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Xu Q, Zheng D, Chen S, He Y, Lin Z, Yao D, Wang J, Zhao J, Wu L, Liao Q, Zhang Y, Yan T. Factors Influencing Disabled Stroke Survivors' Quality of Life in Rural China: Based on the Structural Characteristics and Psychometric Properties of the SF-36 Assessment. J Clin Med 2023; 12:jcm12083012. [PMID: 37109348 PMCID: PMC10143617 DOI: 10.3390/jcm12083012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 04/29/2023] Open
Abstract
Many stroke survivors' quality of life is impaired. Few studies of factors influencing their quality of life have been based on the factors tested by the short form 36 instrument. This study did so with 308 physically disabled stroke survivors in rural China. Principal components analysis was applied to refine the dimension structure of the short form 36 assessment, followed by backward multiple linear regression analysis to determine the independent factors influencing quality of life. The structure revealed differed from the generic structure in showing that the mental health and vitality dimensions are not unidimensional. Subjects who reported access to the outdoors as convenient demonstrated better quality of life in all dimensions. Those who exercised regularly achieved better social functioning and negative mental health scores. Other factors influencing a better quality of life in terms of physical functioning were younger age and not being married. Being older and better educated predicted better role-emotion scores. Being female correlated with better social functioning scores, while men scored better on bodily pain. Being less educated predicted higher negative mental health, while being less disabled predicted better physical and social functioning. The results suggest that the SF-36's dimension structure should be re-evaluated before using it to assess stroke survivors.
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Affiliation(s)
- Qi Xu
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Dingzhao Zheng
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Shanjia Chen
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Yiqi He
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Zhenguo Lin
- Department of Clinical Medicine, Xiamen Medical College, Xiamen 361101, China
| | - Dong Yao
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Jiamei Wang
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Jiapei Zhao
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Longqiang Wu
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Qiuju Liao
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Yun Zhang
- Department of Rehabilitation Medicine, Fifth Hospital of Xiamen, Xiamen 361101, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
- The Engineering Technology Research Center of Rehabilitation and Elderly Care of Guangdong Province, Guangzhou 510120, China
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Sanchez-Andrades MJ, Vinolo-Gil MJ, Casuso-Holgado MJ, Barón-López J, Rodríguez-Huguet M, Martín-Valero R. Measurement Properties of Self-Report Questionnaires for Amyotrophic Lateral Sclerosis: A Systematic Review and Meta-Analysis of Commonly Used Instruments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3310. [PMID: 36834005 PMCID: PMC9959245 DOI: 10.3390/ijerph20043310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. There is no evidence on the analysis of the measurement instruments available to assess quality of life in these patients, following the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist; (2) Methods: A systematic review was performed in PubMed, Embase, PEDro, Web of Science and Cochrane. The psychometric properties of the questionnaires were determined by using the COSMIN checklist. Two searches were carried out. This systematic review was registered in PROSPERO (CRD42021249005); (3) Results: There were four published articles that analysed the measurement properties in patients with ALS for the following scales: Amyotrophic Lateral Sclerosis Assessment Questionnaire 40, Amyotrophic Lateral Sclerosis-Specific Quality of Life Questionnaire, Short Form 36 Healthy Survey, Epworth Sleepiness Scale and Sickness Impact Profile. Another five scales also met the inclusion criteria: ALS-Depression-Inventory, State Trait Anxiety-Inventory, World Health Organization Quality of Life, Schedule for the Evaluation of Individual Quality of Life, Amyotrophic Lateral Sclerosis Assessment Questionnaire 5. Most Patient Reported Outcome Measures (PROMs) present a low-quality synthesis of evidence. It was observed an excellent pooled reliability of 0.92 (95% Confidence Interval: 0.83-0.96, I2 = 87.3%) for four dimensions for questionnaires ALSAQ-40. (4) Conclusions: There is little evidence on generic instruments. Future studies are necessary to develop new tools.
