An assessment of the psychometric properties of the Chinese version of the Gout Impact Scale

The Relationship Between Psychosocial Behavior and the Quality of Life of Male Gout Patients in Southwest China: A Cross-Sectional Study Based on an Information-Motivation-Behavioral Skills Model

Purpose

Gout is more severe in men, leading to a poor quality of life. Previous studies did not sufficiently pay attention to the quality of life and related factors in gout patients in Southwest China. This study aimed to investigate the quality of life of men with gout in Southwest China and explore the relationship between psychosocial factors and health-related quality of life from the perspective of an information-motivation-behavioral skill model.

Patients and Methods

This was a cross-sectional study conducted in the West China Hospital of Sichuan University located in Southwest China. In total, 230 male patients with gout were enrolled. The health-related quality of life of patients was assessed using the gout impact scale. The gout knowledge questionnaire was used to assess patients' information. The positive psycap questionnaire was used to assess motivation. The gout patients' self-management assessment scale was used to assess behavioral skills. Multiple linear regression was used to identify the factors associated with the health-related quality of life of patients.

Results

The overall mean gout impact scale score was 52.7±15.3 (maximum possible = 100). Factors associated with the total gout impact scale score were tophi (β=0.138, P=0.050), pain (β=0.255, P<0.001), and resiliency (β=-0.282, P<0.001). In addition, demographic characteristics (educational level, smoking and marital status), clinical characteristics (tophi, pain, number of attacks over half a year, and number of affected joints) and psychosocial behavior variables (resiliency, hope, disease treatment management, diet management) were associated with several dimensions of the gout impact scale.

Conclusion

The health-related quality of life of male patients with gout in Southwest China was at a medium level. We found that demographic characteristics, clinical characteristics, and psychosocial factors were associated with health-related quality of life of patients with gout. These findings can be used as a reference to improve health-related quality of life of patients with gout.

Reliability and Validity of the Korean Version of the Gout Impact Scale

BACKGROUND

The Gout Impact Scale (GIS), part of the Gout Assessment Questionnaire 2.0, measures gout-specific health-related quality of life (HRQOL). This study aimed to translate the GIS into Korean and validate the Korean version (K-GIS) using generic HRQOL measures.

METHODS

The GIS was translated into Korean and back-translated into English. We asked patients aged 18 years or older who met the 2015 gout classification criteria to fill out the questionnaires (from January 2022 to June 2022); the K-GIS (5 scales [0-100 scores each]), along with the Korean version of Health Assessment Questionnaire (HAQ) and EuroQol-5 dimension (EQ-5D). We investigated the internal consistency, construct validity, and discriminative validity for gout characteristics of K-GIS. The K-GIS form was administrated to patients 4 weeks later to assess the test-retest reliability using the intraclass correlation coefficient (ICC).

RESULTS

One hundred patients completed the questionnaire. The mean ± standard deviation age of the patients was 53.0 ± 15.1 years, and 99.0% of the patients were men. All scales had high degree of internal consistency (Cronbach's α = 0.59 to 0.96) and test-retest reliability (n = 18, ICC = 0.83 to 0.94, all P < 0.001), except for unmet gout treatment needs. Weak-to-moderate correlations were observed between the K-GIS scales and HAQ or EQ-5D (r = 0.21 to 0.46). The K-GIS scores were significantly higher in the presence of bone erosion, absence of urate-lowering therapy, serum urate levels > 6 mg/dL, frequent gout flares in the past year, and fewer comorbidities. In contrast, neither the HAQ nor the EQ-5D could discern these subsets of patients.

CONCLUSION

The K-GIS is a reliable and valid HRQOL measure for patients with gout. Higher K-GIS scores were associated with clinical characteristics leading to unfavorable outcomes, which were not demonstrated by the HAQ and EQ-5D.

Clinical Observation on Therapeutic Effect of Electroacupuncture Combined with Diclofenac Sodium in Treatment of Acute Gouty Arthritis: A Randomized Controlled Study

Objective

To observe the clinical effect of electroacupuncture (EA) combined with diclofenac sodium (DS) in the treatment of acute gouty arthritis (AGA).

Methods

Patients with AGA were randomly divided into three groups: the EA + DS treatment group (i.e., EA + DS group), the low-dose DS treatment group (i.e., low-dose DS group), and the conventional-dose DS treatment group (i. e., conventional DS group). Patients in the low-dose DS group took 50 mg of DS sustained-release capsules once a day. Patients in the conventional DS group took 100 mg of DS sustained-release capsules once a day. Patients in the EA + DS group were treated with EA three times in 7 days combined with 50 mg of DS sustained-release capsules once a day. For all the three groups, 7 days were regarded as a course of treatment. Outcome indicators included pain visual analog scale (VAS), joint tenderness, joint swelling and activity limitation, and levels of inflammatory indicators (C-reactive protein (CRP)/white blood cells (WBC)/percentage of neutrophils (NE%)), level of serum uric acid (SUA), gout impact scale (GIS), and frequency of adverse reactions).

