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Sarac DC, Bayraktar D, Tore NG, Kurut Aysin I, Otman E, Inanc I, Demirbas S, Coskun B, Erol K, Ustun O, Akatay EA, Oskay D, Gucenmez S, Ozmen M, Akar S. Systemic Sclerosis Quality of Life Questionnaire (SScQoL): translation into Turkish and assessing its psychometric properties. Clin Rheumatol 2023:10.1007/s10067-023-06626-4. [PMID: 37178266 DOI: 10.1007/s10067-023-06626-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Systemic sclerosis (SSc) is a chronic autoimmune disease that affects the connective tissues and leads to physical, emotional, and social challenges for patients. Evaluating health-related quality of life (HRQoL) with a disease-specific tool may be preferable for improving patient care and treatment outcomes. The aim of this study was to translate the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into Turkish and to investigate its psychometric properties. METHODS Eighty-six patients with SSc (mean age 51.8 ± 11.7 years, 80 females) participated in the study. Convergent validity was explored by correlation analyses between Turkish SScQoL and Short-Form 36 (SF-36), European Quality of Life Survey-5 Dimensions (EQ-5D), EQ-5D Visual Analog Scale (EQ-VAS), and Scleroderma Health Assessment Questionnaire (SHAQ). Cronbach's alpha was calculated to test internal consistency. Turkish SScQoL was readministered after 7-14 days to fifty-eight patients for determining test re-test reliability. Intraclass correlation coefficients in 95% confidence interval (ICCs [95%CI]) were calculated to examine the agreement between two assessments. Values greater than 15% and an absolute skewness value < 1 were recognized as the presence of a floor or ceiling effect. RESULTS SScQoL correlated significantly with SF-36 subdomains (r = -0.347 to -0.618, p < 0.01), EQ-5D (r = -0.535, p < 0.01), EQ-VAS (r = -0.636, p < 0.01), and SHAQ global score (r = 0.521, p < 0.01). SScQoL demonstrated excellent internal consistency (Cronbach's alpha = 0.917), and good to excellent test-retest reliability (ICC [95%CI] = 0.85 [0.76-0.91]). No floor/ceiling effects were observed. CONCLUSION The Turkish version of SScQoL seems to have adequate psychometric properties and can be used to evaluate HRQoL in clinical and research settings. Key points • Turkish version of SScQoL is a valid and reliable tool for measuring health-related quality of life of patients with systemic sclerosis. • SScQoL is the only diseases-specific quality of life measurement for systemic sclerosis available in Turkish. • Patients with limited and diffuse SSc seem to be similar in terms of self-reported health-related quality of life.
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Affiliation(s)
- Devrim Can Sarac
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatcik, Izmir, Turkey.
| | - Deniz Bayraktar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatcik, Izmir, Turkey
| | - Nurten Gizem Tore
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Balatcik, Ankara, Turkey
| | - Idil Kurut Aysin
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Eda Otman
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Israfil Inanc
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Serife Demirbas
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatcik, Izmir, Turkey
| | - Berfin Coskun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatcik, Izmir, Turkey
| | - Kubra Erol
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatcik, Izmir, Turkey
| | - Oguz Ustun
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Emre Alp Akatay
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Deran Oskay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Balatcik, Ankara, Turkey
| | - Sercan Gucenmez
- Department of Rheumatology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
| | - Mustafa Ozmen
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Kocher A, Simon M, Dwyer AA, Blatter C, Bogdanovic J, Künzler-Heule P, Villiger PM, Dan D, Distler O, Walker UA, Nicca D. Patient Assessment Chronic Illness Care (PACIC) and its associations with quality of life among Swiss patients with systemic sclerosis: a mixed methods study. Orphanet J Rare Dis 2023; 18:7. [PMID: 36624535 PMCID: PMC9828378 DOI: 10.1186/s13023-022-02604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The Chronic Care Model (CCM) is a longstanding and widely adopted model guiding chronic illness management. Little is known about how CCM elements are implemented in rare disease care or how patients' care experiences relate to health-related quality of life (HRQoL). We engaged patients living with systemic sclerosis (SSc) to assess current care according to the CCM from the patient perspective and their HRQoL. METHODS We employed an explanatory sequential mixed methods design. First, we conducted a cross-sectional quantitative survey (n = 101) using the Patient Assessment of Chronic Illness Care (PACIC) and Systemic Sclerosis Quality of Life (SScQoL) questionnaires. Next, we used data from individual patient interviews (n = 4) and one patient focus group (n = 4) to further explore care experiences of people living with SSc with a focus on the PACIC dimensions. RESULTS The mean overall PACIC score was 3.0/5.0 (95% CI 2.8-3.2, n = 100), indicating care was 'never' to 'generally not' aligned with the CCM. Lowest PACIC subscale scores related to 'goal setting/tailoring' (mean = 2.5, 95% CI 2.2-2.7) and 'problem solving/contextual counselling' (mean = 2.9, 95% CI 2.7-3.2). No significant correlations were identified between the mean PACIC and SScQoL scores. Interviews revealed patients frequently encounter major shortcomings in care including 'experiencing organized care with limited participation', 'not knowing which strategies are effective or harmful' and 'feeling left alone with disease and psychosocial consequences'. Patients often responded to challenges by 'dealing with the illness in tailored measure', 'taking over complex coordination of care' and 'relying on an accessible and trustworthy team'. CONCLUSIONS The low PACIC mean overall score is comparable to findings in patients with common chronic diseases. Key elements of the CCM have yet to be systematically implemented in Swiss SSc management. Identified gaps in care related to lack of shared decision-making, goal-setting and individual counselling-aspects that are essential for supporting patient self-management skills. Furthermore, there appears to be a lack of complex care coordination tailored to individual patient needs.
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Affiliation(s)
- Agnes Kocher
- Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. .,Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Michael Simon
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.5734.50000 0001 0726 5157Department of Nursing, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew A. Dwyer
- grid.208226.c0000 0004 0444 7053Boston College, Connell School of Nursing, Chestnut Hill, MA USA ,grid.32224.350000 0004 0386 9924Center for Nursing Research, Massachusetts General Hospital Munn, Boston, MA USA
| | - Catherine Blatter
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Jasmina Bogdanovic
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland
| | - Patrizia Künzler-Heule
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.413349.80000 0001 2294 4705Department of Gastroenterology/Hepatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland ,grid.413349.80000 0001 2294 4705Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | | | - Diana Dan
- grid.9851.50000 0001 2165 4204Service of Rheumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Oliver Distler
- grid.7400.30000 0004 1937 0650Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ulrich A. Walker
- grid.410567.1Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Dunja Nicca
- grid.6612.30000 0004 1937 0642Department Public Health (DPH), Institute of Nursing Science (INS), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland ,grid.7400.30000 0004 1937 0650Department of Global and Public Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
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Kumar V, Malhotra V, Sinha V. Evaluation of Individual Quality of Life (QOL) Among Patients with Tracheostomy Using WHO-QOL BREF Questionnaire. Indian J Otolaryngol Head Neck Surg 2022; 74:5207-5216. [PMID: 36742676 PMCID: PMC9895232 DOI: 10.1007/s12070-020-02052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Tracheostomy is one of the most frequently performed surgical procedures worldwide. The placement of tracheostomy in a patient is associated with significant morbidities as apart from the physical impact of the procedure, a profound and persistent effect on psychosocial, financial, environmental and other aspects of global health of the patient becomes inevitable. However, there is a surprising paucity of literature assessing the Quality of Life (QOL) in patients with tracheostomy tube placement. This study was undertaken with the objective to assess the effect of tracheostomy on Quality of Life (QOL) of patients in an urban tertiary health care setup in India. Patients who underwent tracheostomy tube placement irrespective of the indication were included in the study and followed up for a period of up to 3 months to determine the effect of tracheostomy tube placement on the Quality of Life. A questionnaire based on World Health Organisation (WHO) QOL BREF scheme was utilized to evaluate QOL in the immediate post operative period and again appraised after a period of 3 months. The results were statistically analyzed, tabulated and compared using paired t test to evaluate the 'p' value in every domain i.e., physical, social, psychological and environmental, of the WHO QOL-BREF evaluation tool. 63 patients were enrolled in the study after excluding the patients not fulfilling the selection criteria. The majority of patients were male over the age of 50 years (mean age 57 years). There was a noteworthy depreciation in QOL score in patients as WHO-QOL-BREF scores in all the 4 domains were significantly lower after 3 months. The most affected were the Environmental domain (p value 5E-15) whereas the domain of Psychological showed least depreciation of mean QOL score (p value 7.7E-5). Insertion of a tracheostomy tube has a significant impact on the quality of life of the patient and the amount of burden increases with worsening quality of life. A holistic and scientific approach to assess and manage tracheostomy induced morbidity on the patient is necessary. The patients' views of the aspects of life should be used by health policy makers, clinicians, and caregivers as a reliable guide to the most important priorities for treatment and medical interventions. Large prospective multicenter studies may be undertaken for the developement of a standardized and internationally accepted tracheostomy specific quality of life evaluation tool.
