Novel measures to assess ventricular assist device patient-reported outcomes: Findings from the MCS A-QOL study.

patient-reported outcomes satisfaction with treatment self efficacy stigma ventricular assist device

Journal

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703

Informations de publication

Date de publication:
15 Aug 2023
Historique:
received: 09 03 2023
revised: 24 07 2023
accepted: 09 08 2023
pubmed: 18 8 2023
medline: 18 8 2023
entrez: 17 8 2023
Statut: aheadofprint

Résumé

Generic and heart failure-specific measures do not capture unique aspects of living with a ventricular assist device (VAD). Using state-of-the-science psychometric measurement methods, we developed a measurement system to assess post-ventricular assist device adjustment and health-related quality of life (HRQOL). Patients were recruited from 10/26/16-2/29/20 from 12 U.S. VAD programs. We created a dataset of participants (n = 620) enrolled before left (L)VAD implantation, with data at 3- or 6- months post-implantation (group1 [n = 154]), and participants enrolled after LVAD implantation, with data at one timepoint (group 2 [n = 466]). We constructed 5 item banks: 3 modified from existing measures and 2 new measures. Analyses included item response theory (IRT) modeling, differential item functioning tests for systematic measurement bias, and indicators of reliability and validity. Of 620 participants, 56% (n = 345) were implanted as destination therapy, 51% (n = 316) were <12 months post-implantation, mean age = 57.3 years, 78% (n = 485) male, 70% (n = 433) White, 58% (n = 353) married/partnered, and 58% (n = 357) with >high school education. We developed 5 new VAD item banks/measures: 6-item VAD Team Communication; 12-item Self-efficacy Regarding VAD Self-care; 11-item Being Bothered by VAD Self-care and Limitations; 7-item Satisfaction with Treatment; and 11-item Stigma. Cronbach's alpha reliability ranged from good (≥0.80) to excellent (≥0.90) for item banks/measures. All measures, except VAD Team Communication, demonstrated at least moderate correlations (≥0.30) with construct validity indicators. These measures meet IRT modeling assumptions and requirements; scores demonstrate reliability and validity. Use of these measures may assist VAD clinicians to inform patients about VADs as a treatment option and guide post-VAD interventions.

Sections du résumé

BACKGROUND BACKGROUND
Generic and heart failure-specific measures do not capture unique aspects of living with a ventricular assist device (VAD). Using state-of-the-science psychometric measurement methods, we developed a measurement system to assess post-ventricular assist device adjustment and health-related quality of life (HRQOL).
METHODS METHODS
Patients were recruited from 10/26/16-2/29/20 from 12 U.S. VAD programs. We created a dataset of participants (n = 620) enrolled before left (L)VAD implantation, with data at 3- or 6- months post-implantation (group1 [n = 154]), and participants enrolled after LVAD implantation, with data at one timepoint (group 2 [n = 466]). We constructed 5 item banks: 3 modified from existing measures and 2 new measures. Analyses included item response theory (IRT) modeling, differential item functioning tests for systematic measurement bias, and indicators of reliability and validity.
RESULTS RESULTS
Of 620 participants, 56% (n = 345) were implanted as destination therapy, 51% (n = 316) were <12 months post-implantation, mean age = 57.3 years, 78% (n = 485) male, 70% (n = 433) White, 58% (n = 353) married/partnered, and 58% (n = 357) with >high school education. We developed 5 new VAD item banks/measures: 6-item VAD Team Communication; 12-item Self-efficacy Regarding VAD Self-care; 11-item Being Bothered by VAD Self-care and Limitations; 7-item Satisfaction with Treatment; and 11-item Stigma. Cronbach's alpha reliability ranged from good (≥0.80) to excellent (≥0.90) for item banks/measures. All measures, except VAD Team Communication, demonstrated at least moderate correlations (≥0.30) with construct validity indicators.
CONCLUSIONS CONCLUSIONS
These measures meet IRT modeling assumptions and requirements; scores demonstrate reliability and validity. Use of these measures may assist VAD clinicians to inform patients about VADs as a treatment option and guide post-VAD interventions.

Identifiants

pubmed: 37591454
pii: S1053-2498(23)01969-1
doi: 10.1016/j.healun.2023.08.007
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Auteurs

Kathleen L Grady (KL)

Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois. Electronic address: kgrady@nm.org.

Michael A Kallen (MA)

Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

David G Beiser (DG)

Section of Emergency Medicine, University of Chicago, Chicago, Illinois.

JoAnn Lindenfeld (J)

Department of Medicine, Vanderbilt University, Nashville, Tennessee.

Jeffrey Teuteberg (J)

Department of Medicine, Stanford University, Stanford, California.

Larry A Allen (LA)

Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Colleen K McIlvennan (CK)

Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Jonathan Rich (J)

Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Clyde Yancy (C)

Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Christopher S Lee (CS)

School of Nursing, Boston College, Chestnut Hill, Massachusetts.

Quin E Denfeld (QE)

School of Nursing, Oregon Health and Science University, Portland, Oregon.

Michael Kiernan (M)

Department of Medicine, Tufts University, Boston, Massachusetts.

Mary Norine Walsh (MN)

Ascension St. Vincent Heart Center, Indianapolis, Indiana.

Eric Adler (E)

Department of Medicine, University of California-San Diego, La Jolla, California.

Bernice Ruo (B)

Department of Medicine, University of California-San Diego, La Jolla, California.

Josef Stehlik (J)

Department of Medicine, University of Utah, Salt Lake City, Utah.

James K Kirklin (JK)

Kirklin Solutions, Hoover, Alabama.

Katy Bedjeti (K)

Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Dave Cella (D)

Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Elizabeth A Hahn (EA)

Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Classifications MeSH