The utility of a specific measure for heart transplant patients: reliability and validity of the Kansas City Cardiomyopathy Questionnaire

Abstract

Background: Health-Related Quality of Life of patients with heart transplantation is an important variable; however, it has received little attention so far, and only two Spanish validated measurement instruments are available. The aim of our study was to validate the Spanish version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in heart transplant patients.

Methods: A prospective study was performed in 186 patients awaiting heart transplantation in nine transplant hospitals. Hundred transplant recipients filled out the KCCQ, the Euroqol 5-D (EQ5D), and the Short Form-36 (SF-36) Health Survey at pretransplant, after 3 months, 6 months, and 1 year of follow-up. A complete set of sociodemographic and clinical data were also collected. The validity, reliability, sensitivity to change, and effect size were studied. Two questionnaires, the SF-36 and EQ5D, were used to evaluate the validity.

Results: Mean age of patients was 56.0 years, and 80.5% were men. Twenty-six percent had acute rejection. A five-dimensional factorial structure could be discerned. The questionnaire presented a Cronbach's alpha coefficient of more than 0.7. Correlations between the KCCQ and the other questionnaires and clinical variables were satisfactory.

Conclusions: The KCCQ features adequate psychometric properties. The KCCQ offers several advantages over other questionnaires because it quantifies symptoms (frequency, severity, and stability) and it is much more sensitive to change, even when compared with the SF-36. The specific questionnaire for heart transplant patients is a useful and user-friendly instrument for measuring the Health-Related Quality of Life related to functional status, quality of life, and social limitation more accurately.