Psychometric properties of the Minnesota Living with Heart Failure--Brazilian version--in the elderly.

BACKGROUND: Heart failure (HF) has implications for the quality of life for any age range, more so for the elderly who simultaneously present other limitations imposed by multiple co-morbidities. Although there are several instruments to measure Health Related Quality of Life (HRQL), none is specific to the elderly with HF. Among disease-specific instruments, Minnesota Living with Heart Failure(LHFQ) has not been studied extensively among the elderly with respect to its psychometric properties.

OBJECTIVE: The purpose of this study was to evaluate the convergent, divergent and discriminative validity of the Brazilian version of LHFQ applied to elderly HF patients.

METHOD: One hundred and seventy (170) elderly were interviewed. LHFQ capacity to discriminate subjects among New York Heart Association (NYHA) Classes I, II and III/IV was analyzed. Convergent and divergent validity was evaluated through the correlation between the domains of LHFQ and the generic instrument, Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36).

RESULTS: The LHFQ total score and physical dimension sub-scale discriminated between the three sub-groups of NYHA Classes I, II and III/IV (P < .0001). The emotional dimension discriminated NYHA Classes I and III/IV (P = .0034). The physical and emotional dimensions of the LHFQ and SF-36 were significantly correlated (coefficients from .46 to .70 for physical dimension and from .31 to .65 for emotional dimension). However, contrary to expectations, the divergent validity was not totally confirmed as there was no difference in the magnitude of the correlations between the LHFQ emotional and physical dimensions and the SF-36 role physical, social functioning and role emotional. Thus, the results suggest that LHFQ seems to be a valid tool to measure HRQL in the elderly, but new studies remain necessary to gain a better understanding of its discriminative validity for more advanced NYHA functional classes and for its divergent validity.