Related Quality Of Life Questionnaire Research Articles

Validación de la versión española del cuestionario revisado de calidad de vida para fibrosis quística en adolescentes y adultos (CFQR 14+ Spain)

Background The aim of this study was to assess the validity and reliability of the Spanish version of the revised disease-specific health related quality of life questionnaire for adolescents and adults with cystic fibrosis (CFQR 14+ Spain). Methods A total of 43 cystic fibrosis (CF) patients completed the CFQR 14+ Spain. Forced expiratory volume in 1 second, in percentage of predicted - FEV 1 (%)-, number of respiratory exacerbations, 6-minute walk test, Bhalla score (based on computerized tomography of the chest), fat-free mass index, body mass index (BMI), faecal fat and St George's Respiratory Questionnaire were included as measurements of health status. Results Ten out of the twelve scales had alpha coefficients above 0.70. Test–retest correlations (Spearman) ranged from 0.49 to 0.95 and they were significant in all scales. Intraclass correlations ranged from 0.47 to 0.95 (ten out of the twelve scales were >0.70) forty out of the fifty ítems have correlations between items and scale above 0.70. All the CFQR+14 scales, except the digestive symptoms scale, discriminated significantly between patients with mild, moderate and severe disease (according to FEV 1 (%)). Other respiratory parameters also discriminated significantly between patients with mild-moderate and severe disease. Only some scales discriminated significantly between nourished and malnourished patients. All of the scales met standards for floor effects (<15% of the responders with the lowest score) but not for ceiling effects (only five out of the twelve). Conclusion The Spanish CFQR14+ (Spain) is a reliable and valid instrument for measuring the health-related quality of life in Spanish adolescents and adults with CF, though with the exception of a few of its subscales.

Readability of Health Related Quality of Life Instruments in Urology

The average American adult reads at a fifth to eighth-grade level, with wide variability, presenting challenges for the assessment of self-reported health related quality of life. We identified the health related quality of life instruments used in patients with urological diseases and evaluated their readability. We focused on the most burdensome urological diseases, based on total expenditures in the United States. We then identified disease specific instruments by systematically searching PubMed, the Cochrane Database of Systematic Reviews, Google, Google Scholar, the Patient Reported Outcome and Quality of Life Instruments Database (Mapi Research Institute, Lyon, France) and Yahoo! for health related quality of life studies in patients with these urological conditions. Where disease specific instruments were lacking, we noted the general health related quality of life measures most commonly used. For each instrument, we calculated the median Flesch-Kincaid grade level, the proportion of questionnaire items below an eighth-grade reading level, the mean Flesch Reading Ease, and the mean number of words per sentence and characters per word, all of which are validated measures of readability. The average +/- SD of the median Flesh-Kincaid reading levels was 6.5 +/- 2.1 (range 1.0 to 12.0). Of the 76 instruments 61 (80%) were at or below an eighth-grade reading level. The mean reading ease was greater than 30 for each of the 76 questionnaires and greater than 60 for 66 (87%). Urinary tract infection, the costliest urological disease, has only 1 disease specific health related quality of life measure. Urolithiasis, the second costliest, has none. The reading level of health related quality of life questionnaires in urology is appropriate for the reading ability of most adults in the United States. However, the most burdensome urological diseases lack disease specific health related quality of life instruments.

Which generic health related Quality of Life questionnaire should be used in older inpatients: Comparison of the Duke Health Profile and the MOS Short-Form SF-36?

Which generic health related Quality of Life questionnaire should be used in older inpatients: Comparison of the Duke Health Profile and the MOS Short-Form SF-36?

Improvement in quality-of-life questionnaire measures in obese adolescent females with polycystic ovary syndrome treated with lifestyle changes and oral contraceptives, with or without metformin

We studied the effect of metformin or placebo in a lifestyle modification program combined with oral contraceptives (OC) on quality-of-life parameters measured by the polycystic ovary syndrome (PCOS) questionnaire in obese adolescent women with validated PCOS. The quality-of-life indicators were measured at baseline and conclusion for five domains on the PCOS questionnaire, with equal improvement in scores in both placebo and metformin groups, suggesting that the addition of metformin does not add improvement to quality-of-life measures above those observed with lifestyle modification and OC treatment.

