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Hegland PA, Kolotkin RL, Andersen JR. Sensitivity for Change Analyses of the Patient-Reported Outcomes in Obesity (PROS) Questionnaire: A Prospective Cohort Study. Patient Relat Outcome Meas 2023; 14:235-241. [PMID: 37547056 PMCID: PMC10404038 DOI: 10.2147/prom.s414144] [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: 03/25/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Purpose Many patients seeking bariatric surgery experience reduced health-related quality of life (HRQOL). A simple clinical tool, the Patient-Reported Outcomes in Obesity (PROS), was developed to address patients' HRQOL concerns during clinical consultations and facilitate meaningful dialogue. The present study aims to explore its sensitivity to change. Patients and Methods A prospective study of patients undergoing bariatric surgery was conducted. The patients responded to items on the PROS and the Obesity-related Problems Scale (OP) before surgery and three, 12 and 24 months after surgery. Longitudinal mixed-effects models were applied to estimate the change in PROS and OP scores over time. Results Thirty-eight patients were included. A significant change over time was detected for the PROS with the largest effect size at 24 months (effect size -1.34, p ˂ 0.001), while the corresponding effect size for the OP was -1.32 (p ˂ 0.001). In all items of the PROS, the majority of patients responded not bothered at 24 months. The items physical activity, pain, sleep and self-esteem showed the largest change in the percentage of patients reporting not bothered from baseline to 24 months after surgery. Conclusion The PROS is sensitive to change over time and may be used as a brief, easy to administer tool to facilitate a conversation about obesity-specific quality of life in clinical consultations.
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Affiliation(s)
- Pål André Hegland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Ronette L Kolotkin
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
- Quality of Life Consulting, PLLC, Durham, NC, USA
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
| | - John Roger Andersen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
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Hu FY, Ariagno M, Tavakkoli A, Ghushe N. BODY-Q eating-related symptoms following sleeve gastrectomy. Surg Endosc 2023; 37:2189-2193. [PMID: 35737137 DOI: 10.1007/s00464-022-09389-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent data describing gastrointestinal (GI) symptoms experienced by patients after bariatric surgery is lacking, and previous studies in sleeve gastrectomy patients have been limited in scope of follow-up time or extent of GI symptoms examined. We sought to characterize the prevalence and time course of patient-reported eating-related symptoms in sleeve gastrectomy patients. METHODS From July 2020 to July 2021, sleeve gastrectomy patients seen at three Boston area hospitals received electronic surveys and prospectively reported GI symptoms using the BODY-Q eating-related symptoms scale. Descriptive analyses were performed for patient demographics and symptom prevalence. Chi-square tests were used to compare prevalence of eating-related symptoms between follow-up time intervals. RESULTS 491 sleeve gastrectomy patients completed postoperative surveys with mean follow-up time of 1.9 years. Mean age was 46.6 years, and 81.3% were female. The most reported GI symptoms overall included constipation (56.6%), bloating (54.0%), heartburn when standing (41.5%), and heartburn when lying down (39.9%) while the least commonly reported symptoms were palpitations (16.3%), low blood sugar (15.7%), and emesis (15.1%). At greater than 12 months, the most reported symptoms similarly included bloating (60.3%), constipation (53.2%), and heartburn while standing (46.0%). When comparing prevalence of eating-related symptoms across follow-up time intervals from < 1 to > 12 months, patients reported a significant decrease in constipation, abdominal pain, and nausea over time (p = 0.012, p < .0001, p = 0.03, respectively). CONCLUSION Patients experience both upper and lower GI symptoms following sleeve gastrectomy, and symptoms, including bloating, constipation, and heartburn may persist through long-term follow-up. These patient-centered measures add value by guiding preoperative counseling, informing postoperative expectations, and providing real-time clinical feedback for bariatric surgery patients.