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Affiliation(s)
- Maria Jose Sanchez-Andrades
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain
| | - Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
- CMU Rehabilitation Intercentres-Interlevels Puerto Real and Cadiz Hospitals, Cádiz-La Janda Health District, 11006 Cadiz, Spain
| | - María Jesús Casuso-Holgado
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | - Javier Barón-López
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain
| | - Manuel Rodríguez-Huguet
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain
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Doesburg D, Vennegoor A, Uitdehaag BMJ, van Oosten BW. High work absence around time of diagnosis of multiple sclerosis is associated with fatigue and relapse rate. Mult Scler Relat Disord 2019; 31:32-37. [PMID: 30901702 DOI: 10.1016/j.msard.2019.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/18/2019] [Accepted: 03/15/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is associated with high rates of disability pension and work absence. Little is known about work absence in early MS. The objectives of this study were (1) to assess the prevalence of work absence shortly after MS diagnosis, (2) to explore health-related quality of life (HRQoL) and disease impact in relation to work absence and (3) to investigate demographic and clinical factors that may be associated with high work absence. METHODS Patients with relapsing remitting (RRMS) or primary progressive MS (PPMS) were included shortly after MS diagnosis. We collected data on work absence due to MS in the year prior to inclusion, disability (Expanded Disability Status Scale), relapse rate, fatigue (Neurological Fatigue Index), health-related quality of life (HRQoL, 36-Item Short Form Survey) and disease impact (Multiple Sclerosis Impact Scale). For analysis, patients were divided in 2 groups: low work absence (<1 month) and high work absence (≥1 month). Data was analyzed using backward logistic regression techniques. RESULTS In total, 90 MS patients participated (80 RRMS, 10 PPMS, mean age = 39.3 years, median disease duration since diagnosis = 0.5 year). Work absence in the year prior to inclusion was reported by 66 patients (73.3%). High work absence of ≥ 1 month was reported by 41 patients (45.6%). Disability, gender, age, disease duration and education did not differ between groups. Patients with high work absence reported a lower HRQoL and higher disease impact compared to patients with low work absence. Backward regression analysis showed that high work absence is associated with being single/not married, fatigue and relapses. The strongest association was found for fatigue (highest fatigue vs. lowest fatigue level: OR total group = 7.8, RRMS = 15.8). In RRMS patients the second-strongest association was relapse rate (≥2 relapses in the past year vs. no relapses: OR 11.1). CONCLUSION Prevalence of work absence is high in early MS. Patients with high work absence report a lower HRQoL and a higher disease impact. High work absence is associated with being single/not married, fatigue and relapses. Interventions aimed at fatigue and prevention of relapses may help maintain employment in early MS.
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Affiliation(s)
- D Doesburg
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - A Vennegoor
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Department of Neurology, Flevoziekenhuis, Almere, The Netherlands
| | - B M J Uitdehaag
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
| | - B W van Oosten
- Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands
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Hagell P, Westergren A, Årestedt K. Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations. Res Nurs Health 2017; 40:378-386. [DOI: 10.1002/nur.21806] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/16/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Albert Westergren
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences; Department of Research; Linnaeus University; Kalmar County Hospital; Kalmar Sweden
- Department of Medical and Health Sciences; Linköping University; Linköping Sweden
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Kelly L, Jenkinson C, Morley D. Outcome measurement in neurodegenerative disease: attributes, applications & interpretation. Neurodegener Dis Manag 2015; 5:305-16. [PMID: 26295721 DOI: 10.2217/nmt.15.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There has been a marked shift from clinically assessed to patient assessed outcomes of treatment in neurodegenerative conditions over recent decades. The use of patient-reported outcome measures (PROMs) provides a method with which researchers and clinicians can gain insightful and meaningful data on health status from the patients' perspective. It is imperative that high-quality PROMs are chosen based upon their measurement properties and their suitability for use in the intended clinical or research context. This review aims to give a brief overview of best practice standards for selecting PROMs, current instruments used in exemplar neurodegenerative conditions and their application in clinical trials and routine measurement.
