The Seattle Angina Questionnaire: Reliability and Validity in Women With Chronic Stable Angina - Europe PMC Article. Heart Dis. Author manuscript; available in PMC 2. February 1. 0. Published in final edited form as: Heart Dis. Jul- Aug; 4(4): 2. PMCID: PMC4. 32. 23. NIHMSID: NIHMS2. 58.
Laura P. Kimble, Ph. D, RN,*Sandra B. Dunbar, DSN, RN,*William S. De, Ph. D,* and Ora Strickland, Ph. D, RN**School of Nursing, Emory University, Atlanta, Georgia. Kimble, Ph. D, RN, School of Nursing, Emory University, 1.
The Seattle angina questionnaire: reliability and validity in women with chronic stable angina.
Clifton Road NE, Atlanta, GA 3. Email: ude. yrome@elbmikl. See other articles in PMC that cite the published article. Abstract. Angina pectoris causes substantial psychological and functional disability and adversely effects health- related quality of life, particularly in women. Studies of cardiac disease- specific quality of life in women with coronary artery disease and angina are limited because little reliability and validity data for these instruments exist for women. Therefore, the purpose of this study was to examine reliability and validity of the Seattle Angina Questionnaire (SAQ), a cardiac disease- related quality- of- life measure, in a sample of women with chronic stable angina. A secondary analysis was performed on SAQ data from 1.
CAD and angina pectoris. The majority of the women were older, white, living with their spouse, had a previous acute myocardial infarction, and had undergone revascularization. Results suggest that the SAQ is a reliable and valid quality- of- life measure in women with CAD.
The physical limitations subscale factored into two separate factors, suggesting that the subscale measures two domains of physical function: self- care and exercise tolerance/mobility. Future research is needed to determine whether examining different combinations of SAQ items might provide a more sensitive assessment of cardiac disease- specific quality of life in women. Chronic stable angina, the chest pain or discomfort associated with myocardial ischemia, is a major health problem in the United States.
An estimated 6,0. Americans have angina, 4,0. Anginal symptoms cause substantial psychological. Studies of cardiac disease- specific quality of life in women with coronary artery disease (CAD) are limited because research instruments used in studies often were developed and tested in predominantly male samples, and little reliability and validity data for these instruments exist for women. The Seattle Angina Questionnaire (SAQ), developed by Spertus and first reported in the literature in 1.
CAD and angina. 1. The SAQ was initially developed and evaluated in predominantly elderly male samples from a Veterans Administration hospital,1.
SAQ. Therefore, the purpose of this study was to examine reliability and validity of the SAQ in a sample of women with chronic stable angina. MATERIALS AND METHODSSample. A secondary data analysis was performed after pooling women’s data from three descriptive studies of patients with chronic stable angina. Subjects had participated in only one of the three studies.
Procedures and major findings for these studies are described elsewhere. The 1. 75 women subjects were cardiac outpatients who had been treated in clinical facilities affiliated with a large academic health center in the southeastern United States. All women had 1) a confirmed history of CAD and angina pectoris documented in the medical record or the academic health center’s interventional and cardiac surgery services data bank, and 2) reported one or more episodes of angina in the previous 6 months. Subjects were excluded from participating in the primary studies if they had experienced coronary artery bypass grafting, percutaneous transluminal coronary angioplasty (PTCA), or acute myocardial infarction within the previous 6 months. All studies from which the data for this secondary analysis were drawn were approved by the Human Investigations Committee. Instruments. The SAQ is a self- report instrument with 1. Table 1 provides subscale definitions and shows which items contribute to each of the subscales.
The possible range of scores for each of the five subscales is 0 to 1. A change of 1. 0 points in any of the subscales is considered to be clinically important. The SAQ was completed by a trained research assistant in a telephone interview format for 4. Along with the SAQ, information about demographic and clinical variables was obtained.
Seattle Angina Questionnaire subscale definitions and items. Analysis of Seattle Angina Questionnaire Scores. Data were analyzed using statistical program software (SPSS version 1.
The SAQ is scored so that when subjects mark responses “limited or did not do for other reasons” on questions 1a to 1h or “my doctor has not prescribed pills” for question 5, the answer is coded as “6” and then set to “missing” when the subscales are calculated. This creates cells with missing data in the inter- item correlation matrix. To address this problem, the SAQ scoring rules recommend mean substitution of the subject’s mean to impute the missing values. For example, for the physical limitation subscale, the subject’s mean value of the non- missing items in the same exertional level (low, medium, high) is imputed for the missing value. If more than four items are missing from the physical limitations subscale, the scoring rules recommend that a score not be calculated for the subscale. The SAQ scoring rules also recommend subject’s mean substitution for the treatment satisfaction subscale if up to two of the four items are missing, and for the disease perception subscale if only one of the three items is missing. Mean substitution is not possible for the angina stability subscale as it has only one item, and the SAQ scoring rules do not recommend mean substitution for the angina frequency scale as it has only two items.
