Measuring quality of life in cardiac rehabilitation clients.

Quality of life is being increasingly considered as an expected outcome of cardiac rehabilitation programs. However, few instruments exist that reflect a multidimensional concept of quality of life including disease specific items. This article outlines the method used by researchers to adapt Padilla and Grant's [Padilla, G., Grant, M., 1985. Quality of life as a cancer nursing outcome variable. Adv. Nursing Sci. 8(1), 45-60.] Quality of Life Index for use with a cardiac rehabilitation population. A convenience sample of 222 subjects included three groups: 95 cardiac subjects enrolled in a program; 51 cardiac subjects not enrolled in a program; and 76 healthy individuals. Test-retest reliability yielded a coefficient of 0.81 and an alpha coefficient of 0.87. Exploratory factor analysis resulted in a five factor solution. These factors explained 60.8% of the variance at loadings of 0.43 or greater. Contrasted groups approach to validity showed that the instrument differentiated between healthy subjects and those with cardiac illness (t = 11.57; df = 180; p < 0.0001). As anticipated convergent validity revealed a positive correlation between total scores obtained from Spitzer's [Spitzer, W.O., Dobson, A.J., Hall, A., Chesterman, E., Levy, J., Shepherd, R., Battista, R.N., Catchlove, B.R., 1981. Measuring the quality of life in cancer patients: A concise QL index for use by physicians. J. Chronic Dis. 34, 585-597.] global measure of quality of life and the Cardiac Quality of Life Index (r = 0.67; p < 0.0001). This work is preliminary. Refinement and development of the instrument is ongoing.