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Affiliation(s)
- Laura Kelly
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | - David Morley
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
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Tallner A, Waschbisch A, Hentschke C, Pfeifer K, Mäurer M. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity. Int J Mol Sci 2015; 16:14901-11. [PMID: 26147422 PMCID: PMC4519878 DOI: 10.3390/ijms160714901] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 05/22/2015] [Accepted: 06/26/2015] [Indexed: 11/20/2022] Open
Abstract
Multiple sclerosis (MS) patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36), and Beck Depression Inventory (BDI). We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL). Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.
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Affiliation(s)
- Alexander Tallner
- Institute of Sport Science and Sport, University of Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Germany.
| | - Anne Waschbisch
- Department of Neurology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Christian Hentschke
- Institute of Sport Science and Sport, University of Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Germany.
| | - Klaus Pfeifer
- Institute of Sport Science and Sport, University of Erlangen-Nürnberg, Gebbertstr. 123b, 91058 Erlangen, Germany.
| | - Mathias Mäurer
- Caritas Krankenhaus Bad Mergentheim gGmbH, Uhlandstr. 7, 97980 Bad Mergentheim, Germany.
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McPherson A, Martin CR. A review of the measurement properties of the 36-item short-form health survey (SF-36) to determine its suitability for use in an alcohol-dependent population. J Psychiatr Ment Health Nurs 2013; 20:114-23. [PMID: 22458774 DOI: 10.1111/j.1365-2850.2012.01896.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A psychometric evaluation of the 36-item short-form health survey (SF-36) was undertaken in contemporary studies to assess its suitability for use in an alcohol-dependent population. Three criteria were used to try and determine this: factor analysis, internal consistency reliability and test-retest reliability. Factor analysis revealed that it is mainly consistent with a bidimensional model, internal consistency reliability showed that it consistently provided scores above the recommended threshold and test-retest reliability of the SF-36 highlights that it too provided higher than suggested scores. A conclusion was reached recommending the SF-36 as a reliable screening tool in an alcohol-dependent population, but this is given in caution as no studies were found analysing the instrument in this population.
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Affiliation(s)
- A McPherson
- School of Health, Nursing and Midwifery PhD Student, University of the West of Scotland, Ayr, UK
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8
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Jakobsson U, Westergren A, Lindskov S, Hagell P. Construct validity of the SF-12 in three different samples. J Eval Clin Pract 2012; 18:560-6. [PMID: 21210901 DOI: 10.1111/j.1365-2753.2010.01623.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Studies have challenged the validity and underlying measurement model of the physical and mental component summary scores of the 36-item Short-Form Health Survey in, for example the elderly and people with neurological disorders. However, it is unclear to what extent these observations translate to physical and mental component summary scores derived from the 12-item short form (SF-12) of the 36-item Short-Form Health Survey. This study evaluated the construct validity of the SF-12 in elderly people and people with Parkinson's disease (PD) and stroke. METHODS SF-12 data from a general elderly (aged 75+) population (n = 4278), people with PD (n = 159) and stroke survivors (n = 89) were analysed regarding data quality, reliability (coefficient alpha) and internal construct validity. The latter was assessed through item-total correlations, exploratory and confirmatory factor analyses. RESULTS Completeness of data was high (93-98.8%) and reliability was acceptable (0.78-0.85). Item-total correlations argued against the suggested items-to-summary scores structure in all three samples. Exploratory factor analyses failed to support a two-dimensional item structure among elderly and stroke survivors, and cross-loadings of items were seen in all three samples. Confirmatory factor analyses showed lack of fit between empirical data and the proposed items-to-summary measures structure in all samples. CONCLUSIONS These observations challenge the validity and interpretability of SF-12 scores among the elderly, people with PD and stroke survivors. The standard orthogonally weighted SF-12 scoring algorithm is cautioned against. Instead, when the assumed two-dimensional structure is supported in the data, oblique scoring algorithms appear preferable. Failure to consider basic scoring assumptions may yield misleading results.