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Affiliation(s)
- Vivek Kumar
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
| | | | - Vineet Sinha
- Department of ENT, PMCH, Ashok Rajpath, Patna, 800004 India
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Mitropoulos A, Boström C, Mattsson M, Kouidi E, Dimitroulas T, Liem SIE, Vlieland TPMV, de Vries-Bouwstra JK, Jacobsen S, Cuomo G, Akil M, Klonizakis M. Exploring the effects of a combined exercise programme on pain and fatigue outcomes in people with systemic sclerosis: study protocol for a large European multi-centre randomised controlled trial. Trials 2022; 23:962. [DOI: 10.1186/s13063-022-06853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/19/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background
Pain, related to Raynaud’s phenomenon or digital ulceration, has been identified as very prevalent and debilitating symptoms of systemic sclerosis (SSc), both significantly affecting patients’ quality of life (QoL). Pharmacological therapeutic strategies were found not to be sufficiently effective in the management of SSc-induced pain and fatigue, and evidence for exercise is scarce. As yet, the effects of a long-term, tailored exercise programme on pain and fatigue in patients with SSc have not been explored. In addition to pain and fatigue, this study aims to evaluate the effects of exercise on QoL, physical fitness, functional capacity, and vascular structure in people with SSc (PwSSc).
Methods
This will be a multicentre (n = 6) randomised controlled clinical trial to assess the effect of a previously established, supervised 12-week combined exercise programme on pain and fatigue as compared to no exercise in PwSSc. The study will recruit 180 patients with SSc that will be allocated randomly to two groups. Group A will perform the exercise programme parallel to standard usual care and group B will receive usual care alone. Patients in the exercise group will undertake two, 45-min sessions each week consisting of 30-min high-intensity interval training (HIIT) (30-s 100% peak power output/30-s passive recovery) on an arm crank ergometer and 15 min of upper body circuit resistance training. Patients will be assessed before as well as at 3 and 6 months following randomisation. Primary outcomes of the study will be pain and fatigue assessed via questionnaires. Secondary outcomes include quality of life, structure of digital microvasculature, body composition, physical fitness, and functional capacity.
Discussion
Data from this multi-centre research clinical trial will primarily be used to establish the effectiveness of a combined exercise protocol to improve pain and fatigue in SSc. In parallel, this study will be the first to explore the effects of long-term exercise on potential microvascular alterations assessed via NVC. Overall, this study will provide sufficient data to inform current clinical practice guidelines and may lead to an improvement of QoL for patients with SSc.