When pooling the data, the original sample size was 1. However, we included only the 1. SAQ’s scoring rules. Frequencies were obtained for all categorical variables and measures of central tendencies were calculated for all continuous variables.
Confirmatory factor analysis was performed using principal component analysis to extract factors with eigenvalues greater than one. The extracted factors were then rotated in an oblique method, called “direct oblimin” in SPSS, which yields a correlated factor solution. The factor pattern matrix was used to interpret the factors. RESULTSTable 2 summarizes the demographic and clinical characteristics of the women, and Table 3 provides the sample means and SD for individual SAQ items and subscales. The sample ranged in age from 3.
SD 1. 2. 0). CAD had been diagnosed for a mean of 8. SD 7. 6). The majority of women were older, white, living with their spouse, had a previous myocardial infarction and/or had undergone revascularization, and had a history of hyperlipidemia, hypertension, and a family member with CAD. The mean SAQ subscale scores indicated women had the highest quality of life in the area of treatment satisfaction and the lowest in physical limitation. Demographic and clinical characteristics (n = 1. Individual SAQ items and SAQ subscales (n = 1. Reliability of the Seattle Angina Questionnaire.
Internal consistency reliability coefficients were calculated for the four SAQ subscales that have more than one item. Because mean substitution of the subject’s mean can artificially increase internal consistency reliability coefficients, Cronbach coefficient . The results for unimputed and imputed data were almost identical, so only the results for the imputed data are reported. Internal consistency reliability coefficients were as follows for this sample: physical limitation (0. Item- to- total statistics, including “alpha if item deleted,” suggested that removing items would not improve internal consistency for the subscales, with one exception: removing the question “How bothersome is it for you to take your pills for chest pain, chest tightness of angina as prescribed?” from the treatment satisfaction sub- scale would have increased the coefficient .
Download PDF (29 KB) Reference Work Entry Handbook of Disease Burdens and Quality of Life Measures pp 4316-4316 Seattle Angina Questionnaire. The Seattle Angina Questionnaire is the leading health-related quality-of-life measure for patients with coronary artery disease. It is a reliable, predictive tool that tracks how patients are doing if they have chest pains (angina), prior heart attacks, angioplasty, stents.
You need to login in order to post here. Post in this forum questions and experiences you have about the deployment, data collection, analysis and application of the Seattle Angina Questionnaire. This is a moderated forum, so we will review your posts to make. 1995 Feb;25(2):333-41. Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. Spertus JA(1), Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, McDonell M, Fihn SD. Analysis of Seattle Angina Questionnaire Scores Data were analyzed using statistical program software (SPSS version 10.0). The SAQ is scored so that when subjects mark responses “limited or did not do for other reasons” on questions 1a to 1h or “my doctor has. Original Citation – Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, McDonell M, Fihn SD. Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease.
Table 3 shows the factor loadings for the 1. SAQ items. Question 4 had its largest factor loading of .
Only one item, question 1. How often do you worry that you may have a heart attack or die suddenly?”) loaded at . Factor I comprised items 1d, 1e, 1f, 1g, 1h, and 1i, which are six of the nine items in the SAQ physical limitations subscale.
All the items represented physical activities with middle and high levels of exertional requirements. Factor II accounted for 1. Factor III accounted for 1.
This factor might be described as angina pattern and disease perception because it incorporated all items on the angina stability, frequency, and disease perception subscales. Factor IV accounted for 7. Factor V accounted for 5. How bothersome is it for you to take your pills for chest pain, chest tightness, or angina as prescribed?”). According to the scoring instructions, this item should belong with the treatment satisfaction subscale. However, it did not load with other items on the subscale, suggesting that question 5 does not share common variance with the other treatment- satisfaction items. DISCUSSIONOverall, the results indicate that the SAQ is a reliable and valid instrument in women.
The physical limitation sub- scale demonstrated a good internal consistency of 0. The angina frequency subscale had an internal consistency of 0. Internal consistency reliability is higher in scales with larger numbers of items.
Using the Spearman- Brown prophecy formula discussed by Nunnally and Bernstein. Removing question 5 from the subscale would raise the internal consistency to a very satisfactory 0. One potential explanation for why this item lowered the internal consistency of the treatment satisfaction scale may be that the responses to the item had low variance. A total of 1. 20 women (6. The disease perception subscale had fair internal consistency.