Results

After a course of treatment, indicators regarding the VAS, joint tenderness, joint swelling, activity limitation, GIS, inflammatory indicators (CRP/WBC/NE%), and SUA were all improved (P < 0.05) with no adverse reactions in the EA + DS group. The EA + DS group performed better than the low-dose DS group in improving indicators regarding the VAS, joint tenderness, activity limitation, GIS, inflammatory markers (WBC/NE%), and SUA (P < 0.05). Similarly, the EA + DS group performed better than the conventional DS group in improving indicators regarding GIS, SUA, and adverse reactions (P < 0.05).

Conclusion

EA combined with DS can improve AGA patients' joint pain and functional status, thus improving their quality of life. Moreover, this combined treatment can reduce the levels of inflammatory markers and SUA, leading to fewer adverse reactions in AGA patients.

Translation, internal consistency, reliability and validity of the Thai version of Gout Assessment Questionnaire version 2.0 (GAQ 2.0)

OBJECTIVES

To translate the Gout Assessment Questionnaire version 2.0 (GAQ2.0) with Gout Impact (GI) Scale (GIS) into Thai and determine its psychometric property in gout patients with acute arthritis (acute arthritis group) and during the intercritical period (chronic gout group).

METHODS

Translation followed the ISPOR recommendations. Cronbach's α, intraclass correlation coefficient (ICC) and standardized response mean (SRM) were used to determine internal consistency, reliability and responsiveness to change, respectively. Correlations between GI subscales with generic health-related quality of life (HRQoL) questionnaires (SF-36, HAQ-DI and EQ-5D-5L) and gout clinical parameters were determined.

RESULTS

The acute arthritis group and the chronic gout group comprised 27 and 92 patients, respectively. Internal consistency was sufficient for all GI subscales (Cronbach's α = 0.80-0.98), reliability was moderate to good in most GI subscales (ICC = 0.54-0.88) and responsiveness to change was moderate to large in most GI subscales (SRM = 0.43-0.98). The GI subscales correlated better with SF-36 than HAQ-DI and EQ-5D-5L. In the acute arthritis group, the unmet gout treatment needs subscale showed large and moderate negative correlation with tophi and serum uric acid, respectively. In the chronic gout group, the gout concern overall subscale had statistically significant, moderate correlation with overall gout severity rated by the patients and number of gout attacks over the past year, while the well-being during attack subscale and total GIS score had statistically significant, moderate correlation with overall gout severity rated by the patients.

CONCLUSION

The Thai GAQ2.0 GIS showed acceptable internal consistency, reliability and responsiveness to change and correlated significantly with generic HRQoL questionnaires and clinical parameters. Key Points • The Thai GAQ2.0 GIS showed acceptable internal consistency, reliability and responsiveness to change in gout patients both during acute attack and during the intercritical period • The GI subscales showed significant correlation with SF-36 and HAQ questionnaires and gout clinical parameters in gout patients both during acute attack and during the intercritical period • The Thai GAQ2.0 GIS subscales should be used in conjunction with generic HRQoL for complete HRQoL assessment in gout patients.

Health-related quality of life assessed by Gout Impact Scale (GIS) in Chinese patients with gout

OBJECTIVE

The Gout Impact Scale (GIS) is a disease-specific health-related quality of life (HR-QoL) measurement for patients with gout. This study aimed to investigate the quality of life in Chinese patients with gout and potential risk factors for poorer HR-QoL by GIS.

METHODS

Adults with gout from February 2017 to February 2019 were invited to complete a questionnaire containing the GIS, social demographic characteristics, clinical information and gout-specific questions. Pearson/Spearman correlation and linear regression were used to analyze the data.

RESULTS

A total of 413 patients were included in the analysis (mean age, 51.85 years; 96.4% male). The mean (SD) score of GIS total was 56.79 ± 15.45. Worse gout-specific HR-QoL was associated with anxiety (p < .05), depression (p < .05) and fatigue (p < .05). The effectiveness and global satisfaction of Treatment Satisfaction Questionnaire for Medication (TSQM) were negatively related to each dimension of GIS. Age (B = -0.251, p = .013), fatigue (B = 1.850, p < .001) and depression (B = 9.068, p = .042) were independent predictors of GIS total score.

CONCLUSION

Gout-specific HR-QoL is impaired by social demographic and clinical characteristics, highlighting the importance of psychological factors (fatigue and depression) and patient-reported outcomes (patients' satisfaction and confidence in gout treatment). These findings suggest that more studies should focus on disease-specific HR-QoL.