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Affiliation(s)
- Ulf Jakobsson
- Department of Health Sciences, Lund University, Lund, Sweden
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Klimpe S, Schüle R, Kassubek J, Otto S, Kohl Z, Klebe S, Klopstock T, Ratzka S, Karle K, Schöls L. Disease severity affects quality of life of hereditary spastic paraplegia patients. Eur J Neurol 2011; 19:168-71. [PMID: 21631647 DOI: 10.1111/j.1468-1331.2011.03443.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND PURPOSE Hereditary spastic paraplegia (HSP) causes progressive gait disturbance because of degeneration of the corticospinal tract. To assess its impact on Health-Related Quality of Life (HRQoL), we analyzed the correlation of HRQoL with disease severity and clinical symptoms in HSP. METHODS HRQoL was assessed by the Short-Form 36 (SF-36) Mental and Physical Component summary scores (MCS and PCS) in 143 German patients with HSP. Disease severity was assessed by the Spastic Paraplegia Rating Scale (SPRS) and landmarks of walking ability. Patients with 'pure' or 'complicated' HSP were compared. RESULTS Higher SPRS scores indicating higher disease severity correlated significantly with lower PCS (r = -0.63; P < 0.0005) and MCS (r = -0.38; P < 0.0005) scores. MCS and PCS were reduced in patients with 'complicated' forms compared to 'pure' HSP and with decreasing walking ability. CONCLUSION HRQoL is substantially impaired in patients with HSP and decreases with disease severity and the presence of 'complicating' symptoms. Patients are most affected by the physical restraints of their disease, but mental health is impaired as well. HRQoL is a valid parameter in HSP that should be considered in upcoming therapeutical trials.
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Affiliation(s)
- S Klimpe
- Department of Neurology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.
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Grassi M, Nucera A. Dimensionality and Summary Measures of the SF-36 v1.6: Comparison of Scale- and Item-Based Approach Across ECRHS II Adults Population. VALUE IN HEALTH 2010; 13:469-478. [DOI: 10.1111/j.1524-4733.2010.00703.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Grassi M, Nucera A. Dimensionality and summary measures of the SF-36 v1.6: comparison of scale- and item-based approach across ECRHS II adults population. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2010; 13:469-478. [PMID: 20088893 DOI: 10.1111/j.1524-4733.2009.00684.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The objective of this study was twofold: 1) to confirm the hypothetical eight scales and two-component summaries of the questionnaire Short Form 36 Health Survey (SF-36), and 2) to evaluate the performance of two alternative measures to the original physical component summary (PCS) and mental component summary (MCS). METHODS We performed principal component analysis (PCA) based on 35 items, after optimal scaling via multiple correspondence analysis (MCA), and subsequently on eight scales, after standard summative scoring. Item-based summary measures were planned. Data from the European Community Respiratory Health Survey II follow-up of 8854 subjects from 25 centers were analyzed to cross-validate the original and the novel PCS and MCS. RESULTS Overall, the scale- and item-based comparison indicated that the SF-36 scales and summaries meet the supposed dimensionality. However, vitality, social functioning, and general health items did not fit data optimally. The novel measures, derived a posteriori by unit-rule from an oblique (correlated) MCA/PCA solution, are simple item sums or weighted scale sums where the weights are the raw scale ranges. These item-based scores yielded consistent scale-summary results for outliers profiles, with an expected known-group differences validity. CONCLUSIONS We were able to confirm the hypothesized dimensionality of eight scales and two summaries of the SF-36. The alternative scoring reaches at least the same required standards of the original scoring. In addition, it can reduce the item-scale inconsistencies without loss of predictive validity.
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Affiliation(s)
- Mario Grassi
- Dipartimento di Scienze Sanitarie Applicate, Sezione di Statistica Medica e Epidemiologia, Università di Pavia, Pavia, Italy.
