MacNew QUALITY OF LIFE AFTER MYOCARDIAL INFARCTION QUESTIONNAIRE

[MacNew QLMI]
The original "Quality-of-Life after Myocardial Infarction Questionnaire" (QLMI) is a valid,
reliable, and responsive interviewer-administered condition-specific health-related quality of life
questionnaire [1,2]. The MacMaster-Newcastle modification of the original QLMI (MacNew
QLMI), is a self-administered, condition-specific, health-related quality of life instrument that is
valid, reliable, and responsive, and is simpler to administer than the original QLMI [3,6]. The
appropriate citations for the development and testing of the questionnaire are 1,2,4 and 6.
The MacNew QLMI addresses three major health-related quality of life domains, the
Emotional, Physical, and Social domains [3,6]. There are substantial correlations between the
MacNew QLMI and other HRQL measures, and moderate concordance with predictions about how
the instrument should behave if it is a valid measure of HRQL. Correlations between the MacNew
QLMI and other measures provide moderate to strong evidence to discriminate between patients
following myocardial infarction according to their HRQL, and in measuring changes in HRQL over
time.
The original QLMI , with modifications, is a valid and responsive measure of health-related
quality of life for spouses of survivors of an acute myocardial infarction [7]. With rehabilitation, the
time course of recovery of health-related quality of life, using the original QLMI , is more rapid than
that of exercise tolerance [8]. The original QLMI has been translated into Spanish [9].
References:
1.

2.
3.
4.

5.

6.
7.
8.

9.

Oldridge N, Guyatt G, Jones N, Crowe J, Singer J, Feeny D et al. Effects on

quality of
life with comprehensive rehabilitation after acute myocardial infarction.
Am J Cardiol
1991;67:1084-1089.
Hillers TK, Guyatt GH, Oldridge NB, Crowe J, Willan A, Griffith L, et al. Quality of
life after myocardial infarction. J Clin Epidemiol 1994;47:1287-1296.
Heller RF, Knapp JC, Valenti LA, Dobson AJ. Secondary prevention after acute
myocardial infarction. Am J Cardiol 1993;72:759-762.
Lim L, Valenti L, Knapp J, Dobson A, Plotnikoff R, Higginbotham N, Heller RF. A
self-administered quality-of-life questionnaire after acute myocardial infarction. J
Clin Epidemiol 1993;46: 1249-1256.
Heller R, Lim L, Valenti L, Knapp J. A randomised controlled trial of community
based counselling among those discharged from hospital with ischaemic heart
disease.
Aust NZ J Med 1995;25:362-364.
Valenti L, Lim L, Heller RF, Knapp J. An improved questionnaire for assessing quality of
life after acute myocardial infarction. Quality of Life Research 1996;5:151-161.
Ebbesen L, McCartney N, Guyatt GH, Oldridge NB. Measuring quality of life in cardiac
spouses. J Clin Epidemiol 1990;43:481-487.
Foster C, Oldridge NB, Dion W, Forsyth G, Grevenow P, Hansen MA, et al. Time
course of recovery during cardiac rehabilitation. J Cardiopulmonary Rehabil
1995;15:209-215.
Velasco J, del Barrio M, Mestre M, Penas C, Ridocci F. Assessment of quality of
life in myocardial infarction patients. In: Proceedings Vth World Congress Cardiac
Rehabilitation. Andover, UK: Intercept Ltd, 1993:333-340.

September, 1996

Addresses for correspondence:

Neil Oldridge, PhD
Health Sciences
University of Wisconsin
P.O. Box 413
Milwaukee,
WI 53201
USA

email: neilb@csd.hwn.edu

or
Lynette Lim, PhD
Centre for Clinical Epidemiology and Biostatistics
University of Newcastle
Newcastle
NSW 2308
Australia

email: llim@cceb.newcastle.edu.au

MacNew QLMI
A self-administered questionnaire for Health-related Quality of Life after
Myocardial Infarction
Recommended Scoring System
Item
1. Frustrated
2. Worthless
3. Confident
4. Down in the dumps
5. Relaxed
6. Worn Out
7. Happy with Personal Life
8. Restless
9. Short of Breath
10. Tearful
11. More Dependent
12. Social Activities
13. Others/less Confidence in you
14. Chest Pain
15. Lack Self-Confidence
16. Aching Legs
17. Sports/Exercise Limited
18. Frightened
19. Dizzy/Lightheaded
20. Restricted or Limited
21. Unsure about Exercise
22. Overprotective Family
23. Burden on Others
24. Excluded
25. Unable to socialise
26. Physically Restricted
27. Sexual Intercourse

Emotional

Physical

Social

1. Ticks show domains to which the items contribute.

2. The maximum possible Score in any domain is 7 and the minimum is 1.
3. The Emotional Score is Calculated as the average of the 14 item responses which contribute to
the Emotional domain shown in the above table, the Physical Score is the average of 14
responses and the Social Score is the average of 13 responses.
4. Missing responses do not contribute to the Score. For example, if only 10 of the 14 emotional
items are answered, the Emotional Score is the average of 10 responses.
5. If desired, a Global Score can be calculated as the average over all items.
6. Item 27, Sexual Intercourse, may be excluded in the Physical domain.
September, 1996

MacNew MYOCARDIAL INFARCTION QUALITY OF LIFE AFTER QUESTIONNAIRE

[MacNew QLMI]

We would like to ask you some questions about how you have been feeling DURING THE LAST 2
WEEKS.
Please check the box that matches you answer
1.

