Content validity of the Dutch version of a quality of life questionnaire for patients with a left ventricular assist device (LVAD)

Survival among patients with a left ventricle assist device (LVAD) has improved in recent years, leading to increase us of LVADs in patients with heart failure. Consequently, proper assessment of health-related quality of life (QoL) in this population has become essential. The Quality of Life with a Ventricular Assist Device (QoLVAD) is a 40-item questionnaire, which was developed to measure health-related QoL in LVAD patients. This study aimed to assess the content validity of the Dutch QoLVAD questionnaire, focusing on comprehensibility, relevance, and comprehensiveness, and to propose modifications for potential revisions of the questionnaire.

A qualitative study using cognitive interviewing methodology was conducted between January and June 2025. Twelve LVAD participants were interviewed (8 male (75%), age range 20–75 years).

Most QoLVAD items were perceived as comprehensible, relevant, and comprehensive. Fifteen items were identified as potentially problematic: eight related to comprehensibility, and seven to relevance. No major concerns emerged regarding comprehensiveness. Comprehensibility issues were mainly attributable to phrasing in the Dutch translation and were addressed through wording adaptations or clarifications. Relevance issues mostly involved perceived redundancy and were resolved by rewording items to enhance conceptual distinction. Some items were considered less relevant by individual patients, but this did not warrant item removal. Based on these findings, targeted revisions were proposed.

This findings support the content validity of the Dutch QoLVAD questionnaire. Implementing the proposed modifications may further enhance clarity, cultural relevance, and conceptual accuracy for future use.