Measuring Patient-Reported Outcomes in Ischemic Heart Disease: Validation of the Greek HeartQoL Questionnaire

Background The Greek HeartQoL questionnaire is designed to assess health-related quality of life (HRQoL) in patients with ischemic heart disease. Objectives This study aims to validate its psychometric properties in Greek patients diagnosed with angina pectoris, myocardial infarction, and ischemic heart failure. Methods A cross-sectional study was conducted with 158 patients from five clinical sites in Greece. Participants completed the Greek HeartQoL, the Short Form-36 Health Survey, and the Hospital Anxiety and Depression Scale. Psychometric evaluations included Mokken scale analysis, reliability testing with Cronbach's alpha, and validity assessments through Spearman correlation coefficients, and analysis of covariance. Results The Greek HeartQoL exhibited excellent internal consistency, with Cronbach's alpha values exceeding 0.90. Factor analysis confirmed the questionnaire's two-factor structure, effectively capturing physical and emotional dimensions of HRQoL. Convergent validity was demonstrated by strong correlations with Short Form-36 Health Survey (r > 0.70), and discriminative validity was confirmed by significant differences in HRQoL scores between patients with angina pectoris, myocardial infarction, and ischemic heart failure (P < .001). Conclusions The findings suggest that the Greek HeartQoL demonstrates strong reliability and validity in assessing HRQoL in Greek ischemic heart disease patients. However, further studies with larger and more diverse samples are needed to confirm its psychometric properties across different clinical populations