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Branchford B, Clark K, Stanford RH, Garner DA, Huang SP, Wolford E. Hereditary factor X deficiency in America survey: impact on quality of life and burden of disease in patients and caregivers. Blood Coagul Fibrinolysis 2024; 35:73-81. [PMID: 38305129 PMCID: PMC10990012 DOI: 10.1097/mbc.0000000000001275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
Hereditary factor X deficiency (HFXD) is a rare bleeding disorder causing delayed haemostasis and potentially life-threatening bleeds. Patient/caregiver burden and diagnosis path have not been well characterized. THE AIM OF THIS STUDY WAS TO describe the diagnosis path, disease burden, and HFXD impact on quality of life (QoL) in patients and caregivers.This was a prospective, cross-sectional, web-based survey of patients with HFXD and caregivers addressing the patient/caregiver experience, QoL, humanistic and unmet needs.Thirty patients and 38 caregivers completed the survey with mean ages 24.7 and 44.6 years, respectively. Mean age at diagnosis was 4.1 years. The diagnostic process was somewhat/very difficult for 23% of patients and 26% of caregivers. Approximately half (53%) received single factor replacement (SFR) as prophylaxis or on-demand. Most patients (71%) reported regular prophylaxis treatment. Over one-fourth (27%) reported treatment with fresh frozen plasma. Bleeding episodes were less common in patients using SFR versus non-SFR: three bleeds or fewer were reported by 92% SFR and 75% non-SFR patients. HFXD patients reported low well being in work/school/social activities with mean HFXD-adapted Hemophilia Well being Index. Patient symptoms negatively impacted caregiver burden with a mean HFXD-adapted Hemophilia Caregiver Index (±SD) of 15.9 (4.6), but also unexpectedly had a positive impact on self-worth and inner strength.To our knowledge, this is the first study to assess patient and caregiver burden of HFXD and impact on QoL. Improvements in symptom recognition, prompt diagnosis, and adherence to expert recommendations for treatment could improve QoL and decrease burden on HFXD patients and caregivers.
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Affiliation(s)
- Brian Branchford
- Versiti Medical Sciences Institute and Blood Research Institute, Medical College of Wisconsin, and Children's Wisconsin, Milwaukee, Wisconsin
| | - Kim Clark
- Kedrion Biopharma Inc, Fort Lee, New Jersey
| | | | - Denise A. Garner
- University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
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Geng BF, Feng C, Liu SG, Jiang ZL, Lin F. Haemophilia item bank based on International Classification of Functioning, Disability and Health: a systematic review. Hematology 2023; 28:2191077. [PMID: 36946880 DOI: 10.1080/16078454.2023.2191077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Haemophilia comprises a continuum of blood disorders that often include joint and muscular dysfunction, which may lead to a constellation of activity limitations and participation restrictions. However, there is scant research incorporating functional assessment scales into the common language provided by the International Classification of Functioning, Disability and Health (ICF). This study aims to identify the ICF categories to include in an item bank of functioning aspects relevant for haemophilia. DESIGN AND METHODS A systematic search was carried out in July 2021 based on the PubMed MEDLINE, CLINICAL, and Cochrane databases for qualified articles, investigating haemophilia-specific scales and the scales recommended by the World Federation of Haemophilia (WFH) linked to ICF categories between 2001 and 2021. Well-trained healthcare professionals in the haemophilia field and ICF evaluation conducted group discussions to determine the ICF items for haemophilia. RESULTS A total of 112 out of 176 items measuring function were collected for the haemophilia ICF item bank, including 32 items for body function (b), 45 items for activity and participation (d), 27 items for environmental factors (e), and 8 items for body structure(s). INTERPRETATION AND CONCLUSIONS We recommend that future haemophilia research use the haemophilia-specific ICF item bank, which could capture a whole spectrum of functional measurements and facilitate multidisciplinary and worldwide communication. This study also indicates that further development and analysis of the psychometric properties of the 112 haemophilia-related ICF items is warranted.
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Affiliation(s)
- Bao-Feng Geng
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chun Feng
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, Shanghai, People's Republic of China
| | - Shou-Guo Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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Abstract
Haemophilia A and B are rare congenital, recessive X-linked disorders caused by lack or deficiency of clotting factor VIII (FVIII) or IX (FIX), respectively. The severity of the disease depends on the reduction of levels of FVIII or FIX, which are determined by the type of the causative mutation in the genes encoding the factors (F8 and F9, respectively). The hallmark clinical characteristic, especially in untreated severe forms, is bleeding (spontaneous or after trauma) into major joints such as ankles, knees and elbows, which can result in the development of arthropathy. Intracranial bleeds and bleeds into internal organs may be life-threatening. The median life expectancy was ~30 years until the 1960s, but improved understanding of the disorder and development of efficacious therapy based on prophylactic replacement of the missing factor has caused a paradigm shift, and today individuals with haemophilia can look forward to a virtually normal life expectancy and quality of life. Nevertheless, the potential development of inhibitory antibodies to infused factor is still a major hurdle to overcome in a substantial proportion of patients. Finally, gene therapy for both types of haemophilia has progressed remarkably and could soon become a reality.