Trial registration
ClinicalTrials.gov NCT05234671. Registered on 14 January 2022
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Kocher A, Ndosi M, Denhaerynck K, Simon M, Dwyer AA, Distler O, Hoeper K, Künzler-Heule P, Redmond AC, Villiger PM, Walker UA, Nicca D. A rare disease patient-reported outcome measure: revision and validation of the German version of the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) using the Rasch model. Orphanet J Rare Dis 2021; 16:356. [PMID: 34372892 PMCID: PMC8351336 DOI: 10.1186/s13023-021-01944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background Rare disease patient-reported outcome measures (PROMs) require linguistic adaptation to overcome the challenge of geographically dispersed patient populations. Importantly, PROMs such as health-related quality of life (HRQoL) should accurately capture responses to patient-identified concerns. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL) is a 29-item tool validated in six languages. Previous evaluation of the German version revealed problems with dichotomous responses. This study aimed to revise the German SScQoL, extend the response structure, and evaluate content and construct validity, reliability and unidimensionality. Methods The instrument validation study involved revising the German SScQoL response structure, cognitive debriefing with patients and validation using Rasch analysis. The revised SScQoL was completed by Swiss-German-speaking patients with SSc within the Swiss MANagement Of Systemic Sclerosis (MANOSS) study. Rasch analysis was employed to test the validity, reliability and unidimensionality of the revised instrument. Results Based on cognitive debriefing with patients (n = 6) dichotomous items were extended to a polytomous 4-point response structure. A total of 78 patients completed the revised SScQoL. Initial analysis of the 29 items suggested the scale lacked fit to the model (χ2 = 51.224, df = 29, p = 0.007). Grouping items into five domains resulted in an adequate fit to the Rasch model (χ2 = 5.343, df = 5, p = 0.376) and unidimensionality (proportion of significant independent t tests: 0.045, 95% CI 0.016–0.114). Overall, the scale was well targeted, had high internal consistency (Person Separation Index, PSI = 0.931) and worked consistently in patients with different demographic and clinical characteristics. Conclusions The revised German SScQoL has a 4-point response structure and is a valid, reliable measure. Rasch analysis is useful for validating continuous response structure of quality of life measures. Further evaluation of measurement equivalence with other German-speaking cultures is required for multinational comparisons and data pooling. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01944-9.
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Affiliation(s)
- Agnes Kocher
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Rheumatology, Immunology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Kris Denhaerynck
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Michael Simon
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Nursing Research Unit, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew A Dwyer
- Boston College, Connell School of Nursing, Chestnut Hill, MA, USA
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Kirsten Hoeper
- Hannover Medical School, Department, Rheumatology and Immunology, Hannover, Germany
| | - Patrizia Künzler-Heule
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Gastroenterology/Hepatology and Department of Nursing, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Peter M Villiger
- Department of Rheumatology, Immunology and Allergology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ulrich A Walker
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - Dunja Nicca
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland. .,Department of Global and Public Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland.
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Doutre MS, Godard D, Benani M, Taieb C. Création et validation d’un outil d’évaluation du handicap lié à l’atteinte du visage de la sclérodermie systémique. Ann Dermatol Venereol 2020; 147:595-601. [DOI: 10.1016/j.annder.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 11/30/2022]
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Cultural adaptation and validation of the Systemic Sclerosis Quality of Life questionnaire into Arabic language. Clin Rheumatol 2020; 40:1409-1416. [PMID: 32918142 DOI: 10.1007/s10067-020-05373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Systemic sclerosis (SSc) is a chronic connective tissue disease affecting all quality of life (QoL) parameters. In addition to clinical assessment, QoL measures should be included in patient assessment. There is no Arabic tool specific for assessing QoL in Arabic SSc patients; therefore, this work was designed to translate the SScQoL questionnaire, culturally adapt and check its reliability and validity. METHOD Based on the principle of translation and cross-cultural adaptation in other language, the SScQoL questionnaire was translated into Arabic. Correlation of SScQoL scores for 50 patients with Short Form Health Survey (SF-36) scores has been tested for convergent validity and discriminate validity evaluated by stratifying clinical parameters of patients and disease subtypes. The intraclass correlation coffee (ICC) was used to assess reliability by interviewing patients twice 14 days apart. RESULTS Correlations were present between SScQoL scores and physical and mental component scores of SF-36 questionnaire. We found strong negative correlation between the physical component of SF-36 and QoL function, QoL emotion, QoL total scores (r = - 0.654**, r = - 0.512**, r = - 0.540**) and moderate negative correlation present between SF-36 mental component and QoL function, QoL emotion, QoL social, and QoL total (r = - 0.314*, r = - 0.486**, r = - 0.357*, r = - 0.433*). Also, significant association (P < 0.05*) between scores of total QoL and visceral involvements (GIT involvement, pericardial effusion, and LVDD) was evident. The Arabic edition of SScQoL has a Cronbach's alpha of 0.78. CONCLUSION The translated Arabic version is a valid and reliable tool to assess Egyptian SSc patients' QoL. Key Points • The SScQoL questionnaire items have a convergent validity with physical and mental component scores of SF-36, and discriminant validity with visceral involvement. • The Arabic edition of SScQoL is reliable with a Cronbach's alpha of 0.78.
