Condition-specific Quality Of Life Questionnaires Research Articles

Quality of Life (QoL) changes after orthognathic surgery: Do they correlate with the quantum of hard and soft tissue change?

Aim: To investigate the relationship between post orthognathic surgery changes in soft and hard tissue cephalometric variables in Class II and Class III patients and quality of life (QoL) measured using a condition-specific QoL questionnaire and to determine cephalometric predictors of the overall OQLQ after surgery. Methods: The sample included 50 orthodontic patients, 28 Class II and 22 Class III skeletal relationships whose treatment included orthognathic surgery. Correlations between cephalometric changes and Orthognathic Quality of Life Questionnaire (OQLQ) were tested by Pearson’s correlation. Multiple linear regression was used to determine cephalometric predictors of the overall OQLQ after surgery. Results: In Class II patients, OQLQ before surgery and changes in SNA were significant predictors for OQLQ after surgery. For Class III patients, OQLQ after surgery was significantly correlated with the change in mandibular plane angle and lower face height (r = 0.6 and r = 0.5 respectively). The decrease in facial angle was negatively correlated with OQLQ (r = -0.4). Mandibular plane angle, mandibular length, and OQLQ before surgery were significant predictors for OQLQ after surgery. Conclusion: QoL improved for Class II and III after orthognathic surgery. Changes in certain cephalometric measurements seem to predict quality of life after orthognathic surgery.

Domains of quality of life freely expressed by cancer patients and their caregivers: contribution of the SEIQoL

BackgroundThe purposes of this study, performed on a large sample of cancer patient-caregiver dyads, were: i) to simultaneously investigate, using an individualized quality of life (QoL) measure (Schedule for the Evaluation of Individual QoL, SEIQoL), the QoL domains freely expressed by cancer patients and their caregivers, and ii) to explore overlapping between the SEIQoL assessment and QoL assessment using traditional instruments.MethodsThe study employed a cross-sectional design including cancer patients who were going to receive chemotherapy treatment and their caregivers. Quality of life was assessed using condition-specific questionnaires (EORTC QLQ-C30 and CarGOQoL), generic health-related questionnaire (SF-36), and open individualized measure (SEIQoL).ResultsThe final sample included 205 patient-caregiver dyads. From the SEIQoL, Family, Health, and Leisures were the most freely expressed QoL domains by patients and caregivers, but reported with different weights. Love life and financial issues were less spontaneously mentioned. The SEIQoL index was moderately correlated to the condition-specific QoL questionnaires (R lower than |0.40|) and to SF-36 (correlation coefficients: R ranging from 0.17 to 0.31).ConclusionIndividualized QoL measures allow individuals to spontaneously express important, non-predefined domains. This study highlights the need to explore QoL using a combination of individualized questionnaires and standardized questionnaires, capturing complementary facets that patients consider important in their life.

Translation and psychometric evaluation of the Greek short forms of two condition-specific quality of life questionnaires for women with pelvic floor disorders: PFDI-20 and PFIQ-7

The aim of this study was the cross-cultural adaptation, validation, and psychometric evaluation in the Greek language of two self-reported instruments used for patients with pelvic floor disorders (PFDs): the Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7). For the cross-cultural adaptation, a multistep forward-back translation protocol was utilized. Evaluation of the psychometric properties of the questionnaires involved the assessment of validity, stability, internal consistency, and responsiveness. Validity, stability, and internal consistency were evaluated in women presenting with PFDs (group A), whereas responsiveness was assessed in women undergoing pelvic floor surgery (group B). A total of 100 women presenting with PFDs were included in Group A. A near excellent content/face validity was confirmed as assessed by the missing values criterion (0-5 %). Stability, as assessed by the intraclass correlation coefficient, showed almost perfect agreement with a mean ICC of 0.850 (PFDI-20) and 0.840 (PFIQ-7). Internal consistency was found to be high for both questionnaires (Cronbach's alpha > 0.8). Finally, 85 women underwent pelvic floor repair surgery and were included for the assessment of responsiveness (group B). Good to excellent responsiveness was found for the prolapse and urinary subscales of the questionnaires. However, poor responsiveness was found for the colorectal-anal scale of the PFDI-20, whereas the colorectal-anal scale of the PFIQ-7 proved to be nonresponsive to change. The Greek versions of PFDI-20 and PFIQ-7 were found to be comprehensible, valid, reliable, and responsive to use with patients complaining of PFDs.

