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Myrbakk IN, Friborg O, Høye A, Steigen T, Bergvik S. Psychometric evaluation of the Coronary Revascularisation Outcome Questionnaire (CROQ) in Norwegian patients admitted to elective coronary angiography and possible percutaneous coronary intervention. Health Qual Life Outcomes 2022; 20:21. [PMID: 35123504 PMCID: PMC8818193 DOI: 10.1186/s12955-022-01927-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The Coronary Revascularisation Outcome Questionnaire (CROQ) measures health-related quality of life and outcome of invasive revascularization procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The CROQ has not been properly validated in Norwegian patient populations. The aim of this study was to examine the psychometric properties of the Norwegian CROQ in patients admitted to elective coronary angiographic assessment and receiving PCI. Moreover, to examine its discriminative ability to detect disease severity and effects of invasive coronary treatment.
Methods
The patients (N = 280, Mage = 66.9, SDage = 8.91) completed the CROQ, prior to an elective coronary angiography and at one year follow-up. Analyses included internal consistency, floor and ceiling effects, and confirmatory and exploratory factor analyses of the CROQ. Convergent validity was evaluated by comparing CROQ scores with the RAND-12 measure. Sensitivity to treatment was examined by comparing pre-post effect size differences between the PCI treatment and non-treatment group.
Results
Significant stenosis qualifying for a PCI was detected in 121 (35.1%) patients. The model fit of the original CROQ factor model was inadequate in the PCI group. All but one of the CROQ items demonstrated ceiling effects. The CROQ failed to discriminate between patients’ disease severity prior to the coronary angiography, or improvement in those receiving versus not receiving PCI.
Conclusion
The present study of the Norwegian version of the CROQ identified serious problems with the factor structure, ceiling effects, and lack of sensitivity for disease severity and effects of invasive treatment. Currently, one cannot recommend the use of CROQ in clinical practice.
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Aleksic N, Putnik S, Schroter S, Pavlovic V, Bumbasirevic U, Zlatkovic M, Bilbija I, Matkovic M, Jovanovic A, Pekmezovic T, Maric G. Coronary revascularisation outcome questionnaire: validation study of the Serbian version. Qual Life Res 2022; 31:1883-1895. [PMID: 35034321 DOI: 10.1007/s11136-021-03064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To translate, culturally adapt and validate the Coronary Revascularisation Outcome Questionnaire (CROQ), a disease-specific tool for measuring health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), into Serbian language (CROQ-S). METHODS Validation study was performed at the Clinic for Cardiac Surgery and Clinic for Cardiology, University Clinical Centre of Serbia. We included a convenience sample of 600 patients with IHD divided into four groups. Acceptability, reliability and validity of the CROQ-S were assessed. RESULTS CROQ-S was acceptable to patients as demonstrated by less than 1% of missing data for each single item. Cronbach's Alpha was higher than the criterion of 0.70 for all scales in each version except the Cognitive Functioning scale which only met this criterion in the CABG pre-revascularisation version. Mean values of item-total correlations were greater than 0.30 for all scales except the Cognitive Functioning scale in both the pre-revascularisation groups. Compared to the original version, exploratory factor analysis in our study showed more factors; however, the majority of items had a factor loading greater than 0.3 on the right scale. Correlations of CROQ-S scales with the 36-Item Short Form Health Survey and Seattle Angina Questionnaire showed the expected pattern whereby scales measuring similar constructs were most highly correlated. CONCLUSION CROQ-S is an acceptable, reliable and valid disease-specific instrument for measuring HRQoL in this sample of Serbian speaking patients with IHD both before and after coronary revascularisation. However, the Cognitive Functioning scale did not meet all the psychometric criteria and further validation of its responsiveness is required.
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Affiliation(s)
- Nemanja Aleksic
- Clinic for Cardiac Surgery, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Svetozar Putnik
- Clinic for Cardiac Surgery, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | | | - Vedrana Pavlovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000, Belgrade, Serbia
| | - Uros Bumbasirevic
- Clinic for Urology, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Mina Zlatkovic
- Clinic for Cardiac Surgery, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Ilija Bilbija
- Clinic for Cardiac Surgery, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Milos Matkovic
- Clinic for Cardiac Surgery, University Clinical Center of Serbia, 11000, Belgrade, Serbia
| | - Aleksa Jovanovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia
| | - Tatjana Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia
| | - Gorica Maric
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26A, 11000, Belgrade, Serbia.
