Specific health care instruments to
measure quality of life in patients with heart failure.


The domains or components of quality of life that are measured in health care tools with patients with heart failure often include physical functioning, occupational functioning or ability to perform multiple tasks, beliefs about health status, normal or abnormal psychological functioning and social functioning.

In general, they ask questions related to Maslow’s lower two to three levels of needs – physiological, safety with less questions related to love and belonging. Questions about positive emotion, engagement, relationships, meaning, accomplishment, personal growth or even depression or optimism are not used. Positive health assets are not assessed yet.

According to Slade (2010) measuring recovery and quality of life is being expanded to include hope, and a meaningful and fulfilling life, not just functional measurement.

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Some specific instruments to measure quality of life in heart failure patients include: the Medical Outcomes Trust Short Form 36-Item Health Survey (SF-36) health survey questionnaire; The Health Related Quality of Life questionnaire (HRQOL); and the Kansas City Cardiomyopathy Questionnaire to list the most popular ones. More are being used and developed.

The SF-36 health survey questionnaire and the HRQOL are general health survey questionnaires applicable to patients with many health alterations including heart disease. The Kansas City Cardiomyopathy Questionnaires is a specific questionnaire designed to measure some aspects of quality of life with heart disease.

The Medical Outcomes Trust Short Form 36-Item Health Survey (SF-36)

The SF-36 is currently the most widely used health care measurement of quality of life (Haywood et al, 2005). The SF-36 is a 36 item self-administered questionnaire. The general categories of the questionnaire include physical functioning, ability to physically carry out their life role, bodily pain, general health, vitality, social functioning, role emotional, and mental health.

The Health Related Quality of Life questionnaire (HRQOL-14)

The Health Related Quality of Life questionnaire (HRQOL-14) is being used by the CDC’s Division of Population Health. They are attempting to carry out surveillance and dissemination of HRQOL to assess well-being outcomes in the US. They are encouraging the use of the tool for epidemiological studies, risk factor identification, health disparities and additional research. The tool measures physical and mental health.

On the individual level, HRQOL includes physical and mental health beliefs, functional status, social support and socioeconomic status. The three modules of questions can be seen on at this website address. http://www.cdc.gov/hrqol/hrqol14_measure.htm

Healthy Days Symptoms Module

1. Would you say that in general your health is:

Please Read
a. Excellent
1
b. Very good
2
c. Good
3
d. Fair
4
or
e. Poor
5
Do not read these responses
Don't know/Not sure
7
Refused
9
 

2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?

a. Number of Days _ _
b. None 88
Don't know/Not sure  
Refused  

3. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?

a. Number of Days _ _
b. None 88
If both Q2 AND Q3 = "None," skip next question
Don't know/Not sure 77
Refused 99

4. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?

a. Number of Days _ _
b. None 88
Don't know/Not sure 77
Refused 99

Activity Limitations Module

These next questions are about physical, mental, or emotional problems or limitations you may have in your daily life.

1. Are you LIMITED in any way in any activities because of any impairment or health problem?

a. yes 1  
b. No 2 Go to Q1 of Healthy Days Symptoms Module
Don't know/Not sure 7 Go to Q1 of Healthy Days Symptoms Module
Refused 9 Go to Q1 of Healthy Days Symptoms Module

2. What is the MAJOR impairment or health problem that limits your activities?

Do Not Read. Code Only One Category.
a. Arthritis/rheumatism 01
b. Back or neck problem 02
c. Fractures, bone/joint injury 03
d. Walking problem 04
e. Lung/breathing problem 05
f. Hearing problem 06
g. Eye/vision problem 07
h. Heart problem 08
i. Stroke problem 09
j. Hypertension/high blood pressure 10
k. Diabetes 11
l. Cancer 12
m. Depression/anxiety/emotional problem 13
n. Other impairment/problem 14
   
Don't know/Not sure 77
Refused 99
   
   

3. For HOW LONG have your activities been limited because of your major impairment or health problem?

Do Not Read. Code using respondent's unit of time.
a. Days 1_ _
b. Weeks 2_ _
c. Months 3_ _
d. Years 4_ _
   
Don't know/Not sure 777
Refused 999

4. Because of any impairment or health problem, do you need the help of other persons with your PERSONAL CARE needs, such as eating, bathing, dressing, or getting around the house?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

5. Because of any impairment or health problem, do you need the help of other persons in handling your ROUTINE needs, such as everyday household chores, doing necessary business, shopping, or getting around for other purposes?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

Healthy Days Symptoms Module

1. During the past 30 days, for about how many days did PAIN make it hard for you to do your usual activities, such as self-care, work, or recreation?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

2. During the past 30 days, for about how many days have you felt SAD, BLUE, or DEPRESSED?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

3. During the past 30 days, for about how many days have you felt WORRIED, TENSE, or ANXIOUS?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

4. During the past 30 days, for about how many days have you felt you did NOT get ENOUGH REST or SLEEP?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

5. During the past 30 days, for about how many days have you felt VERY HEALTHY AND FULL OF ENERGY?

a. Yes 1
b. No 2
   
Don't know/Not sure 7
Refused 9

Kansas City Cardiomyopathy Questionnaire (KCCQ)

The development of the Kansas City Cardiomyopathy Questionnaire (KCCQ) was carried out by Green et al in 2000. The tool was tested for reliability and validity. It is a self-administered, 23-item questionnaire that tests for physical limitations, symptoms, self-efficacy, social interference and quality of life. It has been used extensively with patients with cardiovascular disease. This questionnaire can be seen in its entirety at this web address. http://www.queri.research.va.gov/chf/products/hf_toolkit/KansasCity-CardiomyopathyQuestionnaire_Spertus.pdf

References


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