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Di Minno G, Santagostino E, Morfini M, Ettorre C, Cultrera D, Baldacci E, Russo E, Gallucci C. Patient satisfaction and acceptability of an on-demand and on-prophylaxis device for factor VIII delivery in patients with hemophilia A. Patient Prefer Adherence 2019; 13:233-240. [PMID: 30774319 PMCID: PMC6362933 DOI: 10.2147/ppa.s175254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND FuseNGO is a relatively new device consisting of a prefilled dual-chamber syringe (DCS) that was recently introduced for the reconstitution of recombinant factor VIII. Herein, the DCS device was assessed using five questionnaires with the primary aim of evaluating patient perceptions and preferences. METHODS An observational, non-interventional, longitudinal study on 86 patients with a confirmed diagnosis of hemophilia A was carried out at 21 sites in Italy. Each patient underwent a baseline visit and final study visit within 3-6 months. Patients were administered five questionnaires: HemoPREF; Treatment Satisfaction Questionnaire for Medication (TSQM); VeritasPRO; Hemophilia Well-being Index (HWBI); Work Productivity and Activity Impairment Questionnaire (WPAI) + Classroom Impairment Questions (CIQ): Hemophilia Specific (HS). RESULTS Compared to baseline, scores for HemoPREF were higher at follow-up; significant increases in the percentage of positive responses were seen for all questions regarding the ease of use (P<0.05). The mean time needed for the reconstruction of the device at baseline was 11 minutes (range 1-30 minutes), which decreased to 6 minutes (range 30 seconds to 25 minutes) at follow-up. All scores in the TSQM indicated good satisfaction with the device. Patients reported an adherence of >70% in the VeritasPRO questionnaire, and the majority of patients reported in the HWBI that hemophilia A did not affect their lives in a significant way. The perceived level of overall impairment was 30% as reported in the WPAI + CIQ: HS, indicating little impairment. There were no safety concerns. CONCLUSION Considering patient-reported outcomes, the DCS device was associated with easier preparation, storage, disposal of equipment, and overall use. Of particular note, preparation times were reduced by around 50%. The majority of patients were satisfied with the device and overall adherence scores were high. Considering these results, the device has the potential to increase adherence to therapy and, possibly, reduce healthcare costs.
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Affiliation(s)
- Giovanni Di Minno
- Department of Clinical Medicine and Surgery, Azienda Universitaria Policlinico Federico II, Naples, Italy,
| | - Elena Santagostino
- Hemophilia and Thrombosis Center, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Morfini
- Scientific Committee, Italian Association of Haemophilia Centres (AICE), Florence, Italy
| | - Cosimo Ettorre
- Haemophilia and Thrombosis Center, Policlinico Giovanni XXIII, Bari, Italy
| | - Dorina Cultrera
- Hematology Unit, Regional Center for Hemophilia, Italy Ospedaliera-Universitaria "Policlinico - Vittorio Emanuele", Catania, Italy
| | - Erminia Baldacci
- Hemophilia, Thrombosis, and Hematology Center, Dipartimento Biotecnologie cellulari ed Ematologia, Università la Sapienza, Rome, Italy
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Hoxer CS, Zak M, Benmedjahed K, Lambert J. Utility valuation of health states for haemophilia and related complications in Europe and in the United States. Haemophilia 2018; 25:92-100. [PMID: 30461134 DOI: 10.1111/hae.13634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 09/12/2018] [Accepted: 10/23/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION There is currently a paucity of health utility data describing the consequences of haemophilia and related complications. AIM To quantify the impact of distinct stages of severity of haemophilia and disease-related complications on health-related quality of life, expressed as health utilities in Europe and the United States. METHODS Nine health state descriptions were developed based on literature review and interviews with haematologists and haemophilia patients. Three descriptions characterized the impact of mild, moderate and severe haemophilia without inhibitors. Six descriptions characterized disease-related complications added to the moderate haemophilia description (arthroscopic synovectomy, prosthetic joint replacement, chronic pain, spontaneous bleed, traumatic bleed and end-stage joint disease). Time trade-off (TTO) interviews were conducted with 100 adults from the general public in the UK, France, Germany, Italy, Sweden and the United States. Mean TTO-derived utility values were expressed on a scale from 0 (death) to 1 (full health). RESULTS Utility values obtained for the health states corresponding to mild (0.73-0.86), moderate (0.68-0.76) and severe (0.64-0.71) haemophilia followed the increase in severity. The addition of a complication to the "moderate" state leads to a decrease in the associated utility value. The most severe disutility (0.23-0.36) across all countries was associated with the burden of end-stage joint disease. CONCLUSIONS This study underlines the value that the French, Italian, German, Swedish, United States and UK populations ascribe to the avoidance of disease progression in haemophilia without inhibitors. Improved treatment options hold a potential for important benefits to haemophilia patients.
