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Damianova M, Gancheva D, Gabrovski K, Karazapryanov P, Milenova Y, Popivanov ID, Minkin K. Is PDQ-39 a reliable measure of quality of life of patients at advanced stages of Parkinson's disease considered for Deep Brain Stimulation. Heliyon 2024; 10:e31325. [PMID: 38813175 PMCID: PMC11133834 DOI: 10.1016/j.heliyon.2024.e31325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose Parkinson's disease (PD) significantly impedes, especially at its advanced stages, the health-related quality of life (QoL) of patients. The Parkinson's disease questionnaire (PDQ-39) is a widely-used measure assessing the impact of the disease on the patients' QoL. To date, the reliability of PDQ-39 has not been selectively evaluated for patients at a particular delineated stage of the PD progression. Against this backdrop, the study aimed firstly to evaluate comprehensively the internal consistency reliability of PDQ-39 and the constituent scales specifically for patients at the advanced stages of PD who were candidates for Deep Brain Stimulation (DBS) surgery, and secondly, to compare the Cronbach's alpha coefficients with those reported in other studies conducted with patients across all stages of the PD progression. Methods The sample included 36 Bulgarian patients (29 men and 7 women) at advanced stages of PD (Hoehn and Yahr stage 4), PD duration, M = 11.06, SD = 3.50). The internal consistency reliability of the questionnaire and the constituent scales was assessed using three criteria: Cronbach's alpha coefficients, inter-item and item-total correlations. Results The internal consistency reliability indicators were satisfactory for the entire instrument and for most of the scales and similar to those reported in previous studies. None of the scales had low internal consistency reliability results across the three criteria. Except for the Communication scale, seven of the eight scales had Cronbach's alpha values that were satisfactory or marginally below the cut off score. All scales had acceptable inter-item correlations. Three of the scales (Emotional Well-Being, Cognition and Communication) contained more than one item with non-satisfactory item-total correlations. With minor exceptions, the removal of the items with low item-total correlations either did not improve or improved marginally or even decreased the Cronbach's alpha coefficients of the respective scale. The Communication scale was the only scale with a Cronbach's alpha coefficient that was both low and comparatively different to other studies and had as well low item-total correlations for all constituent items, thus showing non-satisfactory results on two of the three internal consistency reliability estimates. In contrast, the Mobility scale met all three internal consistency reliability criteria. Conclusion PDQ-39 is a reliable tool for assessing the QoL of patients at advanced stages of PD across multiple health-related domains. The questionnaire can be recommended for inclusion in the best practice guidelines for evaluating DBS candidacy and the efficacy of DBS treatment for patients' QoL.
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Affiliation(s)
- Maria Damianova
- Neurosurgery Clinic, University Multiprofile Hospital for Active Treatment UMBAL “St. Ivan Rilski”, Sofia, Bulgaria
| | - Desislava Gancheva
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria Sofia, Bulgaria
| | - Kaloyan Gabrovski
- Neurosurgery Clinic, University Multiprofile Hospital for Active Treatment UMBAL “St. Ivan Rilski”, Sofia, Bulgaria
| | - Petar Karazapryanov
- Neurosurgery Clinic, University Multiprofile Hospital for Active Treatment UMBAL “St. Ivan Rilski”, Sofia, Bulgaria
| | - Yoana Milenova
- Neurosurgery Clinic, University Multiprofile Hospital for Active Treatment UMBAL “St. Ivan Rilski”, Sofia, Bulgaria
| | - Ivo D. Popivanov
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria Sofia, Bulgaria
| | - Krasimir Minkin
- Neurosurgery Clinic, University Multiprofile Hospital for Active Treatment UMBAL “St. Ivan Rilski”, Sofia, Bulgaria
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Berardi A, Regoli E, Tofani M, Valente D, Fabbrini G, Fabbrini A, Ruggieri M, Panuccio F, Galeoto G. Tools to assess the quality of life in patients with Parkinson's disease: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2020; 21:55-68. [PMID: 33090885 DOI: 10.1080/14737167.2021.1841638] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The clinical, social, and economic implications of Parkinson's disease (PD) are significant; disability occurs leading to a low quality of life (QoL). Information on the QoL of patients with PD and studies on the relationship between QoL and motor and cognitive function are necessary for both research and clinical use to make informed decisions in healthcare and rehabilitation. The aim of this study was to determine which scales are most used to assess QoL in patients with PD. AREA COVERED A literature search was conducted in MEDLINE, Scopus, CINAHL, PsycINFO, and Web of Science. Two authors independently identified eligible studies based on predefined inclusion criteria and extracted the data. Study quality and the risk of bias were assessed using the COSMIN checklist. EXPERT OPINION 116 suitable studies were included, and 42 different instruments were identified. The most frequently used scales were the 39-items and 8-items Parkinson's Disease Questionnaire (PDQ-39) (PDQ-8). These findings suggest further investigation of existing PD outcome measures would benefit patients, researchers, and clinicians. Validated, universal outcome measures are required to allow comparisons across practice; therefore, we recommend that future researchers use a common set of outcome assessments based on the results of this review.
