Quality of life after myocardial infarction: Translation and validation of the MacNew Questionnaire for a Dutch population

A wide range of instruments have been used in health-related quality of life (HRQL) assessment of patients with coronary artery disease. The MacNew heart disease health-related quality of life questionnaire (MacNew) is a disease-specific measure of HRQL, that has been found to have both good discriminative and evaluative properties. The objective of the present study was to translate the MacNew for a Dutch population, and assess its reliability and validity. Three hundred and thirty-nine cardiac patients, admitted to the hospital after a cardiac event, participated in the study. Questionnaires were filled out at baseline, at 3 months, and at 12 months. A clinically relevant three-factor solution, reflecting an emotional, physical, and social domain of HRQL, allowed us to explain 55% of variance. Angina pectoris was consistently found to be significantly associated with worse HRQL. The pattern of correlations between the subscales of the MacNew on the one hand, and between the subscales of the MacNew and two other, related questionnaires on the other hand, indicated only modest convergent and discriminant validity. The internal consistency was found to be fair to (very) good (ranging between 0.78 and 0.95). Finally, the Dutch MacNew was demonstrated to be substantially more responsive than two other instruments measuring physical and psychological well-being.