Quality of life in patients with gastric cancer: translation and psychometric evaluation of the Iranian version of EORTC QLQ-STO22

BackgroundDisease and treatment related events, can adversely affect the quality of life of patients with cancer. The purpose of this study was to translate and validate a gastric cancer specific health related quality of life questionnaire (EORTC QLQ-STO22) for Iranian patients suffering from gastric cancer.MethodsForward-backward procedure was applied to translate the English language version of the EORTC QLQ-STO22 into Persian (Iranian language). Then, the questionnaire and the EORTC core quality of life instrument (QLQ-C30) were administered to a sample of patients with confirmed diagnosis of gastric cancer. All patients filled in questionnaires before and after one month of treatment. Patients were divided into two groups based on intension of treatment (curative vs. palliative). Reliability and validity of the module was tested by internal consistency and known group comparisons, respectively.ResultsIn all, 105 patients were entered into the study. Cronbach's alpha for multi-item scales (to test reliability) ranged from 0.54 to 0.87. The questionnaire discriminated well between clinically distinct subgroups of patients both before and after treatment lending support to its convergent and clinical validity.ConclusionOverall, the Iranian version of the EORTC QLQ-STO22 demonstrated a good reliability and clinical validity to support its use in combination with core questionnaire in outcome studies of gastric cancer in Iran. However, using the QLQ-STO22 in a wide range of Iranian patients with gastric cancer should allow further confirmation for its psychometric properties.

Health Related Quality of Life of a Tertiary Referral Center Population With Urinary Incontinence Using the DCGM-10 Questionnaire

We evaluated health related quality of life of pediatric patients with nonneurogenic urinary incontinence and determined potential influencing factors. Also, health related quality of life results in our sample were compared to those of other chronic childhood health conditions. This cross-sectional study was done at 3 tertiary referral centers for childhood urinary incontinence. From July 2007 to April 2008 we consecutively evaluated 65 boys and 38 girls with a mean +/- SD age of 9.3 +/- 2.2 years (range 6 to 18) and their parents. Of the patients 12 had monosymptomatic enuresis, 79 had nonmonosymptomatic enuresis and 12 had isolated daytime incontinence. To evaluate participants we used the self-reported and proxy versions of the 10-item DISABKIDS chronic generic measure, short version, a health related quality of life questionnaire with cross-cultural validity. Mean questionnaire total scores were 43.2 and 42.8 for the self-reported and proxy versions, respectively, which showed significant correlation (r = 0.628). Age, sex, urinary incontinence type and severity, fecal incontinence and constipation had no significant association with questionnaire total scores (each p >0.05). Compared to questionnaire results in a reference sample of children with chronic health conditions average scores in our sample did not differ significantly from those in pediatric patients with asthma, arthritis, atopic dermatitis, cystic fibrosis, diabetes or epilepsy on the self-reported version, and asthma, atopic dermatitis, cystic fibrosis or epilepsy in the proxy version. Health related quality of life of children and adolescents with urinary incontinence appears to be comparable to that in pediatric patients with other chronic conditions, eg asthma or epilepsy.

Ispitivanje funkcionalnog statusa bolesnika posle hirurske revaskularizacije miokarda

Determination of patient's functional status in early postoperative period is a delicate task, because of its general health status. Measures that can be used for that purpose are walk tests and functional status questionnaires. To determine correlation of different functional tests administered preoperatively and two minute walk test (2MWT) done postoperatively. To detect predictors of early functional recovery measured with two minute walk test. We examined ninety eight patients hospitalized for an elective coronary artery bypass graft surgery in February and March 2008. Functional status was assessed preoperatively using Duke Activity Status Index questionnaire (DASI), generic health related quality of life questionnaire and two minute walk test. Prior to discharge from the hospital, two minute walk test was repeated along with VAS for intensity of pain. Statistical analyze was done using Pearson's correlation coefficient, T test and multivariate regression analysis. Distance walked in 2 minutes decreased significantly postoperatively (p < 0.001). There was significant correlation between DASI and SF -12 preoperatively (r = 0.6 p < 0.001) and DASI preoperatively with 2MWT postoperatively (r = 0.4 p < 0.001). 2MWT postoperatively showed good correlation with intensity of pain (r = -0.42 p < 0.001) and age (r = -0.35 p < 0.001). There were no significant correlation with comorbidity, number of bypasses or postoperative complications. Multivariate regression analysis showed that the age was the strongest independent predictor of functional recovery (beta = - 0.33 < 0.05p) and that values of DASI preoperatively had moderate importance in prediction of functional status(beta = 0.238 p < 0.06). 2MWT was sensitive to change postoperatively. Significant correlation of 2MWT postoperatively with DASI preoperatively, age and VAS, as well as prediction capacity of age and DASI, gives us possibility to utilize those parameters in early rehabilitation program in order to achieve maximal functional recovery of patients.

