Brief communication Evaluative and discriminative properties of the Portuguese MacNew Heart Disease Health-related Quality of Life questionnaire A. Leal 1 , C. Paiva 1 , S. Ho¨fer 2 , J. Amado 3 , L. Gomes 4 & N. Oldridge 5 1 Cardiac Rehabilitation Unit, Hospital Sto Anto´nio Porto, Largo Prof Abel Salazar 400, Porto, Portugal (E-mail: antl@clix.pt); 2 Medical University Innsbruck, Department of Medical Psychology and Psycho- therapy, Innsbruck, Austria; 3 Director of INSA and Health Community of Instituto de cieˆncias Biome´dicas Abel Salazar, Porto, Portugal; 4 Director of Cardiology Service of Hospital Sto Anto´nio, Porto, Portugal; 5 College of Health Sciences, University of Wisconsin–Milwaukee, Wisconsin, USA Accepted in revised form 10 May 2005 Abstract The aim of this study was to validate the Portuguese version of the self-administered MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire in patients after diagnosis of acute coro- nary syndrome. The MacNew, with a Global score and physical, emotional and social subscales, the Short Form SF-36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline by 150 patients and again by 48 clinically stable patients 2–3 weeks later. A cohort of 50 different patients completed the same questionnaires before and after a cardiac rehabilitation program in order to examine responsiveness. Acceptance of the MacNew by the patients was good and the three factor model was substantiated and explained 52.2% of the variance. Internal consistency, intra-class-correlation, and test– retest reliability each exceeded 0.72. The predicted construct validity hypotheses were partially confirmed. The discriminative validity of the MacNew was confirmed with significantly higher MacNew scores for patients with normal left ventricular function, with improved health status, and who were not anxious or depressed. Even though MacNew scores improved significantly following cardiac rehabilitation, the eval- uative validity of the MacNew was less robust with small responsiveness statistics. The Portuguese version of the MacNew HRQL questionnaire appears to be a reliable, valid, and moderately responsive instrument to evaluate health-related quality of life after diagnosis of acute coronary syndrome. Key words: Acute coronary syndrome, Cardiac rehabilitation, Health-related quality of life Introduction One of the more important developments in health care in the past decade may be the recognition that the patient’s perspective is as legitimate as the clinician’s in monitoring health care outcomes [1, 2]. As a measure of the patient’s perspective, the MacNew Heart Disease Health-related Quality of Life questionnaire (MacNew) is a self-adminis- tered health-related quality of life (HRQL) ques- tionnaire, validated and used with patients with myocardial infarction (MI) and patients with an- gina [3]. Acute coronary syndrome (ACS) refers to a range of acute myocardial ischemia states com- prising a spectrum of conditions that includes unstable angina and acute MI and characterized by the common pathophysiologic process of a disrupted atherosclerotic plaque [4, 5]. As the Quality of Life Research (2005) 14: 2335–2341 Ó Springer 2005 DOI 10.1007/s11136-005-7213-x