Original Article

Translation and Cross-Cultural Adaptation, Reliability and Validation Study of the Persian Version of Kansas City Cardiomyopathy Questionnaire

Abstract

The Kansas City Cardiomyopathy Questionnaire (KCCQ) has been developed to measure the health status of Congestive heart failure (CHF) patients. This study aimed to translate KCCQ into a Persian version and assess its validity and reliability. We used a forward-backward procedure to translate the questionnaire. In a cross-sectional study, 150 CHF patients and 50 healthy subjects over 30 years old were selected to assess the reliability and construct validity of the instrument. The face and content validity were used for the questionnaire's validity. The validity was examined on a population of patients with CHF using the Persian version of the Minnesota Living Heart Failure Questionnaire (MLHF) health survey. Calculation of the Intraclass correlation coefficient (ICC) and Cronbach's alpha was done to evaluate the questionnaire's reliability. Test-retest reliability was examined by re-administering the KCCQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all domains was higher than 0.93, P≤0.000). Internal consistency was found by Cronbach's alpha to be 0.86 for the clinical summary and 0.87 for the overall summary, respectively. Also, the correlation between the components of KCCQ and MLHQ showed satisfactory construct validity. Good Pearson's Correlation Coefficient was seen between KCCQ and MLHF (r= -0.44, P≤0.000 for the clinical summary; r= -0.45, P≤0.000 for the overall summary). Analysing the data from 50 healthy persons and 150 patients were shown that the Persian version of KCCQ has acceptable discriminate validity for all domains except self-efficacy. The Persian version of the KCCQ had satisfactory reliability and validity for assessing health-related quality of life status for Iranian CHF patients.

1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;37:2129-200.
2. Seferovic P, Stoerk S, Filippatos G, Mareev V, Kavoliuniene A, Ristic A, et al. Committee of National Heart Failure Societies or Working Groups of the Heart Failure Association of the European Society of C. Organization of heart failure management in European Society of Cardiology member countries: survey of the Heart Failure Association of the European Society of Cardiology in collaboration with the Heart Failure National Societies/Working Groups. Eur J Heart Fail 2013;15:947-59.
3. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation 2016;133:e38-e360.
4. Dobre D, de Jongste MJ, Haaijer-Ruskamp FM, Sanderman R, van Veldhuisen DJ, Ranchor AV. The enigma of quality of life in patients with heart failure. Int J Cardiol 2008;125:407-9.
5. Parissis JT, Nikolaou M, Farmakis D, Paraskevaidis IA, Bistola V, Venetsanou K, et al. Self‐assessment of healthTranslation and cross-cultural adaptation, reliability and validation study of the persian version questionnaire 620 Acta Medica Iranica, Vol. 61, No. 10 (2023) status is associated with inflammatory activation and predicts long‐term outcomes in chronic heart failure. Eur J Heart Fail 2009;11:163-9.
6. Miani D, Rozbowsky P, Gregori D, Pilotto L, Albanese MC, Fresco C, et al. The Kansas City cardiomyopathy questionnaire: Italian translation and validation. Ital Heart J 2003;4:620-6.
7. 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;35:1245-55.
8. Arnold SV, Spertus JA, Lei Y, Allen KB, Chhatriwalla AK, Leon MB, et al. Use of the Kansas City Cardiomyopathy Questionnaire for monitoring health status in patients with aortic stenosis. Circ Heart Fail 2013;6:61-7.
9. Rossi G. Nomenclature and diagnostic criteria in cardiology set by the New York Heart Association. Cuore Circ 1967;51:287-93.
10. Demers C, McKelvie RS, Negassa A, Yusuf S, Investigators RPS. Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure. Am Heart J 2001;142:698-703.
11. Moghadam BA, Tamartash H, Fereydunnia S, Ravand M. Translation and Cross-Cultural Adaptation of the Persian Version of Minnesota Living With Heart Failure Questionnaire (MLHFQ). Acta Med Iran 2019;57:435-41.
12. Rector TS, Cohn JN. Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan. Am Heart J 1992;124:1017-25.
13. Rector TS, Johnson G, Dunkman WB, Daniels G, Farrell L, Henrick A, et al. Evaluation by patients with heart failure of the effects of enalapril compared with hydralazine plus isosorbide dinitrate on quality of life. VHeFT II. The V-HeFT VA Cooperative Studies Group. Circulation 1993;87:VI71-7.
14. Rector TS, Kubo SH, Cohn JN. Validity of the Minnesota Living with Heart Failure questionnaire as a measure of therapeutic response to enalapril or placebo. Am J Cardiol 1993;71:1106-7.
15. Rector T. Patient's self-assessment of their congestive heart failure: II. Content, reli-ability and validity of a new measure-The Minnesota Living with heart Failure Questionnaire. Heart fail 1987;3:198.
16. Kubo SH, Gollub S, Bourge R, Rahko P, Cobb F, Jessup M, et al. Beneficial effects of pimobendan on exercise tolerance and quality of life in patients with heart failure. Results of a multicenter trial. The Pimobendan Multicenter Research Group. Circulation 1992;85:942-9.
17. Quittan M, Wiesinger GF, Crevenna R, Nuhr MJ, Posch M, Hülsmann M, et al. Cross-cultural adaptation of the Minnesota Living with Heart Failure Questionnaire for German-speaking patients. J Rehabil Med 2001;33:182-6.
18. Staquet MJ, Hays RD, Fayers PM. Quality of life assessment in clinical trials: methods and practice; 1998.
19. Liow RY, Walker K, Wajid MA, Bedi G, Lennox CM. Functional rating for knee arthroplasty: comparison of three scoring systems. SLACK Incorporated Thorofare, NJ; 2003.
20. Bland JM, Altman DG. Statistics notes: measurement error and correlation coefficients. BMJ 1996;313:41-2.
21. 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;7:214-21.
22. McHorney CA, Ware Jr JE, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993:247-63.
23. Riegel B, Moser DK, Glaser D, Carlson B, Deaton C, Armola R, et al. The Minnesota Living With Heart Failure Questionnaire: sensitivity to dif
Files
IssueVol 61 No 10 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/acta.v61i10.15661
Keywords
Congestive Heart failure Health-related quality of life Questionnaires Reliability Validity KCCQ
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Tamartash H, Attarbashi Moghadam B, Hosseini K, Musavi S. Translation and Cross-Cultural Adaptation, Reliability and Validation Study of the Persian Version of Kansas City Cardiomyopathy Questionnaire. Acta Med Iran. 2024;61(10):614-620.