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Affiliation(s)
- Frances Y Hu
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA.
| | - Meghan Ariagno
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA
| | - Ali Tavakkoli
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA
| | - Neil Ghushe
- Department of Surgery, Brigham and Woman's Hospital, c/o Surgery Education Office, 75 Francis Street, Boston, MA, 02120, USA.,Department of Surgery, South Shore Hospital, Weymouth, MA, USA
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Traebert J, Rodrigues MD, Chaves MS, Moritz NMP, Nunes RD, Cremona-Parma GO, Traebert E. Transcultural adaptation of Patient-Reported Outcomes in Obesity (PROS) questionnaire for Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220015. [PMID: 35703717 DOI: 10.1590/1980-549720220015.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). METHODS The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. RESULTS In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. CONCLUSION The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.
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Affiliation(s)
- Jefferson Traebert
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde - Palhoça (SC), Brasil.,Universidade do Sul de Santa Catarina, Curso de Medicina - Palhoça (SC), Brasil
| | | | | | - Nicole Morem Pilau Moritz
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde - Palhoça (SC), Brasil
| | - Rodrigo Dias Nunes
- Universidade do Sul de Santa Catarina, Curso de Medicina - Palhoça (SC), Brasil
| | - Gabriel Oscar Cremona-Parma
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde - Palhoça (SC), Brasil
| | - Eliane Traebert
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde - Palhoça (SC), Brasil.,Universidade do Sul de Santa Catarina, Curso de Medicina - Palhoça (SC), Brasil
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Hegland PA, McAleavey A, Aasprang A, Moltu C, Kolotkin RL, Andersen JR. The Norse Feedback in a population of patients undergoing bariatric surgery-Psychometric properties of a digital computer-adaptive questionnaire assessing mental health. Clin Obes 2022; 12:e12491. [PMID: 34761876 DOI: 10.1111/cob.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/08/2021] [Accepted: 09/28/2021] [Indexed: 11/27/2022]
Abstract
The Norse Feedback (NF) is a questionnaire developed for patient-reported outcome monitoring with a clinical feedback system (PRO/CFS). As mental health is a concern after bariatric surgery, the use of the NF as part of PRO/CFS may be beneficial. The aim of this study is to test the reliability and validity of the NF in patients who have been accepted for or have undergone bariatric surgery. We performed separate robust confirmatory factor analyses (CFAs) to test the unidimensionality on 19 of the NF scales. We also performed correlation analyses on 19 of the NF scales with the Obesity-related Problems scale (OP). We included 213 patients. In the CFA analyses, three out of 12 scales with four or more items showed satisfactory psychometric properties in all goodness of fit indices (Suicidality, Need for Control and Self-Criticism). Four scales showed satisfactory psychometric properties in all indices but RMSEA (Somatic Anxiety, Substance Use, Social Safety and Cognitive Problems). Several of the scales demonstrated floor effects. In the correlation analyses, 18 of the 19 scales showed small-to-moderate correlation coefficients with the OP. Our demonstration of satisfactory psychometric properties on several important scales of the NF suggests that this tool may prove valuable in the routine follow-up of mental health in this population. However, further work is needed to innovate the NF for patients undergoing bariatric surgery.
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Affiliation(s)
- Pål A Hegland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Andrew McAleavey
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
| | - Anny Aasprang
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Ronette L Kolotkin
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA
- Quality of Life Consulting, PLLC, Durham, North Carolina, USA
| | - John Roger Andersen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
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Traebert J, Rodrigues MD, Chaves MS, Moritz NMP, Nunes RD, Cremona-Parma GO, Traebert E. Transcultural adaptation of Patient-Reported Outcomes in Obesity (PROS) questionnaire for Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT: Objective: To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). Methods: The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. Results: In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. Conclusion: The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.
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Affiliation(s)
- Jefferson Traebert
- Universidade do Sul de Santa Catarina, Brasil; Universidade do Sul de Santa Catarina, Brasil
| | | | | | | | | | | | - Eliane Traebert
- Universidade do Sul de Santa Catarina, Brasil; Universidade do Sul de Santa Catarina, Brasil
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