Development and Validation of the Short Form of a Urinary Quality of Life Questionnaire: SF-Qualiveen

The 30-item Qualiveen is a specific health related quality of life questionnaire for urinary disorders in patients with neurological conditions, such as multiple sclerosis and spinal cord injury. Previous studies have demonstrated the reliability, validity and responsiveness of Qualiveen. However, to address the needs of large clinical trials and long-term monitoring, in which efficiency may compete with precision of measurement, we developed the 8-item self-administered SF-Qualiveen. A total of 180 English speaking and French speaking outpatients with multiple sclerosis at multiple sclerosis clinics and departments of rehabilitation in Canada and France completed the entire Qualiveen, the Multiple Sclerosis Quality of Life-54 questionnaire or its French version (SEP-59) as well as urinary function assessments at study enrollment and 2 to 10 weeks later. At visit 2 patients also made global ratings of change in urinary health related quality of life. SF-Qualiveen development and testing used this data set. Correlations of SF-Qualiveen with its original form were high (r = 0.70 to 0.92). SF-Qualiveen proved reliable (ICC 0.83 to 0.93). Its responsiveness was similar to that of the long form (SRM 0.75 to 1.62). Correlations with other measures were consistent with our a priori predictions (weighted kappa 0.55 for cross-sectional correlations and 0.66 for correlations of change), supporting the cross-sectional and longitudinal construct validity of SF-Qualiveen. SF-Qualiveen has excellent measurement properties, similar to those of the long form. The new instrument is likely to perform well in the clinical and research context.

Prospective Evaluation of Health Related Quality of Life for Pediatric Patients With Ureteropelvic Junction Obstruction

Clinical practices are increasingly proposing health related quality of life measures for informed treatment decisions. Dismembered pyeloplasty is an accepted standard therapy for ureteropelvic junction obstruction. This study evaluates health related quality of life in patients with ureteropelvic junction obstruction undergoing pyeloplasty. Patients have perceived it helpful in communicating health care needs to physicians. We believe this is the first study to use child self and parent reports prospectively in ureteropelvic junction obstruction. The goals of the study were to document baseline preoperative health related quality of life assessments, differences between parent and child assessments at given intervals, differences in preoperative and postoperative assessments, and overall clinical outcomes. Patients younger than 18 years (mean 9.1 years) with ureteropelvic junction obstruction were included in the study. Demographic survey and validated health related quality of life questionnaire (Pediatric Quality of Life Inventory 4.0) were used preoperatively and postoperatively. The questionnaire documented subjective health related quality of life (physical, social, emotional and school functioning, and psychosocial health). Clinical outcomes were generated following the office visit. Questionnaire subscales were scored with algorithms provided. Paired t test evaluated differences in parent and child scores of less than 0.05 were statistically significant. Tests were 2-tailed. Response rate was 100%. Preoperatively emotional functioning (81.8) and psychosocial health (80.9) child scores were significantly higher than parent scores (70.7 and 73.9, respectively). Overall child score of the study population (80.9) was similar to that of healthy children (85). However, parent scores of physical functioning (78.3), psychosocial health (73.9), emotional functioning (70.7) and school functioning (65.5) were significantly lower than the general population. At postoperative week 6 child emotional functioning (91.7) and physical functioning (90.3) showed significant improvement (p <0.05). Parent scores of physical functioning (88.4), psychosocial health (82.2) and emotional functioning (80.8) were also significantly higher than preoperative scores. Longer followup demonstrated that child scores of physical functioning (96.9), psychosocial health (96.5), emotional functioning (95.4) and social functioning (97.1) were significantly higher than preoperatively. Postoperatively parents reported significantly higher health related quality of life scores compared to preoperative scores. There was no significant difference at 6 months between parent and child scores. Clinically all patients did well following pyeloplasty. Preoperatively children recorded higher health related quality of life than parents/guardians. At postoperative week 6 children and parents recorded higher health related quality of life compared to preoperative scores. At 6 months overall child health related quality of life was significantly higher than preoperative reports, and no significant difference was seen between parent and child scores. Health related quality of life evaluations enabled us to monitor patient recovery and progress postoperatively. Prospective evaluations at regular intervals helped us to document improvement in overall quality of life in these children.

