The use of convenience sampling strategy from a single tertiary
hospital limits the generalisability and interpretation of the findings,
and caution must be exercised when extrapolating these results to CHD
outpatients in other settings. A more proportionate recruitment may be beneficial in future studies to enhance generalisability of findings and to
better discern any differences in HRQoL status between major ethnic
groups in Singapore. Moreover, the use of self-report questionnaire may
have been susceptible to some common problems such as social
desirability response set bias where participants had a tendency to
misrepresent attitudes or traits by providing responses that place them
in good light. Nevertheless, with the use of instruments that were
established to be valid and reproducible in different populations, one
could only hope to have reduced these biases.