Psychometric Properties of Quality of Life Instruments for Patients with Hypertension: A Systematic Review / Karakteristik Psikometrik Alat Ukur Kualitas Hidup bagi Pasien Hipertensi: Tinjauan Sistematis

Background: Hypertension is a chronic condition significantly impacting physical and psychological well-being. HRQoL instruments must undergo cross-cultural adaptation and psychometric evaluation before clinical application. Objective: This systematic review evaluated the psychometric robustness (reliability, validity, responsiveness) of hypertension-specific HRQoL instruments. Methods: Eight databases were searched for original research published in English or Indonesian (2021–2026) following PRISMA 2020. Methodological quality and evidence certainty were assessed using COSMIN and modified GRADE. Results: 13 studies from 10 countries were included. Six instruments (46.1%) demonstrated strong psychometric profiles, including adequate content validity and robust reliability. While content validity (100%) and internal consistency (84.6%) were strong due to rigorous adaptation, divergent validity and responsiveness were severely underreported (84.6%). According to COSMIN guidelines, test-retest reliability studies with sample sizes below 50 participants are considered to have 'Low' GRADE evidence quality due to insufficient precision, despite demonstrating adequate ICC values. QLICD-HY, STI-HRQoL, and DASI provided the strongest evidence. Conclusion: Instruments are generally reliable, yet future research must evaluate clinical responsiveness through longitudinal designs. Instruments with the strongest psychometric profiles, such as QLICD-HY and DASI, are recommended for accurate patient assessment.

Latar Belakang: Hipertensi merupakan penyakit kronis yang memengaruhi kesehatan fisik dan psikologis sehingga menurunkan kualitas hidup pasien. Instrumen Health-Related Quality of Life (HRQoL) perlu melalui adaptasi lintas budaya dan pengujian psikometrik sebelum digunakan dalam praktik klinis. Tujuan: Tinjauan sistematis ini bertujuan mengevaluasi kualitas psikometrik instrumen HRQoL pada pasien hipertensi berdasarkan validitas, reliabilitas, dan responsivitas. Metode: Penelusuran literatur dilakukan pada delapan basis data terhadap artikel berbahasa Inggris dan Indonesia yang diterbitkan pada 2021–2026. Seleksi artikel mengikuti pedoman PRISMA 2020. Kualitas metodologis dinilai menggunakan COSMIN, sedangkan kualitas bukti dievaluasi dengan GRADE yang dimodifikasi. Hasil: Sebanyak 13 penelitian dari 10 negara memenuhi kriteria inklusi. Enam instrumen (46,1%) menunjukkan validitas isi, konsistensi internal, dan reliabilitas uji ulang yang baik. Seluruh instrumen memiliki validitas isi yang memadai, sedangkan 84,6% menunjukkan konsistensi internal yang kuat. Namun, validitas diskriminan dan responsivitas masih jarang dilaporkan. Instrumen QLICD-HY (V2.0), STI-HRQoL, dan DASI menunjukkan bukti psikometrik terbaik. Kesimpulan: Instrumen HRQoL pada pasien hipertensi umumnya memiliki validitas dan reliabilitas yang baik. Penelitian longitudinal masih diperlukan untuk mengevaluasi responsivitas instrumen. QLICD-HY dan DASI direkomendasikan sebagai instrumen yang paling potensial untuk menilai kualitas hidup pasien hipertensi.