Reproducibility and Reliability of the Quality of Life Questionnaire in Patients With Atrial Fibrillation

Moreira, Rita Simone Lopes; Bassolli, Lucas; Coutinho, Enia; Ferrer, Paloma; Bragança, Érika Olivier; Carvalho, Antonio Carlos Camargo; Paola, Angelo Amato de; Luna Filho, Bráulio

doi:10.5935/abc.20160026

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Original Articles, Clinical arrhythmia • Arq. Bras. Cardiol. 106 (3) • Mar 2016 • https://doi.org/10.5935/abc.20160026 linkcopy

Reproducibility and Reliability of the Quality of Life Questionnaire in Patients With Atrial Fibrillation

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background: Studies have shown the impact of atrial fibrillation (AF) on the patients' quality of life. Specific questionnaires enable the evaluation of relevant events. We previously developed a questionnaire to assess the quality of life of patients with AF (AFQLQ version 1), which was reviewed in this study, and new domains were added.

Objective: To demonstrate the reproducibility of the AFQLQ version 2 (AFQLQ v.2), which included the domains of fatigue, illness perception and well-being.

Methods: We applied 160 questionnaires (AFQLQ v.2 and SF-36) to 40 patients, at baseline and 15 days after, to measure inter- and intraobserver reproducibility. The analysis of quality of life stability was determined by test-retest, applying the Bartko intraclass correlation coefficient (ICC). Internal consistency was assessed by Cronbach's alpha test.

Results: The total score of the test-retest (n = 40) had an ICC of 0.98 in the AFQLQ v.2, and of 0.94 in the SF36. In assessing the intra- and interobserver reproducibility of the AFQLQ v.2, the ICC reliability was 0.98 and 0.97, respectively. The internal consistency had a Cronbach's alpha coefficient of 0.82, compatible with good agreement of the AFQLQ v.2.

Conclusion: The AFQLQ v.2 performed better than its previous version. Similarly, the domains added contributed to make it more comprehensive and robust to assess the quality of life of patients with AF.

Keywords Atrial Fibrillation/psychology; Quality of Life; Questionnaires

	n	%
Type of AF
Persistent	19	47.5
Permanent	21	52.5
Time since diagnosis
up to 1 year	14	35
1 - 5 years	16	40
6 - 10 years	5	12.5
11 or more years	5	12.5
CHADS₂
0	0	0
1	30	75
2	9	22.5
3	1	2.5
EF^* * Echocardiographic values not calculated for 13 patients (32.5%).
> 50%	22	55
< 50%	5	12.5
Left atrial size^* * Echocardiographic values not calculated for 13 patients (32.5%).
Mean ± SD	41.4 ±1.2
Electrical cardioversion
Yes	21	52.5
No	19	47.5
Ablation
Yes	4^ Patients underwent electrical cardioversion and ablation	10
No	36	90
Knowledge of the arrhythmia
Yes	15	37.5
No	25	62.5

		ICC (Bartko)
	Test-retest ( n=40)	Intraobserver ( n=21)	Interobserver (n=19)
Total score	0.98	0.98	0.97
Palpitation	0.84	0.94	0.71
Dyspnea	0.82	0.95	0.75
Chest pain	0.81	1.00	0.72
Dizziness	0.56	0.69	0.48
Fatigue	0.92	0.89	0.94
Well-being	0.87	0.90	0.85
Illness perception	0.88	0.87	0.89

	Item-total correlation coefficient	Cronbach's alpha, if item excluded
AFQLQ v.2 - Total		0.82
Palpitation	0.54	0.80
Dyspnea	0.47	0.81
Chest pain	0.47	0.81
Dizziness	0.44	0.82
Fatigue	0.68	0.78
Well-being	0.76	0.76
Illness perception	0.61	0.79

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[TFN1] EF: ejection fraction.

[TFN2] ^*
Echocardiographic values not calculated for 13 patients (32.5%).

[TFN3] ^**
Patients underwent electrical cardioversion and ablation

Identification		Date:	N:
Name:
ID:	Sex:	Birth date:	Age
Natural:	Proced:	Profession:
Marital status:		Lives with:
Nível de escolaridade:	( ) Illiterate	( ) Incomplete elementary	( ) Complete elementary
	( ) Incomplete middle	( ) Complete middle	( ) Incomplete college
	( ) Complete college
Knowledge of the name of the arrhythmia? ( ) yes ( ) no

A	1.0	H	8.0
B	2.0	I	9.0
C	3.0	J	10.0
D	4.0	K	2.5
E	5.0	L	1.5
F	6.0	M	0.5
G	7.0	Z	0.0