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Pan H, Edwards SW, Ives C, Covert H, Harville EW, Lichtveld MY, Wickliffe JK, Hamilton CM. An Assessment of Environmental Health Measures in the Deepwater Horizon Research Consortia. CURRENT OPINION IN TOXICOLOGY 2020; 16:75-82. [PMID: 32457927 DOI: 10.1016/j.cotox.2019.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research consortia play a key role in our understanding of how environmental exposures influence health and wellbeing, especially in the case of catastrophic events such as the Deepwater Horizon oil spill. A common challenge that prevents the optimal use of these data is the difficulty of harmonizing data regarding the environmental exposures and health effects across the studies within and among consortia. A review of the measures used by members of the Deepwater Horizon Research Consortia highlights the challenges associated with balancing timely implementation of a study to support disaster relief with optimizing the long-term value of the data. The inclusion of common, standard measures at the study design phase and a priori discussions regarding harmonization of study-specific measures among consortia members are key to overcoming this challenge. As more resources become available to support the use of standard measures, researchers now have the tools needed to rapidly coordinate their studies without compromising research focus or timely completion of the original study goals.
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Affiliation(s)
- Huaqin Pan
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Stephen W Edwards
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Cataia Ives
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Hannah Covert
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112
| | - Emily W Harville
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112
| | - Maureen Y Lichtveld
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112
| | - Jeffrey K Wickliffe
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112
| | - Carol M Hamilton
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
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Sierakowska M, Doroszkiewicz H, Sierakowska J, Olesińska M, Grabowska-Jodkowska A, Brzosko M, Leszczyński P, Pawlak-Buś K, Batko B, Wiland P, Majdan M, Bykowska-Sochacka M, Romanowski W, Zon-Giebel A, Jeka S, Ndosi M. Factors associated with quality of life in systemic sclerosis: a cross-sectional study. Qual Life Res 2019; 28:3347-3354. [PMID: 31482431 PMCID: PMC6863937 DOI: 10.1007/s11136-019-02284-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2019] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Systemic sclerosis (SSc) is a connective tissue disease characterized by progressive fibrosis of the skin and internal organs, leading to their failure and disturbances in the morphology and function of blood vessels. The disease affects people in different ways, and identifying how the difficulties and limitations are related to quality of life may contribute to designing helpful interventions. The aim of this study was to identify factors associated with quality of life in people with SSc. METHODS This was a cross-sectional study conducted in 11 rheumatic centres in Poland. Patients diagnosed with SSc were included. Quality of life was measured using the SSc Quality of Life Questionnaire (SScQoL). The following candidate factors were entered in preliminary multivariable analysis: age, place of residence, marital status, occupational status, disease type, disease duration, pain, fatigue, intestinal problems, breathing problems, Raynaud's symptoms, finger ulcerations, disease severity, functional disability, anxiety and depression. Factors that achieved statistical significance at the 10% level were then entered into a final multivariable model. Factors achieving statistical significance at the 5% level in the final model were considered to be associated with quality of life in SSc. RESULTS In total, 231 participants were included. Mean age (SD) was 55.82 (12.55) years, disease duration 8.39 (8.18) years and 198 (85.7%) were women. Factors associated with quality of life in SSc were functional disability (β = 2.854, p < 0.001) and anxiety (β = 0.404, p < 0.001). This model with two factors (functional disability and anxiety) explained 56.7% of the variance in patients with diffuse SSc and 73.2% in those with localized SSc. CONCLUSIONS Functional disability and anxiety are significantly associated with quality of life in SSc. Interventions aimed at improving either of these factors may contribute towards improving the quality of life of people with SSc.