Seventeen years’ follow-up of the tension-free vaginal tape procedure for female stress urinary incontinence

The minimally invasive tension-free vaginal tape (TVT) operation has become the "gold standard" of incontinence surgery. The aim of the present study was to evaluate the long-term effect of the tape material and to assess the continence status 17 years after surgery A cohort of 90 women operated upon with the TVT procedure at three Nordic centers has been prospectively followed for 17 years. All of the women alive according to national registries were contacted and invited to visit the clinics for evaluation. Pelvic examination was performed to reveal any adverse effects of the tape material. Objective and subjective continence status were assessed by a cough stress test and the patients' global impression of improvement as well as by condition-specific quality of life questionnaires. Seventy-eight percent of the potentially assessable women were evaluated either by a clinic visit or by a telephone interview. One case of a minimal, symptom-free tape extrusion was seen. No other tape complications occurred. Over 90 % of the women were objectively continent. Eighty-seven per cent were subjectively cured or significantly improved. The TVT operation is durable for 17 years, with a high satisfaction rate and no serious long-term tape-induced adverse effects.

Condition-specific quality of life questionnaires for caregivers of children with pediatric conditions: a systematic review

Childhood illness or disability can affect the quality of life (QoL) of the child's primary caregiver. Our aim was to identify, describe the content and systematically review the psychometric properties of condition-specific QoL questionnaires for caregivers of children. Medline, PsycInfo, Embase, CINAHL, and the Cochrane library databases were searched from 1 January 1990 to 30 June 2011. Articles related to the development and measurement of caregiver QoL were screened to identify condition-specific questionnaires. The characteristics of the questionnaires were extracted, and their psychometric properties were evaluated using the consensus-based standards for the selection of health measurement instruments checklist with 4-point scale. We identified 25 condition-specific caregiver QoL questionnaires covering 16 conditions. Conditions included atopic dermatitis, asthma, diabetes, oro-facial disorders, and two acute illnesses. Questionnaires were developed predominantly in high-income countries. Questionnaires had the highest quality rating for content validity, followed by hypothesis testing. Methodological quality was satisfactory for criterion validity; fair in reliability and responsiveness; and poor in internal consistency and structural validity. The increasing number of questionnaires developed over time shows improved recognition of the importance of caregiver QoL. There is a paucity of QoL questionnaires for caregivers of otherwise healthy children suffering from physical injuries and acute conditions associated with significant caregiver burden. Cultural validation of existing and new questionnaires in lower-income countries is necessary. Data collected by condition-specific questionnaires can assist clinicians and health economists in estimating caregiver burden and the types of healthcare services caregivers require and may be useful for healthcare administrators to evaluate interventions.