Impacto da obesidade na capacidade funcional de mulheres

The aim of this study was to evaluate the functional capacity of obese, overweight and eutrophic women. An analytical cross study involved 90 adult women from 40 to 60 years of age, distributed in three groups: eutrophic (n=30), overweight (n=30) and obese (n=30).Patients were interviewed by means of the specific health related quality of life questionnaire, Stanford Health Questionnaire (HAQ-20). They were also submitted to an exercise test to compare the maximal oxygen uptake (VO2max) among the three groups. Statistical analysis included the chi-square test, the Kruskal Wallis variance analysis and the Spearman and Pearson correlations for p= 0.05. The group of obese women presented HAQ-20 (0.375) score rates significantly higher (p<0.05) than the other groups (0), reflecting lesser functional capacity. The obese group presented VO2max score rates (25.8+/-5.0ml/kg/min), significantly lower (p<0.001) than the overweight (29.9+/-6.1ml/kg/min) and eutrophic (33.8+/-4,1ml/kg/min) groups, indicating a poorer cardio respiratory aptitude. There was no significant difference between the eutrophic and overweight VO2max and HAQ-20 score rates. Hypertension was more frequent among obese women (p=0.012) who also presented a lower level of schooling p= 0.026). Obese women presented a poorer physical aptitude and lesser functional capacity in relation to those in the eutrophic and overweight groups Furthermore, the obese also exhibited a worse prognosis for cardiovascular disease.

Validation of the nausea and vomiting of pregnancy specific health related quality of life questionnaire

BackgroundThe only existing NVP-specific quality of life (QOL) questionnaire is the "Health-Related Quality of Life for Nausea and Vomiting during Pregnancy" (NVPQOL). However, the reliability and validity of the NVPQOL have never been established. In order to justify its usage, the internal consistency and criterion validity of the NVPQOL questionnaire must be ascertained.MethodsA prospective observational study including pregnant women attending CHU Sainte-Justine or René-Laennec clinics for their prenatal care was conducted from 2004 to 2006. Women were eligible if they were ≥ 18 years of age and ≤ 16 weeks of gestation at the time of their first prenatal visit. During this initial visit, women who reported NVP were also asked to complete the NVPQOL and the SF-12. Cronbach's alpha coefficients were calculated as the measures of the internal consistency of the NVPQOL. With respect to the criterion validity, linear regression models were built to measure the association between the NVPQOL and the SF-12 scores.ResultsOf the 367 women included in the study, 288 (78.5%) reported NVP in the first trimester of pregnancy. Among these women, the Cronbach's alpha coefficients were high for the complete NVPQOL questionnaire (α = 0.98), and for the four distinct domains [physical symptoms and aggravating factors (α = 0.90); fatigue (α = 0.94); emotions (α = 0.86); limitations (α = 0.97)]. NVP-specific QOL as measured by the NVPQOL was significantly associated with physical and mental QOL as measured by the SF-12.ConclusionOur data suggest that the NVPQOL is a reliable and valid index to measure NVP-specific QOL in the first trimester of pregnancy.

