Psychometric Evaluation of the Serbian MacNew Heart Disease Health-Related Quality of Life Questionnaire Before and After Elective Coronary Artery Bypass Grafting

Background/Objectives: To evaluate the psychometric properties of the MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew HRQL) in patients who underwent elective coronary artery bypass grafting (CABG) in Serbia. Methods: Recruitment of participants was organized at the Institute for Cardiovascular Diseases “Dedinje”. The MacNew HRQL was administered prior to having CABG, and 1, 6 and 12 months after CABG. The scale was compared to the Short Form-36 (SF-36) and Depression, Anxiety and Stress Scale-21 (DASS-21). Clinical data were obtained from medical records. Results: A total of 192 patients had complete follow-up data (80.2% male, 64.1 ± 7.6 years old). The Cronbach’s alpha and McDonald’s omega coefficients were ≥0.80. The original three-factor structure was supported by indices on the confirmatory factor analysis using the Unweighted Least Squares estimator (ULS) at 6 and 12 months post-CABG, but not at baseline and 1 month after CABG. Longitudinal measurement invariance suggested that models were not supported. The MacNew HRQL global score correlated with clinical parameters at all four time points. All MacNew HRQL domains correlated with mental and physical scores of the SF-36 and with depression, anxiety and stress scores. Conclusions: The MacNew HRQL in Serbian had good internal consistency and construct validity. The three-factor structure was most favorable under the ULS at 6 and 12 months post-CABG. As the measurement invariance was not supported, changes in scores over time cannot be interpreted unequivocally as changes in the same underlying constructs. The scores right before and after CABG should be interpreted with caution.