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Kiselev AR, Korotin AS, Posnenkova OM, Popova YV, Prokhorov MD, Gridnev VI. Discrepancy between the European clinical guidelines and myocardial revascularization in patients with stable coronary artery disease in Russia. Int J Qual Health Care 2019; 31:269-275. [PMID: 29924371 DOI: 10.1093/intqhc/mzy140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 05/05/2018] [Accepted: 06/02/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE In European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines, six indications have been proposed for making a decision on myocardial revascularization in patients with stable coronary artery disease (CAD). Our aim was to study a discrepancy between the actual clinical situation and ESC/EACTS indications on performing the revascularization in patients with CAD in Russia. DESIGN AND SETTING We used retrospective clinical data on patients with stable CAD enrolled in the 2012-2015 Russian Registry of Hypertension, Coronary Artery Disease, and Chronic Heart Failure. PARTICIPANTS A total of 1522 patients with CAD (aged 53.0 ± 8.5 years, 76.2% male) were used for analysis. INTERVENTIONS All patients were divided into two groups: 591 patients with performed myocardial revascularization (named as R-CAD) and 931 patients refused from revascularization (named as NR-CAD). Factors associated with revascularization performance were identified by discriminant function analysis. MAIN OUTCOME MEASURES ESC/EACTS indications for revascularization were assessed. RESULTS A total of 1196 patients with CAD had any ESC/EACTS indication for revascularization, but only 40.2% of them had performed invasive coronary intervention. Myocardial revascularization was appropriate in 81.4% of R-CAD patients and 76.8% of NR-CAD patients. The main factor of revascularization performance was any stenosis >50% and grades III-IV of stable angina. With non-performed revascularization, the following factors were associated: limiting angina or angina equivalent, unresponsive to medical therapy, atherosclerotic peripheral arterial disease and increasing the New York Heart Association class of chronic heart failure. Most ESC/EACTS indications had little effect on decision-making on revascularization. CONCLUSION There is a discrepancy between the actual clinical situation and ESC/EACTS guidelines on myocardial revascularization in patients with stable CAD in Russia.
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Affiliation(s)
- Anton R Kiselev
- Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
| | - Alexey S Korotin
- Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
| | - Olga M Posnenkova
- Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
| | - Yulia V Popova
- Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
| | - Mikhail D Prokhorov
- Laboratory of Nonlinear Dynamics Modelling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Vladimir I Gridnev
- Department of New Cardiological Informational Technologies, Research Institute of Cardiology, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russia
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Lee YM, Kim RB, Lee HJ, Kim K, Shin MH, Park HK, Ahn SK, Kim SY, Lee YH, Kim BG, Lee H, Lee WK, Lee KS, Kim MJ, Park KS. Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study. Health Qual Life Outcomes 2018; 16:100. [PMID: 29788961 PMCID: PMC5964665 DOI: 10.1186/s12955-018-0921-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/30/2018] [Indexed: 12/17/2022] Open
Abstract
Background The healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients. Methods A cross-sectional study was conducted in 417 post-AMI patients who underwent percutaneous coronary intervention (PCI). Patients were recruited from 11 university hospitals from December 2015 to March 2016 in South Korea. Details regarding socio-demographic factors, six health behaviors (low-salt intake, low-fat diet and/or weight-loss diet, regular exercise, stress reduction in daily life, drinking in moderation, and smoking cessation), medication adherence using the Modified Morisky Scale (MMS), and HRQoL using the Coronary Revascularization Outcome Questionnaire (CROQ) were surveyed in a one-on-one interview. Results In the univariate logistic analysis, sex (female), age (≥70 years), MMS score (≥5), and CROQ score were associated with adherence to lifestyle modification. In the multiple logistic analysis, a high MMS score (≥5) was associated with adherence to lifestyle modification after adjusting for sex, age, marital status, education, and family income (adjusted odds ratio [OR] = 11.7, 95% confidence interval [CI] = 1.5–91.3). After further adjusting for the CROQ score, the association between high MMS score and adherence to lifestyle modification was significant (adjusted OR = 11.5, 95% CI = 1.4–93.3). Conclusions Adherence to medication was associated with adherence to lifestyle modification, suggesting the possible presence of the healthy adherer effect in post-AMI patients. After further adjusting for HRQoL, the association remained. To improve health outcome in post-AMI patients, early detection of patients with poor adherence to medication and lifestyle modification and motivational education programs to improve adherence are important. In addition, the healthy adherer effect should be considered in clinical research, in particular, in studies evaluating the effects of therapies on health outcomes. Electronic supplementary material The online version of this article (10.1186/s12955-018-0921-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu-Mi Lee
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Rock Bum Kim
- Gyeongnam Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, South Korea.,Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, 15 Jinju-daero, 816 Beon-gil, Jinju, 52727, South Korea
| | - Hey Jean Lee
- Gangwon Regional Cardiocerebrovascular Disease Center, Kangwon National University Hospital, Chuncheon, South Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyeung-Keun Park
- Jeju Regional Cardiocerebrovascular Disease Center, Jeju National University Hospital, Jeju, South Korea
| | - Soon-Ki Ahn
- Daejeon-Chungnam Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, South Korea
| | - So Young Kim
- Chungbuk Regional Cardiocerebrovascular Disease Center, Chungbuk National University Hospital, Cheongju, South Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine &Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea
| | - Byoung-Gwon Kim
- Busan-Ulsan Regional Cardiocerebrovascular Disease Center, Dong-A University Hospital, Busan, South Korea
| | - Heeyoung Lee
- Center for preventive medicine and public health, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, South Korea
| | - Kun Sei Lee
- Department of Preventive Medicine, School of Medicine, Konkuk University, Seoul, South Korea
| | - Mi-Ji Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, 15 Jinju-daero, 816 Beon-gil, Jinju, 52727, South Korea
| | - Ki-Soo Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, 15 Jinju-daero, 816 Beon-gil, Jinju, 52727, South Korea.
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