Journal of Korean Academy of Nursing

Review Paper

Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis: Jo, Sojeong , Lee, Haejung , Park, Gaeun; J Korean Acad Nurs 2024;54(3):311-328. Published online August 31, 2024; DOI: https://doi.org/10.4040/jkan.24019

Abstract PDF: Purpose
In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI).
Methods
A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2).
Results
Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality.
Conclusion
Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

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Original Articles

Effects of Spouse-Participated Health Coaching for Male Office Workers with Cardiocerebrovascular Risk Factors: So Hee Kang, Seon Young Hwang; J Korean Acad Nurs 2019;49(6):748-759. Published online December 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.6.748

Abstract PDF

Purpose

This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers.

Methods

A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email.

Results

After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention.

Conclusion

To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

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Effects of a Health Partnership Program Using Mobile Health Application for Male Workers with Cardiovascular Risk Factors in Small and Medium Enterprises: A Randomized Controlled Trial
Eun Jin Kim, Seon Young Hwang
Journal of Korean Academy of Nursing.2024; 54(1): 44. CrossRef
Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial
Kyong Sil Park, Seon Young Hwang
Asian Nursing Research.2024; 18(2): 81. CrossRef
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Nursing Open.2023; 10(3): 1404. CrossRef

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Effects of a Daily Life-Based Physical Activity Enhancement Program for Middle-Aged Women at Risk for Cardiovascular Disease: Kyung Ae Kim, Seon Young Hwang; J Korean Acad Nurs 2019;49(2):113-125. Published online April 30, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.2.113

Abstract PDF

Purpose

The purpose of this study was to examine the effects of a daily life-based physical activity enhancement program performed by middle-aged women at risk for cardiovascular disease.

Methods

This study used a randomized control group pretest-posttest design. Middle-aged women aged 45 to 64 were recruited from two outpatient cardiology departments, and randomly assigned to an experimental group (n=28) and a control group (n=30). For the experimental group, after providing one-on-one counseling and education, we provided customized text messages to motivate them in daily life. To monitor the practice of physical activity, they also used an exercise diary and mobile pedometer for 12 weeks. Subjects' physical activities (MET-min/week) were measured using the International Physical Activity Questionnaire (IPAQ). Their physiological data were obtained by blood tests using a portable analyzer, and the data were analyzed using the SPSS 21.0/WIN program.

Results

There were significant differences in exercise self-efficacy, health behavior, IPAQ score, body fat, body muscle, and fasting blood sugar between the two groups. However, there were no significant differences in total cholesterol, hemoglobin A1c, high-density lipoprotein cholesterol, and waist-to-hip ratio.

Conclusion

Strengthening physical activity in daily life without being limited by cost burden and time and space constraints. Therefore, it is essential to motivate middle-aged women at risk for cardiovascular disease to practice activities that are easily performed in their daily lives.

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Development and effectiveness of a mobile-based autonomy support program for the prevention of metabolic syndrome in middle-aged women
Miseon Seo, Eun-Young Jun, Hyunjin Oh
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Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial
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Bo LIN, Qiu JIN, Chunhua LIU, Wenhui ZHAO, Runyuan JI
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Factors related to the Identification of Middle-Aged Women Who are Disadvantaged by Cardio-cerebrovascular Disease
Moon Jung Kang, Jee Seon Yi, Chang Seung Park
Korean Journal of Women Health Nursing.2018; 24(2): 185. CrossRef

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Effects of a Occupational Health Promotion Program for Prevention of Cardiovascular Disease: Jee Won Park, Yong Soon Kim, Gi Yon Kim; Journal of Korean Academy of Nursing 2002;32(2):196-205. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.2.196

Abstract PDF

PURPOSE: The purposes of this study was to evaluate an occupational health promotion program for the prevention of cardiovascular disease. METHOD: This study employed a quasi-experimental non-equivalent pre and post test to evaluate the program. The subjects of this study were 48 employees selected by convenience sampling who were suspected of having hypertension and hyperlipidemia in routine physical examinations and who were working in A University Hospital in Suwon. 25 subjects were assigned to the experimental group and 23 to the control group. Data collection was done using questionnaries before and after the subjects used the program. RESULTS: The results of this study showed that systolic blood pressure, ALT, gamma-GTP in the experimental group was lower than that of the control group. There were significant differences between two groups in the percentage of 'irregularity of diet' and in health behavior compliance. There were significant differences between the two groups in the number of complaints of symptoms after using the program. CONCLUSION: This study shows that there were no obvious differences between the two groups in all areas, but this program had a positive effect on health behavior changes. It is expected that employees' lifestyles can be changed through continuous health promotion programs.