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Affiliation(s)
- Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
| | | | - Marco Tofani
- Department of Neurorehabilitation and Robotics, Bambino Gesù Paediatric Hospital , Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy.,IRCCS Neuromed , Pozzilli, Italy
| | | | | | | | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome , Rome, Italy
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Farhadi F, Vosoughi K, Shahidi GA, Delbari A, Lökk J, Fereshtehnejad SM. Sexual dimorphism in Parkinson's disease: differences in clinical manifestations, quality of life and psychosocial functioning between males and females. Neuropsychiatr Dis Treat 2017; 13:329-338. [PMID: 28203083 PMCID: PMC5295791 DOI: 10.2147/ndt.s124984] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Sex-related differences in clinical manifestations and consequences of Parkinson's disease (PD) have been poorly explored. Better understanding of sexual dimorphism in neurologic diseases such as PD has been announced as a research priority. The aim of our study was to determine independent sex differences in clinical manifestations and subtypes, psychosocial functioning, quality of life (QoL) and its domains between male and female individuals with PD. PATIENTS AND METHODS A comprehensive list of demographics, motor symptoms and subtypes, nonmotor features, health-related quality of life (HRQoL), psychosocial functioning and general aspects of daily life was assessed in 157 individuals (108 males and 49 females) with idiopathic PD. In order to control for potential confounding variables, we applied Orthogonal Partial Least Squares - Discriminant Analysis (OPLS-DA) to explore the strength of each feature to discriminate male and female patients with PD. RESULTS While no sex difference was found in the total Unified Parkinson's Disease Rating Scale (UPDRS) score and cumulative daily dose of levodopa, females had significantly more severe anxiety (mean difference =2.2 [95% confidence interval, CI: 0.5-4.0], P=0.011), worse nutritional status (23.8 [standard deviation, SD =4.2] vs 25.8 [SD =2.6], P=0.003) and poorer QoL (28.3 [SD =15.7] vs 17.9 [SD =14.2], P<0.001). Based on multivariate discriminant analysis, emotional well-being, bodily discomfort, social support, mobility and communication domains of HRQoL, together with anxiety, depression and psychosocial functioning, were the strongest features with more severe/worse status in females after adjustment for potential statistical confounders. CONCLUSION Our study provides a comprehensive understanding of sexual dimorphism in PD. Anxiety, depression, specific domains of HRQoL (mobility, emotional well-being, social support and bodily discomfort) and psychosocial functioning were significantly worse in female individuals with PD. Sexual dimorphism in PD highlights the features that are more likely to be affected in each sex and should be specifically targeted when managing male and female individuals with PD.
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Affiliation(s)
| | | | - Gholam Ali Shahidi
- Movement Disorders Clinic, Department of Neurology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Delbari
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Johan Lökk
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada; Firoozgar Clinical Research Development Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
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Assessing health-related quality of life with the SCOPA-PS in French individuals with Parkinson's disease having undergone DBS-STN: A validation study. Rev Neurol (Paris) 2016; 172:281-8. [PMID: 27158039 DOI: 10.1016/j.neurol.2015.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aims of this study were to validate the French version of the SCales for Outcomes in Parkinson's Disease-PsychoSocial (SCOPA-PS) in individuals with Parkinson's disease (PD) who underwent deep brain stimulation of the subthalamic nucleus (DBS-STN), to confirm the unifactorial structure of this questionnaire, and to establish its psychometric properties. METHODS Routinely used psychological questionnaires (BDI-II, STAI-Y, PDQ-39, UPDRS III) and the SCOPA-PS were used for a cross-sectional observational study of 154 PD patients. SCOPA-PS acceptability, scaling assumption, reliability, ordinal confirmatory factor analysis and validity were assessed. RESULTS The ICC for two-week test-retest reliability was 0.88. SEM was 8.42. In confirmatory factor analysis, the one-factor model showed an acceptable fit to the data (Chi(2)/df=2.130; CFI=0.976; RMSEA=0.086). No floor or ceiling effects were observed. Skewness was 0.33. Item-total correlation coefficients ranged from 0.47 to 0.71. Cronbach's alpha was 0.86. SCOPA-PS SI correlated with PDQ-39 SI (rs=0.83) and with state-anxiety and depression (rs=0.56 and 0.69 respectively). The SCOPA-PS SI was higher in more depressed patients and in those with the most severe PD motor symptoms. CONCLUSION AND DISCUSSION SCOPA-PS French version is a one-factor scale with satisfactory psychometric properties consistent with other language versions. This short scale can be used to evaluate the psychosocial component of QoL in PD patients treated with DBS-STN.