In general, how much of the time during the last 2 weeks, have you felt frustrated, impatient or angry?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

2.

How often, during the last 2 weeks, have you felt worthless or inadequate?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

3.

In the last 2 weeks, how much of the time did you feel very confident and sure that you could deal with
your heart problem?
1
NONE OF THE TIME
2
A LITTLE OF THE TIME
3
SOME OF THE TIME
4
A GOOD BIT OF THE TIME
5
MOST OF THE TIME
6
ALMOST ALL OF THE TIME
7
ALL OF THE TIME

4.

In general how much of the time did you feel discouraged or down in the dumps during the last 2
weeks?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

5.

How much of the time, during the last 2 weeks, did you feel relaxed and free of tension?
1
NONE OF THE TIME
2
A LITTLE OF THE TIME
3
SOME OF THE TIME
4
A GOOD BIT OF THE TIME
5
MOST OF THE TIME
6
ALMOST ALL OF THE TIME
7
ALL OF THE TIME

6.

How often, during the last 2 weeks, have you felt worn out or low in energy?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

7.

How happy, satisfied, or pleased have you been with your personal life during the last 2 weeks?
1
VERY DISSATISFIED, UNHAPPY MOST OF THE TIME
2
GENERALLY DISSATISFIED, UNHAPPY
3
SOMEWHAT DISSATISFIED, UNHAPPY
4
GENERALLY SATISFIED, PLEASED
5
HAPPY MOST OF THE TIME
6
VERY HAPPY MOST OF THE TIME
7
EXTREMELY HAPPY, COULD NOT HAVE BEEN MORE SATISFIED OR
PLEASED

8.

In general, how often during the last 2 weeks, have you felt restless, or as if you were having difficulty
trying to calm down?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

9.

How much shortness of breath have you experienced during the last 2 weeks while doing your day-today physical activities?
1
EXTREME SHORTNESS OF BREATH
2
VERY SHORT OF BREATH
3
QUITE A BIT OF SHORTNESS OF BREATH
4
MODERATE SHORTNESS OF BREATH
5
SOME SHORTNESS OF BREATH
6
A LITTLE SHORTNESS OF BREATH
7
NO SHORTNESS OF BREATH

10.

How often, during the last 2 weeks, have you felt tearful, or like crying?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

11.

How often, during the last 2 weeks, have you felt as if you were more dependent than you were before
your heart problem?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

12.

How often, during the last 2 weeks, have you felt you were unable to do your usual social activities, or
social activities with your family?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

13.

How often, during the last 2 weeks, have you felt as if others no longer have the same confidence in
you as they did before your heart problem?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

14.

How often, during the last 2 weeks, have you experienced chest pain while doing your day-to-day
activities?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

15.

How often, during the last 2 weeks, have you felt unsure of yourself or lacking in self-confidence?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

16.

How often, during the last 2 weeks, have you been bothered by aching or tired legs?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

17.

During the last 2 weeks, how much have you been limited in doing sports or exercise as a result of
your heart problem?
1
EXTREMELY LIMITED
2
VERY LIMITED
3
LIMITED QUITE A BIT
4
MODERATELY LIMITED
5
SOMEWHAT LIMITED
6
LIMITED A LITTLE
7
NOT LIMITED AT ALL

18.

How often, during the last 2 weeks, have you felt apprehensive or frightened?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

19.

How often, during the last 2 weeks, have you felt dizzy or lightheaded?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

20.

In general, during the last 2 weeks, how much have you been restricted or limited as a result of your
heart problem?
1
EXTREMELY LIMITED
2
VERY LIMITED
3
LIMITED QUITE A BIT
4
MODERATELY LIMITED
5
SOMEWHAT LIMITED
6
LIMITED A LITTLE
7
NOT LIMITED AT ALL

21.

How often, during the last 2 weeks, have you felt unsure as to how much exercise or physical activity
you should be doing?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

22.

How often, during the last 2 weeks, have you felt as if your family is being over-protective toward
you?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

23.

How often, during the last 2 weeks, have you felt as if you were a burden on others?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

24.

How often, during the last 2 weeks, have you felt excluded from doing things with other people
because of your heart problem?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

25.

How often, during the last 2 weeks, have you felt unable to socialise because of your heart problem?
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME

26.

In general, during the last 2 weeks, how much have you been physically restricted or limited as a result
of your heart problem?
1
EXTREMELY LIMITED
2
VERY LIMITED
3
LIMITED QUITE A BIT
4
MODERATELY LIMITED
5
SOMEWHAT LIMITED
6
LIMITED A LITTLE
7
NOT LIMITED AT ALL

27.

How often, during the last 2 weeks, have you felt your heart problem limited or interfered with sexual
intercourse?
0
NOT APPLICABLE
1
ALL OF THE TIME
2
MOST OF THE TIME
3
A GOOD BIT OF THE TIME
4
SOME OF THE TIME
5
A LITTLE OF THE TIME
6
HARDLY ANY OF THE TIME
7
NONE OF THE TIME
[September 1996]