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Affiliation(s)
| | | | | | - Jérémy Lambert
- Patient-Centered Outcomes, Mapi, an ICON plc Company, Lyon, France
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McCabe E, Miciak M, Dennett L, Manns P, Guptill C, Hall J, Gross DP. Measuring therapeutic relationship in the care of patients with haemophilia: A scoping review. Health Expect 2018; 21:1208-1230. [PMID: 30160003 PMCID: PMC6250875 DOI: 10.1111/hex.12827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE We conducted a scoping review of the tools used to measure therapeutic relationship in patients with haemophilia. BACKGROUND Haemophilia is an inherited bleeding disorder caused by a deficiency of a clotting factor in the blood. Therapeutic relationship is foundational to the management of patients with chronic diseases like haemophilia. A reliable and valid measurement tool for assessing therapeutic relationship is needed to evaluate the quality of care received by these patients, and to rigorously study the association between therapeutic relationship and the outcomes of treatment. METHODS We adopted the Arksey and O'Malley framework for scoping studies. The following electronic databases were searched for studies that measured a construct related to therapeutic relationships in haemophilia care: MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus. We inventoried these studies, identified the measurement tools used, and described each tool by purpose, content, measurement properties and target population. We identified gaps in the current evidence and directions for future research. RESULTS There were 253 unique records retrieved in the search, and twenty studies were deemed relevant. Ten measurement tools were identified. None of the tools measured therapeutic relationship as a single entity; however, six tools measured constructs considered part of patient-provider relationship (eg trust, communication, working alliance). There has been little validation testing of these tools in haemophilia patient populations. CONCLUSIONS There is a need for a validated tool for measuring therapeutic relationship in the care of patients with haemophilia. This review provides a foundation for future research in this area.
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Affiliation(s)
- Erin McCabe
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Performance Management and Evaluation, Alberta Innovates, Edmonton, AB, Canada
| | - Liz Dennett
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Patricia Manns
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Christine Guptill
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jeremy Hall
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Douglas P Gross
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
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Bonanad S, Schulz M, Gordo A, Spurden D, Cicchetti M, Cappelleri JC, Tolley C, Staunton H, Brohan E. HaemoPREF: Further evaluation of patient perception and preference for treatment in a real world setting. Haemophilia 2017; 23:884-893. [PMID: 28925586 DOI: 10.1111/hae.13321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Adherence to haemophilia A (HA) treatment may be influenced by patients' beliefs about their condition and treatment. Furthermore, difficulties administering treatment may lead to poor adherence. New treatment strategies aim to reduce the burden associated with administration and to improve patient perception of treatment, which, in turn, increase adherence levels. AIMS This study aimed to examine patient perception of HA treatment and related factors using patient-reported outcome (PRO) questionnaires and to confirm the psychometric properties of a recently developed questionnaire, the HaemoPREF. METHODS A non-interventional, cross-sectional, questionnaire study was conducted with adult HA patients in Spain (n=31), Germany (n=10) and Italy (n=48), who were using ReFacto AF with the FuseNGo administration device. Patients completed the HaemoPREF and other questionnaires measuring related constructs: treatment adherence, satisfaction and well-being, online at two time points. Correlational, regression and psychometric analyses were conducted. RESULTS PRO scores indicated that patients are satisfied with and adherent to their treatment. Multivariate regression of the HaemoPREF global score identified a number of significant predictors (P≤.05). The HaemoPREF Global Score had a moderate relationship with subscales on the related questionnaires (mean correlation=0.43; range=0.39-0.48). The HaemoPREF demonstrated good test-retest reliability (intraclass correlation coefficient=0.82), internal consistency reliability (Cronbach's alpha range=0.69-0.82) and convergent validity with measures of treatment satisfaction (Spearman correlation coefficient, r=.48) and well-being (r=.41). CONCLUSION The findings suggest that patients using ReFacto AF with FuseNGo were satisfied with and adherent to their treatment. The HaemoPREF can identify important concepts relating to patient treatment experience in HA.
