Validation of the Bangla Version of the HeartQoL Health-Related Quality-of-Life Questionnaire for Patients With Coronary Heart Disease in Bangladesh

Objectives

To evaluate the psychometric properties of the Bangla version of the HeartQoL questionnaire, a core heart disease health-related quality-of-life (HRQoL) instrument, specifically in coronary heart disease (CHD) patients.

Methods

The English HeartQoL was translated into Bangla and then a cross-sectional and a test-retest study was undertaken in 2 specialized cardiac hospitals in Bangladesh. All patients admitted for percutaneous coronary intervention or coronary artery bypass graft between April and October 2019 and diagnosed with CHD were eligible for recruitment. The Bangla HeartQoL, EQ-5D-3L, PHQ-9, and GAD-7 questionnaires were administered before and after discharge. Factor structure, internal consistency, and construct validity of Bangla HeartQoL were assessed.

Results

A total of 945 patients with CHD were enrolled with a subgroup of 198 patients providing test-retest data. Mokken scale analysis supported the 2-factor structure (physical/mental subscales) of the HeartQoL Bangla questionnaire. Although no floor effects were observed, there was some evidence of a ceiling effect on the HeartQoL emotional subscale in 16.1% of patients. The Bangla HeartQoL questionnaire demonstrated satisfactory internal consistency (Cronbach’s alpha > 0.75), discriminative validity (lower scores in patients with poorer health), and responsiveness to change (effect sizes of 0.23 to 0.68).

Conclusions

The Bangla HeartQoL questionnaire was found to be a valid, reliable, and responsive measure of HRQoL in CHD patients. However, future research is needed around its use, particularly in terms of its potential cultural sensitivity.