Pelvic Floor Function Before and After Robotic Sacrocolpopexy: One-Year Outcomes

Study objective Estimate pelvic floor function and support 1 year after robotic sacrocolpopexy. Design Prospective cohort analysis of women undergoing robotic sacrocolpopexy for correction of advanced pelvic organ prolapse (Canadian Task Force Classification III). Primary outcome was pelvic floor function. Secondary outcomes included anatomic support and long-term surgical failures and complications. Setting One university hospital in the southeastern United States. Patients Primarily postmenopausal women (mean age 60) with advanced pelvic organ prolapse. Interventions All subjects underwent robotic sacrocolpopexy during the study period. Subjects then underwent 1-year postoperative assessment of pelvic floor function via validated condition-specific quality of life questionnaires and assessment of pelvic floor support, long-term surgical failures, and complications via physical examination. Measurements and main results From November 2007 to April 2009, there were 28 subjects, 25 of whom (89.3%) were evaluated. Mean time since surgery was 14.8 months. Pelvic floor function remained significantly improved over preoperative baseline: PFDI-20 (117 vs 38, p <.001), PFIQ-7 (60 vs 10, p = .001), with stable high sexual function: PISQ-12 (34 vs. 36, p = .17), and improved pelvic support on POP-Q: Ba (+3 vs −2, p = .001), Bp (+0.5 vs −1, p = .092), C (+2.25 vs −8, p = .001). Anatomic cure for vault prolapse was 100% at 1 year. There were two mesh exposures and two subsequent prolapse surgeries. Conclusion Robotic sacrocolpopexy demonstrates durable improvement in pelvic floor function and support, with high sexual function and reasonable failure and complication rates 1 year after surgery.

A randomized trial comparing tension-free vaginal tape with tension-free vaginal tape-obturator: 36-month results

This is a randomized multicenter study comparing two mid-urethra tape procedures, the tension-free vaginal tape (TVT) with the tension-free vaginal tape-obturator (TVT-O) in terms of cure rate and complication rate. Seven Finnish hospitals participated. Power calculations required 130 women in each group to detect a 10% difference in cure rate. A total of 267 underwent the allocated operation. Follow-up was scheduled at 2, 12, 36 and 60 months. A cough stress test was used as an objective outcome measure. Subjective outcome was assessed by five different condition-specific quality of life questionnaires. At 36 months of follow-up, 96% of the patients were evaluated. Objective cure rate was 94.6% in the TVT group and 89.5% in the TVT-O group (p = 0.131). Subjective cure rates were significant with no difference between the groups. The TVT and the TVT-O are equally effective in the treatment of stress urinary incontinence after 36-month follow-up with no difference in complication rates.

A menopause-specific quality of life questionnaire: Development and psychometric properties

Objective: to develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women’s experience. Methods: Subjects: Women 2–7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines’ Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger’s Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. Results: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and −0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 fgr the vasomotor domain, 0.55 and −0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. Conclusions: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.

A randomized trial comparing TVT with TVT-O: 12-month results

The aim of this randomized clinical trial was to compare the cure rate and the rate of complications of the tension-free vaginal tape (TVT) with those of the tension free vaginal tape obturator (TVT-O) procedure after one year of follow-up. The study was powered to show a ten per cent difference in cure rate and/or rate of complications. Of the initially treated 267 women 134 in the TVT group and 131 in the TVT-O group were evaluated. A cough stress test and a 24 h pad test were used as objective outcome measures. Subjective outcome was assessed by different condition-specific quality of life questionnaires and general health by the EQ-5D questionnaire. Objective cure rate was 95.5% in the TVT patients and 93.1% in TVT-O patients. Subjective cure rates showed significant improvement at one the year follow up in both groups. No significant differences in cure rates between groups were seen. The complication rate was equal in both groups.

Validation of telephone administration of 2 condition-specific quality-of-life questionnaires

To validate telephone-administered versions of 2 condition-specific quality of life questionnaires: Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. Between December 2005 and September 2006, 55 women were recruited at their 6-week postpartum visit at a university hospital. Written and telephone versions of the 2 questionnaires were completed, with a 2-week interval between each version. The order of administration was randomized. The scores of the written vs telephone versions of the questionnaires were not significantly different (PFDI: 9.8 vs 9.0 respectively; P = .36; PFIQ: 4.4 vs 3.7 respectively; P = .38). These scores were also highly correlated (PFDI, r = 0.96 and PFIQ, r = 0.90). Telephone administration of these instruments is a reliable and accurate measure of the impact of pelvic floor disorders and may facilitate clinical and epidemiologic research by decreasing cost and improving access to research participants.