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Effects of a Comprehensive Lifestyle Improvement Program for Middle-aged Women with Cardio-cerebrovascular Disease-related Risk Factors
Mi-Kyoung Park, Jeong-Hee Kim
Journal of Korean Academy of Community Health Nursing.2013; 24(2): 111. CrossRef
Effects of a Tailored Health Promotion Program to Reduce Cardiovascular Disease Risk Factors Among Middle-Aged and Advanced-Age Bus Drivers
Gyu-Seok Hwang, Jae-Wook Choi, Seoung-Hyung Choi, Seoung-Gil Lee, Kyung-Hee Kim, Yong-Min Cho, Chungsik Yoon
Asia Pacific Journal of Public Health.2012; 24(1): 117. CrossRef
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Ji-Yeon Kang, Sang-Woon Cho, Ji-Young Lee, Sook-Hee Sung, Yoo-Kyoung Park, Yun-Mi Paek, Tae-In Choi
The Korean Journal of Nutrition.2010; 43(1): 57. CrossRef

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Comparison of Cardiovascular Risk Profile Clusters Among Industrial Workers: Seon Young Hwang, Ji Hyun Lee; Journal of Korean Academy of Nursing 2005;35(8):1500-1507. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2005.35.8.1500

Abstract PDF

Purpose

The purpose of this study was to identify subgroups of the physical and behavioral risk profiles for cardiovascular disease among industrial workers, and to examine predicting factors for the subgroups.

Sample and Methods

Health records of 2,616 male and female workers aged 19-56 years who were employed in an airplane manufacturing industry were analyzed. Data were analyzed using the Latent class cluster analysis.

Results

Four different clusters (two high-risk groups, one low-risk group, and one normal group) were found and these clusters were significantly different by age, gender, and work type (p<.05). The two high-risk groups had higher chances of drinking alcohol, elevated BMI, FBS, total cholesterol, having hypertension, and were significantly older, and had relatively high chances of being day workers rather than other groups. The low-risk group had higher chances of drinking alcohol, higher BMI and total cholesterols compared to normal group, and highest portions of current smokers and shift workers in the four clusters and their mean BP was within prehypertension criteria.

Conclusion

Industrial nurses should guide the lifestyle behaviors and risk factors of the high risk groups for CVD and need to intervene early for behavioral change for the low-risk group who are young and shift workers. Age, and work environment should be considered in planning for targeted preventive interventions for industrial workers.

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Factors Associated with Blue-collar Workers' Risk Perception of Cardiovascular Disease
Won Ju Hwang, OiSaeng Hong, Mi Ja Kim
Journal of Korean Academy of Nursing.2012; 42(7): 1095. CrossRef

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The Effect of Patient-centered CPR Education for Family Caregivers of Patients with Cardiovascular Diseases: Hyun Sun Kim, Hyun-Jin Kim, Eunyoung E. Suh; J Korean Acad Nurs 2016;46(3):463-474. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.463

Abstract PDF

Purpose

For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases.

Methods

Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1.

Results

The PCE group demonstrated significant improvements in knowledge (F=91.09, p<.001), self-efficacy (F=15.19, p<.001) and CPR skills and performance (F=8.10, p=.008), as well as significant differences over time (knowledge: F=364.25, p<.001; self-efficacy: F=1162.28, p<.001; CPR skills and performance: F=1798.81, p<.001). There were significant group-by-time interactions for knowledge (F=8.10, p=.001), self-efficacy (F=4.30, p=.019) and CPR skills and performance (F=4.81, p=.036) by repeated measures ANOVA.

Conclusion

This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.

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Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study: Won Ju Hwang, Yunhee Park; J Korean Acad Nurs 2015;45(6):857-867. Published online December 15, 2015; DOI: https://doi.org/10.4040/jkan.2015.45.6.857

Abstract PDF

Abstract Purpose

The purpose of this study was to investigate individual and organizational level of cardiovascular disease (CVD) risk factors associated with CVD risk in Korean blue-collar workers working in small sized companies.

Methods

Self-report questionnaires and blood sampling for lipid and glucose were collected from 492 workers in 31 small sized companies in Korea. Multilevel modeling was conducted to estimate effects of related factors at the individual and organizational level.

Results

Multilevel regression analysis showed that workers in the workplace having a cafeteria had 1.81 times higher CVD risk after adjusting for factors at the individual level (p=.022). The explanatory power of variables related to organizational level variances in CVD risk was 17.1%.