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Affiliation(s)
- Matylda Sierakowska
- Department of Integrated Medical Care, Medical University of Bialystok, 7a Maria Sklodowska-Curie Street, 15-096, Bialystok, Poland.
| | | | - Justyna Sierakowska
- Department of Foreign Languages, Medical University of Bialystok, Bialystok, Poland
| | - Marzena Olesińska
- Department of Connective Tissue Disease, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Agnieszka Grabowska-Jodkowska
- Department of Connective Tissue Disease, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Marek Brzosko
- Department of Rheumatology, Internal Diseases and Geriatrics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Piotr Leszczyński
- Department of Rheumatology and Rehabilitation, Medical University in Poznań, Poznań, Poland
| | - Katarzyna Pawlak-Buś
- Department of Rheumatology and Rehabilitation, Medical University in Poznań, Poznań, Poland
| | - Bogdan Batko
- Center of Rheumatology, J. Dietl Hospital in Krakow, Krakow, Poland
| | - Piotr Wiland
- Department of Rheumatology and Internal Diseases and Geriatrics, Medical University in Wroclaw, Wroclaw, Poland
| | - Maria Majdan
- Department of Rheumatology and Connective Tissue Diseases, Medical University in Lublin, Lublin, Poland
| | | | | | - Aleksandra Zon-Giebel
- Silesian Center of Rheumatology, Rehabilitation and Prevention of Disability, Ustroń, Poland
| | - Sławomir Jeka
- Department of Rheumatology and Connective Tissue Diseases, 2nd University Hospital in Bydgoszcz, Bydgoszcz, Poland
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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10
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Kocher A, Simon M, Dwyer AA, Villiger PM, Künzler-Heule P, De Geest S, Berben L, Nicca D. Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol. J Adv Nurs 2019; 75:3774-3791. [PMID: 31452216 DOI: 10.1111/jan.14185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/26/2019] [Accepted: 08/13/2019] [Indexed: 12/19/2022]
Abstract
AIM The aim of the management of systemic sclerosis (MANOSS) study described in this protocol is to develop a chronic care model, based on a contextual analysis and stakeholder involvement, for patients living with the rare disease systemic sclerosis (SSc) in Switzerland. DESIGN Applying an implementation science approach, this study starts with an explanatory sequential mixed method study for contextual analysis, followed by broad stakeholder involvement for model development and a Delphi study to reach consensus. METHODS First, a quantitative cross-sectional survey with patients and healthcare professionals (HPs) will be conducted to identify current practice patterns of chronic illness management and technology readiness. Second, qualitative interviews with patients, family members and HPs will be performed to gain a deeper understanding of care needs identified in the quantitative survey. Third, a model of care will be co-created with input from patients, HPs and other experts. The eHealth enhanced Chronic Care Model will serve as a guiding framework. The new model and corresponding outcome parameters will be refined using a Delphi-study approach to reach consensus on a testable model of care for persons living with SSc. The protocol has received research ethics committee approval in September 2018 by the Swiss Ethics Committee. DISCUSSION The MANOSS study's participatory approach is essential for contextual fit of the model for patients with SSc in this setting. Subsequent feasibility testing and implementation are planned to evaluate the model's value in relation to health disparities faced by this patient population. IMPACT Patients living with this rare disease lack access to coordinated, specialized care and self-management support from qualified HPs. Reengineering of current care, with consideration for technological opportunities, is warranted to meet patients' and families' needs.