Retropubic Compared With Transobturator Tape Placement in Treatment of Urinary Incontinence

To compare the intraoperative and immediate postoperative performance of the retropubic tension-free vaginal tape (TVT) procedure with that of the transobturator tension-free vaginal tape (TVT-O) procedure as primary treatment for female urinary stress incontinence. Randomized multicenter comparative trial including four university hospitals and three central hospitals in Finland. Assessment preoperatively and 2 months postoperatively included a cough stress test and the following condition-specific quality of life questionnaires: the Urinary Incontinence Severity Score (UISS), the Detrusor Instability Score, the Incontinence Impact Questionnaire-Short Form, the Urogenital Distress Inventory-Short Form, and a visual analog scale (VAS). Operation time, theater time, hospital stay, intraoperative and immediate postoperative complications were recorded. Of the 273 originally randomized patients, 267 underwent the allocated operation, 136 in the TVT group and 131 in the TVT-O group. No significant differences in objective or subjective cure rates were detected. Patients in the TVT-O group had a significantly longer hospital stay, needed significantly more postoperative opiate analgesia and had significantly more complications than the patients in the TVT group. Patients in both groups had a significant postoperative improvement in quality of life, as indicated by the results of all the questionnaires used, with no difference between the groups. The TVT and the TVT-O procedures perform equally in terms of objective and subjective cure. The statistically significant higher complication rate in the TVT-O group is not regarded as clinically significant. (www.ClinicalTrials.gov), NCT00379314 I.

Comparison of three disease-specific quality-of-life questionnaires (Bristol Female Lower Urinary Tract Symptoms, Incontinence Quality of Life and King's Health Questionnaire) in women with stress urinary incontinence

To examine the impact of stress urinary incontinence (UI) on quality of life (QOL) using three disease-specific QOL instruments and compare the results obtained with these instruments. A total of 28 women (age range 36-74 years) with stress UI were included in the study. To obtain QOL assessments, patients were asked to complete the Bristol Female Lower Urinary Tract Symptoms (BFLUTS), Incontinence Quality of Life (I-QoL) and King's Health Questionnaire (KHQ) instruments. One domain in the BFLUTS (Incontinence symptoms) and one in the KHQ (Severity measures) correlated inversely with the Valsalva leak point pressure and the cough leak point pressure, respectively; however, other domains in the three questionnaires did not correlate with objective data. Two BFLUTS domains (Incontinence symptoms and QOL) correlated weakly or moderately with six KHQ domains; however, other BFLUTS domains did not correlate with most KHQ domains. Significant negative correlations were noted between two BFLUTS domains (Incontinence symptoms and QOL) and most I-QoL domains; however, other BFLUTS domains did not correlate with the I-QoL. Role limitations, Emotional problems and Severity measures in the KHQ correlated weakly or moderately with the I-QoL; however, General health and Personal relationships did not correlate significantly with the I-QoL. Subjective QOL results of stress UI using condition-specific QOL questionnaires may differ because there are a plethora of measurement instruments that vary in terms of their scope and content. Our findings suggest that, before deciding on an instrument, its contents should be thoroughly reviewed to ensure that a particular aspect of QOL does not need additional assessment.

A Comparison of the Objective and Subjective Outcomes of Colposuspension for Stress Incontinence in Women

Objectives To investigate the impact of colposuspension for stress incontinence on the symptoms and quality of life of women undergoing both primary and repeat surgery for genuine stress incontinence and in addition to assess the use of a condition specific quality of life questionnaire as an outcome measure following surgery. Design Prospective case series: videocystourethrography performed before and between six and twelve months after surgery. Validated condition specific quality of life (QoL) questionnaires completed by women before and six to twelve months after surgery. Setting A tertiary referral Urogynaecology Unit in a teaching hospital. Participants A consecutive series of 83 women undergoing colposuspension between March 1995 and December 1997. Pre-operative assessment and surgery was performed by, or was under the direct supervision of, the unit director. Intervention Modified Burch colposuspension. Main outcome measures Objective results of surgery assessed with videocystourethrography. Subjective results evaluated using a condition specific QoL tool, the Kings Health Questionnaire (KHQ). Symptom severity was evaluated as a component of the condition specific QoL questionnaire. Results Objective cure was demonstrated in 92% of women undergoing primary surgery with an 8% incidence of de-novo detrusor instability and a 10% incidence of voiding difficulties. In the group of women having repeat surgery the objective cure rate was 81% with no de-novo detrusor instability and a 6% incidence of post-operative voiding difficulties. QoL scores improved in 95% of women. Improvements of over 25% were seen in 70% of women and of over 50% in 28%. However, 2.4% of women recorded a deterioration in QoL scores. Conclusions Colposuspension performed in this setting, assessed using both objective and standardised subjective measures, completed by women themselves, appears to produce good objective and subjective results and leads to enhanced quality of life in the great majority of women.