Conclusion

The results of this study indicate that differences in the CVD risk were related to organizational factors. It is necessary to consider not only individual factors but also organizational factors when planning a CVD risk reduction program. The factors caused by having cafeteria in the workplace can be reduced by improvement in the CVD-related risk environment, therefore an organizational-level intervention approach should be available to reduce CVD risk of workers in small sized companies in Korea.

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Won Ju Hwang, Yunhee Park
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Factors Associated with Blue-collar Workers' Risk Perception of Cardiovascular Disease: Won Ju Hwang, OiSaeng Hong, Mi Ja Kim; J Korean Acad Nurs 2012;42(7):1095-1104. Published online December 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.7.1095

Abstract PDF

Purpose

The purpose of this study was to investigate the contribution of actual cardiovascular disease (CVD) risk, as well as, individual, psychosocial, and work-related factors as predictors of CVD risk perception among Korean blue-collar workers.

Methods

The participants were 238 Korean blue-collar workers who worked in small companies. Data were collected through a survey; anthropometric and blood pressure measures; and blood sampling for lipid levels.

Results

Blue-collar workers had high actual CVD risk and low CVD risk perception. The significant predictors of risk perception included perceived health status, alcohol consumption, knowledge of CVD risk, actual CVD risk, decision latitude, and shift work. The model explained 26% of the variance in CVD risk perception.

Conclusion

The result suggests when occupational health nurses are giving routine health examination in small companies, they can enhance CVD risk perception in blue-collar workers by providing essential information about CVD risk factors and personal counseling on the individual worker's CVD risk status.

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Development and Evaluation of a Small Group-based Cardiocerebrovascular Disease Prevention Education Program for Male Bus Drivers: Eun Young Kim, Seon Young Hwang; J Korean Acad Nurs 2012;42(3):322-332. Published online June 29, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.3.322

Abstract PDF

Purpose

This study was conducted to examine effects of a small group-based cardiocerebrovascular disease (CVD) prevention education program on knowledge, stage of change and health behavior among male bus drivers with CVD risk factors.

Methods

A non-equivalent control group pretest-posttest design was used. Participants were 68 male bus drivers recruited from two urban bus companies. Participants from the two groups were selected by matching age, education and risk factors. Experimental group (n=34) received a small group-based CVD prevention education program 8 times over 6 weeks and 3 times through telephone interviews at 2-week intervals. Data were collected between December, 2010 and March, 2011, and were analyzed using chi-square test, t-test, and repeated measure analysis of variance with SPSS/Win18.0.

Results

Experimental group showed significantly higher scores in CVD prevention knowledge (p<.001) and health behavior (p<.001) at 6 and 12 weeks after intervention. Participants in pre-contemplation and contemplation stages made progress to contemplation and action. This was significantly better at 6 and 12 weeks after intervention (p<.001).

Conclusion

Results suggest that small group-based education programs for CVD prevention are effective in increasing knowledge, stage of change, and health behavior to prevent CVD among male bus drivers with CVD risk.

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Kyong Sil Park, Seon Young Hwang, Bo Youl Choi, June Kim, Sang Il Kim, Woo-Joo Kim, Chun Kang
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Comparison of Cardiovascular Health Status and Health Behaviors in Korean Women based on Household Income: Young-Joo Park, Nah-Mee Shin, Ji-Won Yoon, Jiwon Choi, Sook-Ja Lee; J Korean Acad Nurs 2010;40(6):831-843. Published online December 31, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.6.831

Abstract PDF

Purpose

In this study cardiovascular health status and health behavior of Korean women based on their household income were explored.

Methods

For this cross-sectional study, 91 women residing in the community were recruited to complete survey questionnaires and biophysical tests including blood pressure (BP), body mass index (BMI), body fat rate, waist circumference (WC), and blood chemistry tests.

Results

Compared to non-low income women (NLIW), low income women (LIW) were more likely to be older, less educated, and jobless, and further more LIW were postmenopause and reported having been diagnosed with hypertension or hypercholesterolemia. Significant differences were found in systolic BP, triglyceride level, BMI, body fat rate, and WC between the groups. Two fifths of the LIW had indications for metabolic syndrome. Their 10-yr risk estimate of myocardioal infarction or coronary death demonstrated a higher probability than that of NLIW. Although these significant differences were due to age gap between the groups, advanced age is known to be one of the key characteristics of LIW as well as a non-modifiable risk factor.

Conclusion

Effective community programs for vulnerable women at risk of cardiovascular disease should be based on strategies targeting unhealthy behaviors and modifiable risk factors.