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Sansone VA, Panzeri M, Montanari M, Apolone G, Gandossini S, Rose MR, Politano L, Solimene C, Siciliano G, Volpi L, Angelini C, Palmieri A, Toscano A, Musumeci O, Mongini T, Vercelli L, Massa R, Panico MB, Grandi M, Meola G. Italian validation of INQoL, a quality of life questionnaire for adults with muscle diseases. Eur J Neurol 2010; 17:1178-1187. [DOI: 10.1111/j.1468-1331.2010.02992.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. A. Sansone
- Department Neurology, University of Milan, IRCCS Policlinico San Donato
| | - M. Panzeri
- Department Neurology, University of Milan, IRCCS Policlinico San Donato
| | - M. Montanari
- Mario Negri Institute, Laboratory for Translational and Outcome Research, Department Oncology, Milan, Italy
| | - G. Apolone
- Mario Negri Institute, Laboratory for Translational and Outcome Research, Department Oncology, Milan, Italy
| | - S. Gandossini
- Department Neurology, University of Milan, IRCCS Policlinico San Donato
| | - M. R. Rose
- Department Neurology, Kings College, University of London, London, UK
| | - L. Politano
- Department of Cardiomyology and Clinical Genetic, University of Naples, Naples
| | - C. Solimene
- Department of Cardiomyology and Clinical Genetic, University of Naples, Naples
| | - G. Siciliano
- Department of Neurosciences, University of Pisa, Pisa
| | - L. Volpi
- Department of Neurosciences, University of Pisa, Pisa
| | - C. Angelini
- Department of Neurosciences, University of Padua, Padua
| | - A. Palmieri
- Department of Neurosciences, University of Padua, Padua
| | - A. Toscano
- Neurological and Neurosurgery Institute, University of Messina, Messina
| | - O. Musumeci
- Neurological and Neurosurgery Institute, University of Messina, Messina
| | - T. Mongini
- Department of Neurosciences, University of Turin, Turin
| | - L. Vercelli
- Department of Neurosciences, University of Turin, Turin
| | - R. Massa
- Department of Neurosciences, University of Tor Vergata and Fond IRCCS S Lucia, Rome
| | - M. B. Panico
- Department of Neurosciences, University of Tor Vergata and Fond IRCCS S Lucia, Rome
| | - M. Grandi
- Respiratory Physiopathology, Costa Masnaga, Como, Italy
| | - G. Meola
- Department Neurology, University of Milan, IRCCS Policlinico San Donato
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Doward LC, McKenna SP, Meads DM, Twiss J, Eckert BJ. The development of patient-reported outcome indices for multiple sclerosis (PRIMUS). Mult Scler 2009; 15:1092-102. [PMID: 19556315 DOI: 10.1177/1352458509106513] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Complex diseases such as multiple sclerosis (MS) present dilemmas over the choice of patient-reported outcome measures as no single scale can inform on all types of MS impact from the patient's perspective. OBJECTIVE To develop an outcome tool, the Patient-Reported Indices for Multiple Sclerosis (PRIMUS), to assess MS symptoms, activities, and quality of life. METHODS PRIMUS content was derived from qualitative interviews with UK MS patients and checked by clinical experts. Semi-structured cognitive debriefing interviews assessed scale face and content validity. PRIMUS scaling properties, reliability, and construct validity were assessed by a test-retest postal survey. RESULTS Cognitive debriefing interviews (n = 15) demonstrated scale clarity, relevance, and comprehensiveness. The postal survey was completed by 135 patients with MS. After removal of misfitting items and those exhibiting differential item functioning, all scales fitted the Rasch model, confirming unidimensionality. For all scales, test-retest reliability exceeded 0.80. Scale scores were related to perceived MS severity, general health, and symptoms of depression. Moderate correlations were observed between PRIMUS and Nottingham Health Profile scores. CONCLUSIONS Clinicians and researchers can have confidence in scores obtained by respondents on the PRIMUS. The PRIMUS will aid the assessment of the impact of MS from the patient's perspective.