Self‐rated menopausal status and quality of life in women aged 40‐63 years

Objectives. To determine whether quality of life (QOL) changes during the menopause as a function of menopausal status and other medical and lifestyle variables. Design. A postal questionnaire sent to three different samples of women. Method. A total of 1188 questionnaires were received from (a) two samples recruited from two Family Health Service Association (FHSA) lists and (b) one sample recruited through an advertisement in a women's magazine. The questionnaires consisted of (a) a seven domain, 48‐item, condition‐specific QOL questionnaire which was developed for this study (MQOL), (b) a single item global QOL questionnaire (GQOL), (c) questions about medical history, (d) questions about work status, (e) questions assessing menopausal status using two different techniques. Results. Both the MQOL and GQOL indicated a relationship with menopausal status. GQOL and MQOL showed a U‐shaped relationship with menopausal status, with lowest scoresassociated with the middle of the menopause. However, domain scores of Sleep and Energy failed to reach the levels reported by women who perceive themselves to be pre‐menopausal, and domain scores of Symptom Impact and Social Interaction indicate steady decline during the menopausal transition. Women who experienced the menopause long ago reported the highest GQOL, feelings and cognition domain scores. Medical history and work outside the home play an important role in determining MQOL‐womenwho had undergone hysterectomy, those who had tried but discontinued HRT while still in the middle of the climacteric, and those with greater co‐morbidity had poorer QOL. Those who worked outside the home reported better MQOL, and those recruited through the magazine reported poorer QOL. Conclusions. QOL is affected by the menopause, but the way it is affected depends on the measure of QOL used. QOL during the menopause is also affected by medical and lifestyle variables. QOL during the menopause is a complex interaction of several different kinds of variable.

A new questionnaire to assess the quality of life of urinary incontinent women.

To design and validate a condition-specific quality of life questionnaire for the assessment of women with urinary incontinence, and to use the questionnaire to assess the quality of life of women with specific urodynamic diagnoses. A tertiary referral urogynaecology unit at King's College Hospital, London. The questionnaire was designed following six different pilot studies; in this study it was tested for validity and reliability using standard psychometric techniques. The questionnaire was used in 293 consecutive women referred for investigation of urinary incontinence. The questionnaire was shown to be reliable both by test-retest analysis and by measurement of its internal consistency. The construct of the questionnaire and the answers by respondents confirmed its face and content validity. Criterion validity was measured by correlation with scores obtained on a validated generic measure of quality of life, the Short Form 36. Women with detrusor instability had greater quality of life impairment than women with other urodynamic diagnoses. The questionnaire was easy for the women to use and was a valid and reliable instrument for the assessment of quality of life in women with urinary incontinence. It will be useful for the rapid appraisal and follow up of women with urinary incontinence in many different clinical settings, including the evaluation of new treatments of urinary incontinence in controlled clinical trials.

A menopause-specific quality of life questionnaire: development and psychometric properties

Objective: to develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. Methods: Subjects: Women 2–7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines' Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. Results: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and −0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 for the vasomotor domain, 0.55 and −0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. Conclusions: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.

A menopause-specific quality of life questionnaire: development and psychometric properties

Objective: to develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. Methods: Subjects: Women 2–7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines' Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. Results: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and −0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 for the vasomotor domain, 0.55 and −0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. Conclusions: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.