Document Type : Original Article(s)
Authors
- Shayan MirShafiee 1
- Somayyeh Moradi 1
- Ali Mehrakizadeh 1
- Reza Mazaheri 2
- Masih Tajdini 3
- Reza Mollazadeh 1
1 Department of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Sports and Exercise Medicine, Sports Cardiology Section, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
3 Division of Cardiology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
Abstract
Background: Syncope is defined as a transient loss of consciousness, with vasovagal syncope (VVS) being the most common cause. Although VVS episodes are typically self-limiting, they can significantly impact patients’ quality of life. The syncope functional status questionnaire (SFSQ) is an internationally standardized tool designed to assess two major health dimensions: the physical and psychosocial domains. This study aimed to translate and culturally adapt the SFSQ into Persian and assess its validity and reliability.
Methods: This study was conducted in Tehran, Iran, between October 2022 and January 2023. It consisted of three phases: first, the translation and cultural adaptation of the questionnaire into Persian; second, an assessment of the comprehensibility of the pre-final version through a pilot study involving 50 individuals; and third, an evaluation of the reliability and validity of the final translated version. We assessed test-retest reliability, content validity, and convergent validity by examining the correlations between the dimensions of the translated SFSQ and other relevant measures.
Results: Among 50 patients, 26 were women, and 24 were men. The mean age of the participants was 26.5±5.5 years. Test-retest reliability was good, with a Cronbach’s alpha coefficient of 0.84. Both face validity and content validity index (CVI) were deemed acceptable, with a misunderstanding index of 18% (below the 20% significance threshold) and a CVI of 92% (above the 88% significance threshold for all questions).
Conclusion: The Persian version of the SFSQ was found to be a reliable and valid tool for data collection in patients with syncope. This instrument represents a significant step toward standardizing syncope-related research.
Highlights
Shayan MirShafiee (Google Scholar)
Reza Mollazadeh (Google Scholar)
Keywords
- Brignole M, Moya A, de Lange FJ, Deharo JC, Elliott PM, Fanciulli A, et al. 2018 ESC Guidelines for the diagnosis and management of syncope. Kardiol Pol. 2018;76:1119-98. doi: 10.5603/KP.2018.0161. PubMed PMID: 30117520.
- Shen W-K, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology. 2017;70:e39-e110.
- Williams EL, Raj SR, Schondorf R, Shen WK, Wieling W, Claydon VE. Salt supplementation in the management of orthostatic intolerance: Vasovagal syncope and postural orthostatic tachycardia syndrome. Auton Neurosci. 2022;237:102906. doi: 10.1016/j.autneu.2021.102906. PubMed PMID: 34823150.
- Eslami M, Mollazadeh R, Mirshafiee S, Sehat P, Alizadeh F, Emkanjoo Z, et al. Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Post COVID-19. Infect Disord Drug Targets. 2023;23:e100622205846. doi: 10.2174/1871526522666220610143504. PubMed PMID: 35692134.
- Ganzeboom KS, Mairuhu G, Reitsma JB, Linzer M, Wieling W, van Dijk N. Lifetime cumulative incidence of syncope in the general population: a study of 549 Dutch subjects aged 35-60 years. J Cardiovasc Electrophysiol. 2006;17:1172-6. doi: 10.1111/j.1540-8167.2006.00595.x. PubMed PMID: 17074006.
- Sheldon RS, Grubb BP, 2nd, Olshansky B, Shen WK, Calkins H, Brignole M, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12:e41-63. doi: 10.1016/j.hrthm.2015.03.029. PubMed PMID: 25980576; PubMed Central PMCID: PMC5267948.
- Magnavita N, Di Prinzio RR, Arnesano G, Cerrina A, Gabriele M, Garbarino S, et al. Association of Occupational Distress and Low Sleep Quality with Syncope, Presyncope, and Falls in Workers. Int J Environ Res Public Health. 2021;18. doi: 10.3390/ijerph182312283. PubMed PMID: 34886008; PubMed Central PMCID: PMC8657064.
- Ng J, Sheldon RS, Ritchie D, Raj V, Raj SR. Reduced quality of life and greater psychological distress in vasovagal syncope patients compared to healthy individuals. Pacing Clin Electrophysiol. 2019;42:180-8. doi: 10.1111/pace.13559. PubMed PMID: 30488466; PubMed Central PMCID: PMC6358504.
- Smith HJ, Taylor R, Mitchell A. A comparison of four quality of life instruments in cardiac patients: SF-36, QLI, QLMI, and SEIQoL. Heart. 2000;84:390-4. doi: 10.1136/heart.84.4.390. PubMed PMID: 10995407; PubMed Central PMCID: PMC1729427.