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Affiliation(s)
- S Bonanad
- Haematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - M Schulz
- Pfizer Pharma GmbH, Berlin, Germany
| | - A Gordo
- Lab.Pfizer, Lda, Porto Salvo, Portugal
| | | | - M Cicchetti
- A Parexel Company, Execupharm, Groton, CT, USA
| | | | - C Tolley
- Adelphi Values, Bollington, Cheshire, UK
| | - H Staunton
- Adelphi Values, Bollington, Cheshire, UK
| | - E Brohan
- Adelphi Values, Bollington, Cheshire, UK
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Limperg PF, Haverman L, Maurice-Stam H, Coppens M, Valk C, Kruip MJHA, Eikenboom J, Peters M, Grootenhuis MA. Health-related quality of life, developmental milestones, and self-esteem in young adults with bleeding disorders. Qual Life Res 2017; 27:159-171. [PMID: 28900823 PMCID: PMC5770500 DOI: 10.1007/s11136-017-1696-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 11/26/2022]
Abstract
Background The treatment of bleeding disorders improved in the last decades. However, the effect of growing up with bleeding disorders on developmental, emotional, and social aspects is understudied. Therefore, this study assesses HRQOL, developmental milestones, and self-esteem in Dutch young adults (YA) with bleeding disorders compared to peers. Methods Ninety-five YA (18–30 years) with bleeding disorders (78 men; mean 24.7 years, SD 3.5) and 17 women (mean 25.1 years, SD 3.8) participated and completed the Pediatric Quality of Life Inventory Young Adult version, the Course of Life Questionnaire, and the Rosenberg Self-Esteem Scale. Differences between patients with bleeding disorders and their peers, and between hemophilia severity groups, were tested using Mann–Whitney U tests. Results YA men with bleeding disorders report a slightly lower HRQOL on the total scale, physical functioning, and school/work functioning in comparison to healthy peers (small effect sizes). YA men with severe hemophilia report more problems on the physical functioning scale than non-severe hemophilia. YA men with bleeding disorders achieved more psychosexual developmental milestones than peers, but show a delay in ‘paid jobs, during middle and/or high school.’ A somewhat lower self-esteem was found in YA men with bleeding disorders in comparison to peers (small effect size). For YA women with bleeding disorders, no differences were found on any of the outcomes in comparison to peers. Conclusion This study demonstrates some impairments in HRQOL and self-esteem in YA men with bleeding disorders. By monitoring HRQOL, problems can be identified early, especially with regard to their physical and professional/school functioning.
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Affiliation(s)
- P F Limperg
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L Haverman
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - H Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Coppens
- Department of Vascular Medicine, Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - C Valk
- Department of Vascular Medicine, Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - M J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Eikenboom
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - M Peters
- Department of Pediatric-Hematology, Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center, AMC, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, AMC, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
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Limperg P, Terwee C, Young N, Price V, Gouw S, Peters M, Grootenhuis M, Blanchette V, Haverman L. Health-related quality of life questionnaires in individuals with haemophilia: a systematic review of their measurement properties. Haemophilia 2017; 23:497-510. [DOI: 10.1111/hae.13197] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 01/29/2023]
Affiliation(s)
- P.F. Limperg
- Psychosocial Department; Emma Children's Hospital; AMC; Amsterdam the Netherlands
| | - C.B. Terwee
- Department of Epidemiology and Biostatistics; EMGO Institute for Health and Care Research; VU University Medical Centre; Amsterdam the Netherlands
| | - N.L. Young
- School of Rural and Northern Health; Laurentian University; Sudbury Ontario Canada
| | - V.E. Price
- Division of Pediatric Hematology/Oncology; Department of Pediatrics; IWK Health Centre; Dalhousie University; Halifax Nova Scotia Canada
| | - S.C. Gouw
- Department of Pediatric-Hematology; Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center; AMC; Amsterdam the Netherlands
| | - M. Peters
- Department of Pediatric-Hematology; Emma Children's Hospital and Hemophilia Comprehensive Care Treatment Center; AMC; Amsterdam the Netherlands
| | - M.A. Grootenhuis
- Psychosocial Department; Emma Children's Hospital; AMC; Amsterdam the Netherlands
| | - V. Blanchette
- Department of Pediatrics; University of Toronto; Division of Hematology/Oncology; The Hospital for Sick Children; University of Toronto; Toronto Ontario Canada
| | - L. Haverman
- Psychosocial Department; Emma Children's Hospital; AMC; Amsterdam the Netherlands
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10