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Zhang T, Yin A, Sun X, Liu Q, Song G, Li L. Development, reliability and validity of the psychosocial adaptation scale for Parkinson's disease in Chinese population. Int J Clin Exp Med 2015; 8:19731-19738. [PMID: 26770638 PMCID: PMC4694538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/06/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To develop psychosocial adaptation scale for Parkinson's disease (PD) in Chinese population and evaluate its reliability and validity. METHODS The items were designed by literature review, expert consultation and semi-structured interview. The methods of corrected item-total correlation, discrimination analysis and exploratory factor analysis were used for items selection. 427 valid scales from PD patients were collected in the study to test the reliability and validity. RESULTS The scale incorporated six dimensions: anxiety, self-esteem, attitude, self-acceptance, self-efficacy and social support, a total of 32 items. The scale possessed good internal consistency. The test-retest correlation coefficient was 0.99 and average content validation rate was 0.97. The Hoehn and Yahr stage were correlated with total score of the scale. CONCLUSIONS The psychosocial adaptation scale in this study showed good reliability and validity, it can be used as a reliable and valid instrument to evaluate the psychosocial adaptation of PD objectively and effectively.
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Affiliation(s)
- Tingting Zhang
- Department of Neurological, The First Affiliated Hospital of Dalian Medical UniversityDalian 116011, China
| | - Anchun Yin
- Department of Nursing, The First Affiliated Hospital of Dalian Medical UniversityDalian 116011, China
| | - Xiaohong Sun
- Department of Neurological, The First Affiliated Hospital of Dalian Medical UniversityDalian 116011, China
| | - Qigui Liu
- School of Public Health, Dalian Medical UniversityDalian 116044, China
| | - Guirong Song
- School of Public Health, Dalian Medical UniversityDalian 116044, China
| | - Lianhong Li
- Department of Neurological, The First Affiliated Hospital of Dalian Medical UniversityDalian 116011, China
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Heterogeneous Determinants of Quality of Life in Different Phenotypes of Parkinson's Disease. PLoS One 2015; 10:e0137081. [PMID: 26335773 PMCID: PMC4559401 DOI: 10.1371/journal.pone.0137081] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/12/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Health-related quality of life (HRQoL) is considered a very important outcome indicator in patients with Parkinson's disease (PD). A broad list of motor and non-motor features have been shown to affect HRQoL in PD, however, there is a dearth of information about the complexity of interrelationships between determinants of HRQoL in different PD phenotypes. We aimed to find independent determinates and the best structural model for HRQoL, also to investigate the heterogeneity in HRQoL between PD patients with different phenotypes regarding onset-age, progression rate and dominant symptom. METHODS A broad spectrum of demographic, motor and non-motor characteristics were collected in 157 idiopathic PD patients, namely comorbidity profile, nutritional status, UPDRS (total items), psychiatric symptoms (depression, anxiety), fatigue and psychosocial functioning through physical examination, validated questionnaires and scales. Structural equation model (SEM) and multivariate regressions were applied to find determinants of Parkinson's disease summary index (PDSI) and different domains of HRQoL (PDQ-39). RESULTS Female sex, anxiety, depression and UPDRS-part II scores were the significant independent determinants of PDSI. A structural model consisting of global motor, global non-motor and co-morbidity indicator as three main components was able to predict 89% of the variance in HRQoL. In older-onset and slow-progression phenotypes, the motor domain showed smaller contribution on HRQoL and the majority of its effects were mediated through non-motor features. Comorbidity component was a significant determinant of HRQoL only among older-onset and non-tremor-dominant PD patients. Fatigue was not a significant indicator of non-motor component to affect HRQoL in rapid-progression PD. CONCLUSIONS Our findings showed outstanding heterogeneities in the pattern and determinants of HRQoL among PD phenotypes. These factors should be considered during the assessments and developing personalized interventions to improve HRQOL in PD patients with different phenotypes or prominent feature.
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