- van Dijk N, Boer KR, Wieling W, Linzer M, Sprangers MA. Reliability, validity and responsiveness of the syncope functional status questionnaire. J Gen Intern Med. 2007;22:1280-5. doi: 10.1007/s11606-007-0266-5. PubMed PMID: 17610019; PubMed Central PMCID: PMC2039793.
- Linzer M, Gold DT, Pontinen M, Divine GW, Felder A, Brooks WB. Recurrent syncope as a chronic disease: preliminary validation of a disease-specific measure of functional impairment. J Gen Intern Med. 1994;9:181-6. doi: 10.1007/BF02600121. PubMed PMID: 8014722.
- Aminorroaya A, Tavolinejad H, Sadeghian S, Jalali A, Alaeddini F, Emkanjoo Z, et al. Comparison of Outcomes with Midodrine and Fludrocortisone for Objective Recurrence in Treating Syncope (COMFORTS trial): Rationale and design for a multi-center randomized controlled trial. Am Heart J. 2021;237:5-12. doi: 10.1016/j.ahj.2021.03.002. PubMed PMID: 33689731.
- Tavolinejad H, Poopak A, Sadeghian S, Bozorgi A, Oraii A, Mollazadeh R, et al. Compression stockings for treating vasovagal syncope (COMFORTS-II) trial: Rationale and design of a triple-blind, multi-center, randomized controlled trial. Am Heart J. 2022;249:57-65. doi: 10.1016/j.ahj.2022.04.002. PubMed PMID: 35405100.
- Ayre C, Scally AJ. Critical values for Lawshe’s content validity ratio: revisiting the original methods of calculation. Measurement and evaluation in counseling and development. 2014;47:79-86. doi: 10.1177/0748175613513808.
- Bujang MA, Omar ED, Baharum NA. A Review on Sample Size Determination for Cronbach’s Alpha Test: A Simple Guide for Researchers. Malays J Med Sci. 2018;25:85-99. doi: 10.21315/mjms2018.25.6.9. PubMed PMID: 30914882; PubMed Central PMCID: PMC6422571.
- van Dijk N, Sprangers MA, Colman N, Boer KR, Wieling W, Linzer M. Clinical factors associated with quality of life in patients with transient loss of consciousness. J Cardiovasc Electrophysiol. 2006;17:998-1003. doi: 10.1111/j.1540-8167.2006.00533.x. PubMed PMID: 16764705.
- Hosseini SMS, Sarhady M, Nurani-Gharaborghe S. Validity and reliability of the Iranian-developed version of the leisure questionnaire for people with multiple sclerosis: Psychometric properties. Curr J Neurol. 2024;23:15-20. doi: 10.18502/cjn.v23i1.16429. PubMed PMID: 39431228; PubMed Central PMCID: PMC11489631.
- Goyal AK, Bakshi J, Panda NK, Kapoor R, Vir D, Kumar K, et al. A hybrid method for the cross-cultural adaptation of self-report measures. International Journal of Applied Positive Psychology. 2021;6:45-54. doi: 10.1007/s41042-020-00039-3.
- Rose MS, Koshman ML, Ritchie D, Sheldon R. The development and preliminary validation of a scale measuring the impact of syncope on quality of life. Europace. 2009;11:1369-74. doi: 10.1093/europace/eup106. PubMed PMID: 19797151.
- Miranda CM, da Silva RMFL, Amore Filho ED, Nascimento IMA, Carvalho PS. Quality of Life After Diagnosis of Neurally Mediated Reflex Syncope by Tilt Test. International Journal of Cardiovascular Sciences. 2024;37:e20230017. doi: 10.36660/ijcs.20230017.
- de Barros ESRLA, Volich RM, de Barros ESPGM, da Costa Darrieux FC, Scanavacca MI, Hachul DT. Effect of psychotherapy on recurrence of events and quality of life in patients with vasovagal syncope. Sci Rep. 2022;12:5745. doi: 10.1038/s41598-022-09513-1. PubMed PMID: 35388029; PubMed Central PMCID: PMC8986773.
- Soni B, Gupta D, Gopinathannair R. Quality of life improvement following cardioneuroablation for vasovagal syncope: expected or too early to say? J Interv Card Electrophysiol. 2025;68:253-5. doi: 10.1007/s10840-023-01489-w. PubMed PMID: 36705871.
- Nave-Leal E, Oliveira M, Pais-Ribeiro J, Santos S, Oliveira E, Alves T, et al. Impact of syncope on quality of life: Validation of a measure in patients. Revista Portuguesa de Cardiologia. 2015;34:173-7. doi: 10.1016/j.repce.2014.08.026.
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