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Concept Analysis of Resilience in Patients with Cardiovascular Diseases: Su-Jin Shin, Duk-Yoo Jung, Eun-Hee Hwang; J Korean Acad Nurs 2009;39(6):788-795. Published online December 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.6.788

Abstract PDF

Purpose

The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases.

Methods

A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention.

Results

The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined.

Conclusion

A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.

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Analyses of Studies on Cardiac Rehabilitation for Patients with Cardiovascular Disease in Korea: Yeoungsuk Song; J Korean Acad Nurs 2009;39(3):311-320. Published online June 29, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.3.311

Abstract PDF

Purpose

This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease.

Methods

Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association (AHA) and Scottish Intercollegiate Guidelines Network (SIGN).

Results

The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain.

Conclusion

Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.

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Effects of Tai Chi Exercise on Cardiovascular Risk Factors and Quality of Life in Post-menopausal Women: Rhayun Song, Sukhee Ahn, Hee Young So, In Sook Park, Hyun Li Kim, Kyung Ok Joo, Jong Sung Kim; J Korean Acad Nurs 2009;39(1):136-144. Published online February 17, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.1.136

Abstract PDF

Purpose:

Natural menopause resulting in the decline in endogenous estrogen concentrations is responsible for an increased risk of coronary heart disease in postmenopausal women. The purpose of the study was to examine the effects of a 6-month Tai Chi exercise program on cardiovascular risk factors and quality of life in post-menopausal women.

Methods:

A quasi-experimental design with pretest and posttest measures was used. The participants in the study, 29 women in the Tai Chi group and 31 in the control group, were enrolled for 6 months.

Results:

After 6 months of Tai Chi exercise, total cholesterol (M=213 to 185), LDL-cholesterol (M=135 to 128), and their 10 yr cardiovascular disease risk (M=2.62 to 2.27) had improved significantly for the Tai Chi participants compared to the control group. Total scores for quality of life along with the sub-dimensions of health perception and mental functioning were also significantly higher in the Tai Chi participants.

Conclusion:

Tai Chi exercise favorably affected cardiovascular health and quality of life in post-menopausal women after 6 months. Additional rigorous studies are needed to examine long term effects on the prevention of cardiovascular disease in this population.

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Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease: Kyoungok Ju, Heeyoung So; Journal of Korean Academy of Nursing 2008;38(1):64-73. Published online February 28, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.1.64

Abstract PDF

Purpose

This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD).

Method

Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by X²-test and independent t-test using the SPSSWIN 11.5 program.

Result

Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group.

Conclusion

A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.

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The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease: Eun Kyeung Song, Youn Jung Son; Journal of Korean Academy of Nursing 2008;38(1):19-28. Published online February 28, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.1.19

Abstract PDF

Purpose

The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions.

Methods

A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified.

Results

Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment.

Conclusion

There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

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Development and a Psychometric Evaluation of Cardiovascular Disease-Specific Quality of Life Scale for Koreans: Eun Hyun Lee, Seong Jai Tahk, Jun Han Shin, Young Whee Lee, Rhayun Song; Journal of Korean Academy of Nursing 2007;37(3):313-323. Published online April 30, 2007; DOI: https://doi.org/10.4040/jkan.2007.37.3.313

Abstract PDF

Purpose

Health-related quality of life (HRQOL) in patients with cardiovascular disease in Korea has rarely been studied, mostly due to the lack of a psychometrically validated disease-specific instrument. The purpose of this study was to develop and validate a cardiovascular specific-HRQOL questionnaire (CD-QOL).

Method

The CD-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. Patients were recruited from three-university hospitals. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, SF-36, and CES-D. The NYHA and KASI classifications were used to classify the functional performance of the patients. The data was analyzed using correlation, factor analysis, multidimensional scaling, multitrait/multi-item matrix, ANOVA, and Cronbach's alpha.

Result

Preliminarily, thirty-nine items were generated. Factor analysisextracted a five-factor solution with a total of twenty-two items. One item was deleted based upon the MDS. The remaining items were moderately correlated with the subscales of the SF-36 and associated with depression measured with the CES-D. The mean scores of patients in NYHA and KASI class I were significantly higher than those in NYHA and KASI class II or/and III, which suggested patients with better functional performance were likely to have a better HRQOL. Cronbach's alphas of the total and subscales were all greater than 0.70.

Conclusion

The CD-QOL is a easily applicable instrument with excellent psychometric properties of content, criterion, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with cardiovascular disease.

Citations

Citations to this article as recorded by

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