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Affiliation(s)
- Agnes Kocher
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Rheumatology, Immunology and Allergology, Inselspital Bern University Hospital, Bern, Switzerland
| | - Michael Simon
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Nursing Research Unit, Inselspital Bern University Hospital, Bern, Switzerland
| | - Andrew A Dwyer
- Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Peter M Villiger
- Department of Rheumatology, Immunology and Allergology, Inselspital Bern University Hospital, Bern, Switzerland
| | - Patrizia Künzler-Heule
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Gastroenterology/Hepatology and Department of Nursing Development, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sabina De Geest
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU-Leuven, Belgium
| | - Lut Berben
- Division of Nursing, Department of Medicine, University Hospital Basel, Basel, Switzerland.,Department of Nursing Development, University Children's Hospital Basel, Basel, Switzerland
| | - Dunja Nicca
- Institute of Nursing Science (INS), Department Public Health (DPH), Faculty of Medicine, University of Basel, Basel, Switzerland.,University Hospital Basel, Basel, Switzerland
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11
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Sinha A, Patel AS, Siegert RJ, Bajwah S, Maher TM, Renzoni EA, Wells AU, Higginson IJ, Birring SS. The King's Brief Interstitial Lung Disease (KBILD) questionnaire: an updated minimal clinically important difference. BMJ Open Respir Res 2019; 6:e000363. [PMID: 30956799 PMCID: PMC6424243 DOI: 10.1136/bmjresp-2018-000363] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction The King’s Brief Interstitial Lung Disease (KBILD) is a 15-item validated health-related quality of life (HRQOL) questionnaire. The method of scoring the KBILD has recently changed to incorporate a logit-scale transformation from one that used raw item responses, as this is potentially a more linear scale. The aim of this study was to re-evaluate the KBILD minimal clinically important difference (MCID) using the new logit -transformed scoring. Methods 57 patients with interstitial lung disease (17 idiopathic pulmonary fibrosis, IPF) were asked to complete the KBILD questionnaire on two occasions in outpatient clinics. At the second visit, patients also completed a 15-item global rating of change of health status questionnaire (GRCQ). The MCID was calculated as the mean of four different methods: the change in KBILD for patients indicating a small change in GRCQ, patients with a 7%–12% change in FVC, 1 SE of measurement of baseline KBILD and effect size (ES) of 0.3. Results The mean (SD) KBILD total score for all patients was 55.3 (15.6). 16 patients underwent a therapeutic intervention. 36 patients reported a change in their condition on the GRCQ; 22 deteriorated, 14 improved and 21 were unchanged. There was a significant change in KBILD total score in patients reporting a change in GRCQ; mean (SD) 57.0 (13.6) versus 50.0 (9.7); mean difference 7.0; 95% CI of difference 3.0 to 11.0; p<0.01. The change in KBILD total score correlated with the GRCQ scale; r=−0.49, p<0.01. The mean KBILD total score MCID was 5. The MCID of KBILD domains were 6 for Psychological, 7 for Breathlessness and Activities, and 11 for Chest Symptoms. Conclusion The KBILD is a responsive tool for longitudinal assessment of HRQOL in patients with ILD. The MCID of the KBILD total score is a 5-unit change.
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Affiliation(s)
- Aish Sinha
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Department of Respiratory Medicine, King's College Hospital, London, UK
| | - Amit Suresh Patel
- Department of Respiratory Medicine, King's College Hospital, London, UK
| | - Richard J Siegert
- Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand
| | - Sabrina Bajwah
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Toby M Maher
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Athol U Wells
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Surinder S Birring
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,Department of Respiratory Medicine, King's College Hospital, London, UK
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12
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Sandqvist G, Hesselstrand R. Validity of the Swedish version of the systemic sclerosis quality of life questionnaire (SSCQoL): A novel measure of quality of life for patients with systemic sclerosis. Ann Rheum Dis 2019; 78:855-857. [PMID: 30610065 DOI: 10.1136/annrheumdis-2018-214260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Gunnel Sandqvist
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden
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