scales. Internal consistency was satisfactory with a lower bound confidence interval (95%) for Cronbach’s α .70 or greater for all the ASTA HRQOL scales.

Conclusions: The ASTA HRQOL questionnaire can be a valuable contribution to HRQOL assessments in patients with different forms of arrhythmia. Until there is more evidence regarding validity and reliability, using both the total and subscale scores is recommended.

Author Information

Walfridsson Ulla, PhD, RN Registered Nurse, Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Department of Cardiology University Hospital, County Council of Östergötland, Linköping, Sweden.

Strömberg Anna, PhD, RN Professor, Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Department of Cardiology University Hospital, County Council of Östergötland, Linköping, Sweden.

Kristofer Årestedt, PhD, RN Assistant Lecturer, School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Sweden; Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.

The authors have no funding or conflicts of interest to disclose.

Correspondence Walfridsson Ulla, PhD, RN, Department of Cardiology University Hospital, County Council of Östergötland, Linköping, Sweden (ulla.walfridsson@lio.se).

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