Measuring quality of life in heart failure: one versus multiple items

Background: Symptoms of heart failure and consequences of treatment can have a great impact on patients' lives. Improving quality of life is generally recognised as one of the major goals of treatment. The purpose of this study was to determine the relationship between a one-item quality-of-life measure (Ladder of Life) and the Minnesota Living with Heart Failure Questionnaire and possible equality.

Method: 231 patients who were admitted with symptoms of chronic heart failure to a cardiology ward in a general hospital (53% male, age 75±11, LVEF 40±16) completed the Minnesota Living with Heart Failure Questionnaire (MLwHFQ) and were asked to rate their sense of well-being on the Ladder of Life (10= best possible life, 0= worst possible life). Demographic and clinical data were obtained by chart review.

Results: The overall well-being score on the Ladder of Life correlated significantly with the total MLwHFQ (r=-0.36, p<0.001). However, there is a large variation in MLwHFQ scores (12-83) in patients who score a relatively high overall well-being (>6, relatively good Q0L). A large variation in MLwHFQ scores (10-105) also exists in patients with a relatively low score on the Ladder of Life (<1, low QOL).

Conclusion: Assessment of quality of life with a simple and practical tool using the one-item Ladder of Life can give clinicians and researchers important information on the quality of life of patients. Whether such a single-item question is responsive enough to detect changes in treatment and predict readmission needs to be studied in more detail.