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heart failure, instrument, symptoms



  1. Heo, Seongkum PhD, RN
  2. Moser, Debra K. DNSc, RN, FAAN
  3. Pressler, Susan J. PhD, RN
  4. Dunbar, Sandra B. DSN, RN
  5. Mudd-Martin, Gia PhD, RN
  6. Lennie, Terry A. PhD, RN


Background and Purpose: Many patients with heart failure (HF) experience physical symptoms, poor health-related quality of life (HRQOL), and high rates of hospitalization. Physical symptoms are associated with HRQOL and are major antecedents of hospitalization. However, reliable and valid physical symptom instruments have not been established. Therefore, this study examined the psychometric properties of the Symptom Status Questionnaire-Heart Failure (SSQ-HF) in patients with HF.


Method: Data on symptoms using the SSQ-HF were collected from 249 patients (aged 61 years, 67% male, 45% in New York Heart Association functional class III/IV). Internal consistency reliability was assessed using Cronbach's [alpha]. Item homogeneity was assessed using item-total and interitem correlations. Construct validity was assessed using factor analysis and testing hypotheses on known relationships. Data on depressive symptoms (Beck Depression Inventory II), HRQOL (Minnesota Living With Heart Failure Questionnaire), and event-free survival were collected to test known relationships.


Results: Internal consistency reliability was supported: Cronbach's [alpha] was .80. Item-total correlation coefficients and interitem correlation coefficients were acceptable. Factor analysis supported the construct validity of the instrument. More severe symptoms were associated with more depressive symptoms, poorer HRQOL, and more risk for hospitalization, emergency department visit, or death, controlling for covariates.


Conclusions: The findings of this study support the reliability and validity of the SSQ-HF. Clinicians and researchers can use this instrument to assess physical symptoms in patients with HF.