Thirty‐count breathlessness score: Reliability, sensitivity, specificity and validity

The fifteen-count breathlessness score (15CBS) has been reported to quantify breathlessness; however, a ceiling effect limits its ability to discriminate between subjects with varying degrees of breathlessness. The aim of this study was to determine the reliability, sensitivity, specificity and validity of the thirty-count breathlessness score (30CBS) in adults with COPD. Using an observational correlation design, subjects with clinical signs and symptoms of COPD were videotaped performing the 30CBS on two occasions. Respiratory related quality of life questionnaires, self-report shortness breathlessness measures and pulmonary function tests were completed by all subjects. Asymptomatic subjects of a similar age completed the 30CBS for comparison. Thirty-eight COPD subjects and 24 control subjects completed the protocol. The 30CBS was reliable within and between assessors (intraclass correlation coefficients >0.7). The 30CBS demonstrated a higher sensitivity (55.8% sensitivity, 82.3% specificity) than the 15CBS (33.2% sensitivity, 93.2% specificity); however, the sensitivity of the 30CBS was still not great enough to discriminate between those with and without COPD. Regression analysis calculated significant relationships between the 30CBS and a majority of measures of pulmonary impairment (flows and volumes), age, height, Visual Analogue Scale for breathlessness and physical aspects of the Short Form-36. While reliable, the 30CBS did not display sufficient discriminative ability to predict subjects with COPD though subjects requiring greater than two breaths may warrant further investigation. The 30CBS may be a useful indicator of physiological impairment, but was not significantly correlated with measures of breathlessness.

Quality of Life for Men Receiving a Second Treatment for Prostate Cancer

We assessed the impact of second treatment on health related quality of life for men with prostate cancer. This issue is important because second treatment resulting from prostate specific antigen recurrence has the potential to further negatively impact health related quality of life and affect the overall value of treatment. We compared differences in health related quality of life before and after second treatment for men who had asymptomatic prostate specific antigen recurrence with those who did not have biochemical failure. Men in this analysis (897) had localized disease, initially underwent radical prostatectomy monotherapy, and completed at least 1 health related quality of life questionnaire before and after radical prostatectomy. In this cohort 175 men underwent second treatment (nonadjuvant). The Medical Outcomes Survey Short Form-36 and UCLA Prostate Cancer Index were used to measure health related quality of life. Associations between patient groups and time on health related quality of life were analyzed using repeated measures. Men who received a second treatment presented with more severe disease before radical prostatectomy and had worse general health related quality of life. Although health related quality of life differed significantly with time for the 2 groups, most domains for the second treatment group improved or remained stable until 15 months before second treatment, at which point they declined. Scores in the sexual functioning and role-physical domains showed clinically and statistically significant patterns of decreasing with time. Health related quality of life is affected following second treatment but starts to decline approximately 1 year before second treatment. Not all aspects of health related quality of life decreased at the same rate, so patients should be counseled that certain domains may be affected more by additional treatment.

Prospective, Longitudinal Evaluation of Health Related Quality of Life in the Pediatric Spina Bifida Population Undergoing Reconstructive Urological Surgery

Spina bifida, the most frequent permanently debilitating birth defect, results in major urological problems of voluntary bladder control and bowel function, which may impair quality of life. We prospectively assessed quality of life in patients with spina bifida using child and parent reports simultaneously. This study had 3 goals, that is to 1) document baseline health related quality of life in patients with spina bifida preoperatively, 2) study health related quality of life, reporting differences between parents and children, and 3) study changes in health related quality of life prospectively at preoperative and postoperative intervals. Patients with spina bifida who were 2 to 18 years old and required reconstructive urological surgery in 2004 were included in the study. Demographic survey and the validated PedsQL 4.0 health related quality of life questionnaire were used preoperatively and postoperatively. A clinical outcomes data set was completed after the clinician saw the patient. PedsQL 4.0 subscales were scored using the algorithms provided. The response rate was 100%. Mean participant age was 10.3 years. Preoperatively child physical and psychosocial health and school functioning were significantly higher than parent reports (p <0.001). Overall health related quality of life in patients with spina bifida was lower than in healthy children (62.4 vs 85, p <0.001). Six weeks postoperatively significant differences in health related quality of life reporting between parents and children had lowered. Six months postoperatively child emotional and social functioning scores were higher than parent scores (p <0.001). No correlation was found between health related quality of life, and clinical and demographic factors due to insufficient sample size. Children with spina bifida recorded higher health related quality of life scores than parents/guardians. This health related quality of life study addresses concerns that impact daily quality of life in patients with spina bifida. Future health related quality of life studies in patients with spina bifida should use child self-reports.