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Hagell P, Reimer J, Nyberg P. Whose quality of life? Ethical implications in patient-reported health outcome measurement. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2009; 12:613-617. [PMID: 19900259 DOI: 10.1111/j.1524-4733.2008.00488.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Patient-reported health status questionnaires intend to assess illness and therapy from the patients' perspective. To provide fair and valid assessments, they should be equally relevant to major subsets of respondents. Furthermore, disease-specific measures are assumed to be perceived as more relevant than generic ones. This study assessed these assumptions among people with Parkinson's disease. METHODS Cross-sectional data from 202 people with Parkinson's disease (54% men; mean age, 70) were analyzed regarding patient-rated relevance and predictors of patient-rated poor relevance of two generic [the 36-item Short Form Health Survey (SF-36) and Nottingham Health Profile (NHP)] and one disease-specific [Parkinson's Disease Questionnaire (PDQ-39)] health status questionnaire. RESULTS There were no differences in relevance ratings across the questionnaires. Poorer overall quality of life [odds ratio (OR), 2.459] and mental health (OR, 1.023) were associated with poorer patient-rated relevance of the SF-36, and higher age was associated with poorer patient-rated relevance of the PDQ-39 (OR, 1.040). No significant predictors were found for the NHP. CONCLUSIONS The PDQ-39 failed to meet the assumption that disease-specific scales are more relevant than generic ones. Nevertheless, the most important implication of this study is an ethical one. Because the relevance of the SF-36 and PDQ-39 is perceived as poorer by those who fare least well and by older people, these scales may not reflect the perspectives of these groups. This challenges bioethical principles and threatens scientific validity. Perceived relevance of patient-centered outcomes needs to be considered, or the voice of vulnerable groups may be silenced, fair inferences prohibited, and opportunities for improved care lost.
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Affiliation(s)
- Peter Hagell
- Department of Health Sciences, Lund University, Lund, Sweden.
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15
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Beckerman H, van Zee IE, de Groot V, van den Bos GAM, Lankhorst GJ, Dekker J. Utilization of health care by patients with multiple sclerosis is based on professional and patient-defined health needs. Mult Scler 2008; 14:1269-79. [PMID: 18653735 DOI: 10.1177/1352458508094884] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This cross-sectional study investigates healthcare utilization, and determines which predisposing, enabling, and health factors are associated with healthcare utilization among 121 patients with multiple sclerosis (MS). METHODS Data on patient-related predisposing, enabling, and health factors were collected by means of written questionnaires and a home visit from a well-trained physiotherapist. RESULTS Of the 121 patients with MS (mean age 43 years, mean score on the Expanded Disability Status Scale 3.5, disease duration 6 years), 16% were hospitalized in the previous year; 62% consulted their general practitioner, and 69% consulted their neurologist in the previous 6 months. Other medical specialists were consulted in the 6-month period by 50% of the study population. In a 4-week period preceding the home visit, 41% of the patients were treated by an allied healthcare professional. Multivariate logistic regression analyses showed that consulting the general practitioner, the neurologist, other medical specialists, and allied healthcare professionals, and the use of equipment/aids by MS patients is primarily related to their health, either as perceived by the patients themselves or defined by the professional. CONCLUSIONS MS patients in the Netherlands make appropriate use of healthcare facilities, because their utilization can predominantly be explained by health-related factors, and not by predisposing or enabling factors.
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Affiliation(s)
- H Beckerman
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
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Testing the SF-36 in Parkinson's disease. J Neurol 2008; 255:246-54. [PMID: 18204806 DOI: 10.1007/s00415-008-0708-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 06/28/2007] [Accepted: 07/19/2007] [Indexed: 10/22/2022]
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Lindskov S, Westergren A, Hagell P. A controlled trial of an educational programme for people with Parkinson's disease. J Clin Nurs 2007; 16:368-76. [DOI: 10.1111/j.1365-2702.2007.02076.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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