Translation, cultural adaptation, and validation of the amharic version of the Minnesota Living with Heart Failure Questionnaire (MLHFQ)

Abstract Background Heart failure has a significant impact on the health-related quality of life of affected individuals. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most widely used instruments for measuring the health-related quality of life of people with heart failure. This study aimed to translate, culturally adapt, and validate the psychometric properties of the Amharic MLHFQ among people with heart failure in Ethiopia. Methods A hospital-based cross-sectional study was conducted among adults with heart failure attending the cardiac outpatient clinics of two tertiary-level public hospitals in Ethiopia. The health-related quality of life of these people was measured using the Amharic version of the MLHFQ. The study was conducted in two phases: translation and cultural validation, followed by psychometric testing to assess the reliability and validity of the instrument. The translation and cross-cultural adaptation process involved forward translation, synthesis, back translation, expert panel review, and pre-testing. The scale level content validity index (S-CVI) was calculated to assess content validity. The internal consistency of the tool was evaluated using reliability test, while construct validity was examined using confirmatory factor analysis (CFA). Results A total of 383 adults with heart failure participated in the study. The scale-level content validity index (S-CVI) was 0.87, indicating good content validity. The Cronbach’s α coefficient for the Amharic version of the MLHFQ was 0.90, demonstrating strong internal consistency. Confirmatory factor analysis (CFA) results revealed that the two-factor model provided an acceptable fit to the data (CFI = 0.92, RMSEA = 0.10, SRMR = 0.10, χ 2 = 278.047, p < 0.001). There were significant differences in MLHFQ scores across age groups, depression status, New York Heart Association (NYHA) class and social support levels. Conclusion The Amharic version of the MLHFQ demonstrated good reliability and acceptable validity, supporting its use as a culturally appropriate tool for assessing the health-related quality of life of Amharic-speaking Ethiopian people with heart failure. Health care providers can use this tool in both clinical practice and research settings to better evaluate and monitor patient-reported outcomes. Future research is recommended to confirm and strengthen the findings of this study.