Physical Function and Health Related Quality of Life in COPD Patients with and without Comorbidities

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating disease, and as the disease progresses, a persons' physical function and health related quality of life can be severely affected. Many persons with COPD also suffer from other comorbid conditions which may further compromise their level of function and quality of life. PURPOSE: To compare differences in measures of physical function and health related quality of life between COPD patients with comorbidities and those without. METHODS: Participants included 291 COPD patients, FEV1/FVC ≤ 70% and FEV1 ≥ 20% of predicted. All participants completed a pulmonary function test, a 6-minute walk and stair climb test to assess physical function, the Chronic Respiratory Disease health related quality of life questionnaire, and a questionnaire to assess self-reported physical function. Comorbidities were determined based on a medical questionnaire that queried patients as to whether they had been diagnosed by a physician with any of the following conditions: diabetes, hypertension, cancer, stroke, arthritis, kidney disease, liver disease, circulatory disease, or cardiac disease. Analysis of covariance was used to determine if there were significant differences in measures of physical function and quality of life between those patients with and without comorbidities. Significance was set at a p value <0.05. RESULTS: After adjusting for age and FEV1 (% of predicted), those patients without comorbidities as compared to those with were found to walk significantly farther in six minutes (520.3 ± 14.9 vs 457.0 ± 5.9 meters, respectively) and climb stairs significantly faster (10.5 ± 0.6 vs 13.1 ± 0.2 sec., respectively). There was a trend (p = 0.08) for those without comorbidities as compared to those with to report greater physical function (1.54 ± 0.07 vs 1.67 ± 0.02 units, respectively). There were no differences between the groups when comparing health related quality of life (p = 0.81) as a mean score on all four domains. However, when differences between the groups were compared among the four domains of the health related quality of life questionnaire separately (i.e. emotion, dyspnea, fatigue and mastery), those with comorbidities reported significantly higher levels of fatigue than those without comorbidities (3.99 ± .07 vs 4.39 ± .07, respectively, the higher score represents greater quality of life). CONCLUSION: These results indicate that persons with COPD who present with other comorbid conditions exhibit greater declines in physical function and experience greater levels of fatigue than those with COPD only.

Is Psychometric Scoring of the McNew Quality of Life After Myocardial Infarction Questionnaire Superior to the Clinimetric Scoring? A Comparison of the Two Approaches

'Clinimetric' and 'psychometric' approaches are currently used to develop health related quality of life questionnaires. The Quality of Life after Myocardial Infarction questionnaire (QLMI) was originally developed using 'clinimetric' criteria; it was subsequently modified (McNew QLMI) and a new domain structure was defined using factor analysis. The objective of this study was to compare the measurement properties of the McNew QLMI scores when both approaches for scoring are used. The McNew QLMI and SF-36 were administered to patients 2 weeks and 2 months after myocardial infarction. Two sets of scores for the McNew QLMI were computed using the original 'clinimetric' and the subsequent 'psychometrically' derived scoring systems. Reliability statistics for the two sets of domains were compared and construct validity was assessed by establishing a priori hypotheses on the expected correlation between each score and the dimensions of the SF-36. Both sets of scores had similar reliability (Cronbach's alpha between 0.64 and 0.93) and responsiveness (SRMs between 0.17 and 0.87) while validity was better for the 'clinimetric' set of scores (concordance between observed and expected correlations was moderate for the 'clinimetric' scores and fair for the 'psychometric' scores). Since overall measurement properties of the 'clinimetrically' scored McNew QLMI are better than the 'psychometrically' scored version, we suggest that either the original 'clinimetric' system is used or that an improved 'psychometric' version is developed.