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Salomon T, Chaves DG, Brener S, Martins PRJ, Mambrini JVM, Peixoto SV. Determining the health-related quality of life in individuals with haemophilia in developing economies: results from the Brazilian population. Haemophilia 2016; 23:42-49. [PMID: 27928900 DOI: 10.1111/hae.13130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Several studies show the negative impact of haemophilia in health-related quality of life (HRQOL). This issue is not well explored in developing countries. OBJECTIVES This cross-sectional study aimed to evaluate the HRQOL and its associated factors in patients with haemophilia A/B in Brazil. Data were collected by questionnaire and in medical records, including a Portuguese version of Haem-A-Qol. RESULTS Brazilian patients were invited to the study and 175 participants (147 haemophilics A and 28 haemophilics B) were included. The total score of the Haem-A-QoL had a median of 36.96 (range of 0-100), with worse performance in 'sport and leisure' and best on 'relationships' fields. HRQOL was worst among the older participants, the less educated, non-white, non-working, who were hospitalized in the last year, who did not have a single medical consultation and among those with the highest number of affected joints. Moreover, patients with hepatitis B had a significantly worse HRQOL in the domain 'sports and leisure', also observed in married patients. Otherwise, married individuals reported better HRQOL on 'dealing with the disease' domain. Patients with haemophilia B reported worse HRQOL in the domain 'self-perception'. CONCLUSION The results obtained could be helpful in guidance of haemophilia treatment which is determinant to improve HRQoL of the most vulnerable groups of patients. This work also reinforced the relevance of joint bleeds in all aspects of HRQoL in haemophilic patients. The use of prophylactic factor concentrates and multidisciplinary treatments could contribute to improve the quality of life in haemophilia.
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Affiliation(s)
- T Salomon
- Programa de Pós-Graduação em Saúde Coletiva - Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil.,Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil
| | - D G Chaves
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - S Brener
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - P R J Martins
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - J V M Mambrini
- Fiocruz Minas - Centro de Pesquisas René Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - S V Peixoto
- Programa de Pós-Graduação em Saúde Coletiva - Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil.,Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fiocruz Minas - Centro de Pesquisas René Rachou, Belo Horizonte, Minas Gerais, Brazil.,Escola de Enfermagem - Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Abstract
Interest in the study of psychological health and well-being has increased significantly in recent decades. A variety of conceptualizations of psychological health have been proposed including hedonic and eudaimonic well-being, quality-of-life, and wellness approaches. Although instruments for measuring constructs associated with each of these approaches have been developed, there has been no comprehensive review of well-being measures. The present literature review was undertaken to identify self-report instruments measuring well-being or closely related constructs (i.e., quality of life and wellness) and critically evaluate them with regard to their conceptual basis and psychometric properties. Through a literature search, we identified 42 instruments that varied significantly in length, psychometric properties, and their conceptualization and operationalization of well-being. Results suggest that there is considerable disagreement regarding how to properly understand and measure well-being. Research and clinical implications are discussed.
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12
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Remor E. Psychometric field testing of the HemoLatin-QoL questionnaire. Haemophilia 2016; 22:e390-400. [PMID: 27481399 DOI: 10.1111/hae.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The present work aims to describe the psychometric field testing of the Latin American Hemophilia-Specific Quality of Life Assessment Measure for Adults (the HemoLatin-QoL questionnaire) in 306 adults (age range 16-80) with haemophilia living in seven Latin American countries (i.e. Argentina, Brasil, Chile, Nicaragua, Panama, Uruguay and Venezuela). METHODS The HemoLatin-QoL questionnaire is a patient-reported outcomes instrument that evaluates relevant health-related quality-of-life domains for haemophilia, selected by an exploratory qualitative study with patients, and taking into account healthcare specialists in haemophilia also. Psychometric examination involved the assessment of the data quality, scaling assumptions, reliability (internal consistency and test-retest) and evidences for validity (dimensionality, convergent and external-related clinical criterion). RESULTS A 27-item version with a six-factor structure (e.g. physical functioning, pain, emotional functioning, social functioning, mental health, environment conditions) was psychometrically tested using exploratory factor analysis. The instrument and its subscales fulfilled the construct (dimensionality, convergent and criterion-related) validity hypotheses. The criteria for adequate internal consistency and test-retest reliability of the HemoLatin-QoL instrument were also met. CONCLUSION The HemoLatin-QoL showed acceptable psychometric properties with respect to responses from haemophilia patients. The questionnaire is now available for adult assessment and is ready for use in research in Latin America.
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Affiliation(s)
- E Remor
- Institute of Psychology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
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