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Health complaints and outcome assessment in coronary heart disease
1University Hospital of Antwerp, Belgium.
Insights
Researchers developed the Health Complaints Scale (HCS) to measure recovery from coronary heart disease (CHD). This new scale effectively captures somatic and cognitive complaints, showing significant improvement in patients undergoing cardiac rehabilitation.
Area of Science:
- Cardiology
- Psychometrics
- Health Outcomes Research
Background:
- Coronary heart disease (CHD) research requires more sensitive outcome measures.
- Subjective health complaints can offer insights into recovery from CHD.
- Existing measures may not fully capture the patient experience post-coronary event.
Purpose of the Study:
- To identify common health complaints in men recovering from CHD.
- To develop and validate a scale to measure these health complaints.
- To assess the utility of the Health Complaints Scale (HCS) in distinguishing from psychopathology and its responsiveness to cardiac rehabilitation.
Main Methods:
- Study 1: Identified common health complaints in 535 men with CHD, leading to the development of the HCS (12 somatic, 12 cognitive items).
- Statistical analyses included confirmatory factor analysis for scale validation.
- Study 2: Assessed the HCS's distinctiveness from psychopathology scales and its change over time in 266 men with CHD.
Main Results:
- The HCS demonstrated high internal consistency (alpha >= .89) and adequate test-retest reliability (r >= .69).
- The HCS scales were distinct from psychopathology symptoms, showing higher baseline scores and normal clustering.
- HCS scores significantly decreased in patients undergoing cardiac rehabilitation but not in controls (p < .0001).
Conclusions:
- The Health Complaints Scale (HCS) is a reliable and valid measure for assessing health complaints in CHD patients.
- The HCS can differentiate between health complaints related to CHD recovery and symptoms of psychopathology.
- Accurate assessment of health complaints is crucial for managing CHD patients, particularly those in cardiac rehabilitation programs.
Abstract:
Research on coronary heart disease (CHD) lacks sensitive outcome measures. Health complaints, although subjective in nature, may provide information on the degree of recovery from CHD. The purpose of Study 1 was to identify common health complaints in a group of 535 men (mean age, 57.5 years) with CHD. In the weeks after a coronary event, they frequently reported somatic (e.g., chest pain, dyspnea, fatigue, sleep problems) and cognitive (e.g., concern about health and functional status) health complaints. Statistical analyses produced the Health Complaints Scale (HCS), which comprises 12 somatic and 12 cognitive complaints. Confirmatory factor analysis provided evidence for the model undergirding the HCS, and the somatic and cognitive scales of the HCS were found to have high internal consistency (alpha > or = .89), adequate test-retest reliability (r > or = .69), and good construct validity. Study 2 provided evidence for the idea that the HCS can be distinguished from standard scales of psychopathology. Statistical analyses in 266 men with CHD indicated that, compared to symptoms of psychopathology, the HCS scales displayed discrete factor loadings as well as higher scores at baseline and a normal clustering of scores. Important to note, HCS scores decreased in 60 subjects participating in cardiac rehabilitation (p < .0001) but not in 60 control subjects. Although research should not disregard psychological biases on symptom reporting, it is argued that health complaints need to be accurately assessed in CHD patients.