Low vision quality of life assessment: Psychometric validation of Portuguese version of NEI-VFQ 25

The goal was to make the validation, for the Portuguese people of a functional vision measurement instrument, that could be used to help characterise a situation of low vision and to evaluate a visual rehabilitation process results. An American visual functioning questionnaire was applied to a 100 individuals group, after being made its cultural and linguistic adaptation to Portuguese. Simultaneously, a general health condition related quality of life questionnaire was applied, to obtain the health condition's perception and to establish the NEI-VFQ 25's specific scales' validity, intended to evaluate the loss of vision's influence in the health's physical and mental aspects. Two visual functions were assessed to the same individuals: visual acuity and visual fields. The relation between the actual evaluated values of the visual functions and the questionnaires responses was studied. It was observed that there is a relation between the best scores of visual functions values and the high scores in responses obtained in the different scales of the visual functioning questionnaire. It was concluded that the NEI-VFQ-25 could be considered a valid measurement instrument for the goals described.

Development and validation of a health related quality of life questionnaire for Brazilian children with epilepsy: preliminary findings

To construct a multidimensional questionnaire that analyses the epileptic child quality of life from the parental point of view. The pilot questionnaire was composed of 157 questions distributed in several dimensions. Fifty-one epileptic children's parents answered the questionnaire. The instrument was tested in its diverse properties: frequency of endorsement, homogeneity (Cronbach alpha), criterion and face validity, and later it was reduced. Endorsement frequency excluded 65 questions that did not attain a minimum of 5% response per item. Cronbach alpha was as follows: physical (0.93), psychological (0.91), social (0.91), familiar (0.70), cognitive (0.92), medical (0.30) and economical (0.37). Patient groups, in relation to seizure control, significantly differed only in physical domain and total score, although there was a trend to differences in other domains. The final questionnaire (QVCE50) has 50 items, with good homogeneity in the physical, psychological and cognitive domains. QVCE-50 is a promissing Brazilian HRQL questionnaire for children with epilepsy. It needs to be applied in a larger population to confirm its psychometric properties.

Validity and reliability of the PDQ-39 and the PDQ-8 in English-speaking Parkinson's disease patients in Singapore

The purpose of the study was to assess the validity and reliability of the Parkinson's disease questionnaire (PDQ-39, UK English version) as well as its briefer version (the PDQ-8) among Asian patients with Parkinson's disease (PD) in Singapore. Eighty-eight patients recruited from movement disorder clinics or patient support groups completed the PDQ-39 and EQ-5D, a generic health related quality of life questionnaire previously validated for use in Singapore. PDQ-39 items showed good convergent and discriminant validity. Construct validation against the EQ-5D showed strong correlation between these scales as hypothesised (Spearman's ρ: 0.53–0.71, P<0.001 for all). Factor analysis yielded a component on which all eight PDQ-39 dimensions were substantially loaded (loading range: 0.50–0.79). The PDQ-39 also demonstrated acceptable internal consistency (Cronbach's α: 0.59–0.94) and test–retest reliability (intra-class correlation coefficient:0.67–0.87, n=68). Six of eight PDQ-8 items showed the strongest correlation with their PDQ-39 dimensions as hypothesised. PDQ-39 and PDQ-8 summary indexes were highly correlated (Pearson's r=0.96, ICC=0.95), and both were strongly correlated with the EQ-5D utility index and EQ-5D visual analogue scale ( P<0.001). We conclude that the PDQ-39 and PDQ-8 are valid and reliable disease-specific HRQoL instruments for PD in Singapore.

Clinical priority criteria in orthopaedics: a validation study using the SF36 quality of life questionnaire.

This study reports a validation trial of a clinical priority scoring tool in orthopaedic surgery based on five dimensions related to need and ability to benefit using the SF36 health related quality of life questionnaire. Seventy patients attending an orthopaedic outpatient clinic were asked to complete the questionnaire before being seen by an orthopaedic specialist. Their clinical priority for surgery was scored using a tool which assesses five dimensions of clinical need with a maximum of 100 points. Our study has shown that the clinical priority scores correlate very well with the quality of life of patients and that those who were selected for surgery had a significantly worse quality of life compared to those not qualifying for surgery due to the lack of financial resources. Although this study has limits, it should provide sufficient information to healthcare clinicians and managers that this tool will select those patients who have the highest need and ability to benefit from surgery.