[Measuring quality of life: generic or specific questionnaires?]

Health-related quality of life in women aged 20-64 years with urinary incontinence

Introduction and hypothesis

Urinary incontinence (UI) in women is a frequent and invisible clinical situation that affects several aspects in the lives of patients. The aim of this study is to assess the impact of urinary incontinence on different dimensions of quality of life.

Methods

Cross-sectional observational study. The sample brings together 381 women living in the Metropolitan Region of Chile, who answered a survey between June 2020 and June 2021, with questions about the sociodemographic situation, obstetric history and the EQ5D-3L questionnaire Chilean version and urinary incontinence variables. For the analysis of association between variables were used a correlation coefficient and logistic regressions.

Results

The mean age of the sample was 39.9 (SD: 12.6) years, with 68.5% of multiparous women and 42.5% had a history of vaginal delivery. Fifty percent of the respondents belong to a medium-high socioeconomic level according to the health insurance proxy. The analysis adjusted for age, health insurance and obstetrics variables showed that women with a frequency of moderate/severe urine loss had a 72% greater probability of suffering from moderate/severe pain/discomfort compared to women with nothing/little urine loss. In turn, the self-perception of affectation of urine loss was significantly associated with problems in the dimensions of mobility, anxiety/depression and health status.

Conclusions

This research contributes with evidence that makes visible the affectation on physical and psychological dimensions in women with urinary incontinence, allowing decision-makers to prioritize resources and design health programs that include clinical management.

Analysis of two questionnaires on quality of life of Chronic Obstructive Pulmonary Disease patients

Objective:

to evaluate the efficacy of quality of life questionnaires St. George Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test in patients with chronic obstructive pulmonary disease based on correlation and agreement analyses, and identify the most effective tool to assess their quality of life.

Method:

cross-sectional cohort study with patients hospitalized in a Spanish hospital for exacerbation of chronic obstructive pulmonary disease. Health-related quality of life was assessed with both questionnaires. The correlation and the agreement between the questionnaires were analyzed, as well as the internal consistency. Associations were established between the clinical variables and the results of the questionnaire.

Results:

one hundred and fifty-six patients participated in the study. The scales had a correlation and agreement between them and high internal consistency. A higher sensitivity of the Chronic Obstructive Pulmonary Disease Assessment Test was observed for the presence of cough and expectoration.

Conclusion:

the questionnaires have similar reliability and validity to measure the quality of life in patients with acute chronic obstructive pulmonary disease, and the Chronic Obstructive Pulmonary Disease Assessment Test is more sensitive to detect cough and expectoration and requires a shorter time to be completed.

Translation, cross-cultural adaptation and psychometric evaluation of yoruba version of the short-form 36 health survey

Background and objective

The Short-Form Health Survey (SF-36) is a valid quality of life tool often employed to determine the impact of medical intervention and the outcome of health care services. However, the SF-36 is culturally sensitive which necessitates its adaptation and translation into different languages. This study was conducted to cross-culturally adapt the SF-36 into Yoruba language and determine its reliability and validity.

Methods

Based on the International Quality of Life Assessment project guidelines, a sequence of translation, test of item-scale correlation, and validation was implemented for the translation of the Yoruba version of the SF-36. Following pilot testing, the English and the Yoruba versions of the SF-36 were administered to a random sample of 1087 apparently healthy individuals to test validity and 249 respondents completed the Yoruba SF-36 again after two weeks to test reliability. Data was analyzed using Pearson’s product moment correlation analysis, independent t-test, one-way analysis of variance, multi trait scaling analysis and Intra-Class Correlation (ICC) at p < 0.05.

Results

The concurrent validity scores for scales and domains ranges between 0.749 and 0.902 with the highest and lowest scores in the General Health (0.902) and Bodily Pain (0.749) scale. Scale-level descriptive result showed that all scale and domain scores had negative skewness ranging from −2.08 to −0.98. The mean scores for each scales ranges between 83.2 and 88.8. The domain scores for Physical Health Component and Mental Health Component were 85.6 ± 13.7 and 85.9 ± 15.4 respectively. The convergent validity was satisfactory, ranging from 0.421 to 0.907. Discriminant validity was also satisfactory except for item ‘1’. The ICC for the test-retest reliability of the Yoruba SF-36 ranges between 0.636 and 0.843 for scales; and 0.783 and 0.851 for domains.

Conclusion

The data quality, concurrent and discriminant validity, reliability and internal consistency of the Yoruba version of the SF-36 are adequate and it is recommended for measuring health-related quality of life among Yoruba population.

[Pharmacoeconomics in uro-oncology: the concept of QALYs]

The QALY (quality-adjusted life year) is often used in pharmacoeconomic evaluations. It combines the two dimensions 'quality of life' and 'life expectancy' into one index. Quality of life is expressed as a utility, corresponding to a value between 0 (death) and 1 (perfect health). Life expectancy is then multiplied by the utility corresponding to the quality of life of the respective life time. Accordingly, 1 QALY corresponds to 1 year in perfect health (1 year multiplied by utility 1) or 2 years with a quality of life reduced by 50% (2 years multiplied by utility 0.5). Results of pharmacoeconomic evaluations are often reported as additional costs in relation to the added value of a new treatment, expressed as cost per additional QALY gained for the patient with the new therapeutic intervention. The main advantage of the QALY concept is its validity for all patients and indications. And the use of benefit measures which are not restricted to a specific indication is most important for resource allocation, i.e. to avoid that varying amounts of money are paid for the same health benefit in different disease areas.

Health related quality of life among adolescents with sickle cell disease in Saudi Arabia

INTRODUCTION

Increased life expectancy due to recent medical advances has increased the need to understand more fully the quality of life (QoL) in patients with sickle cell disease (SCD) and factors predicting disease adaptation .The objectives of this study were to assess the impairment of health related quality of life (HRQoL) domains in a sample of Saudi Arabian adolescents with SCD.

METHODS

A non-probability sample composed of Saudi adolescents with SCD (n=180) aged 14-18 years and comparable age and gender matched healthy controls (n=202). Socio-demographics and disease related data were obtained through personal interview with parents/legal guardians and reviewing patients' medical records. Self-administered 'Short Form-36' questionnaire was used to assess HRQoL of the included groups.

RESULTS

HRQoL showed significant deterioration in adolescents with SCD especially in role physical, general health, and bodily pain domains irrespective of the gender, while female adolescents with SCD demonstrated significant deterioration in emotional wellbeing. Those with SCD-complications showed worse scores along the physical, general health, and emotional wellbeing domains. HRQol scores were negatively associated with increasing age, female gender, rural residence, low family income, presence of disease-related complications and frequent hospital admissions as revealed by multivariate regression analysis.

CONCLUSION

Saudi adolescents with SCD experience deterioration along all domains of HRQoL especially the physical. Disease related complications and sociodemographic correlates are significant determinants to worse HRQoL among the included adolescents with SCD.

The health-related quality of life of patients with chronic obstructive pulmonary disease and asthma evaluated by the SGRQ

AIMS

To compare the effects of asthma and chronic obstructive pulmonary disease (COPD) on the quality of life of patients evaluated using the Saint George Respiratory Questionnaire (SGRQ) through correlating the variables, domains and total score.

METHODS

A cross-sectional study from October 2008 to March 2009 with 75 adult outpatients at the University Hospital of Salamanca, Spain. Patients provided their clinical and socio-demographical data after being informed of the study's aims and ethical aspects. The Spanish version of the SGRQ and the statistical packa ge Statistics SPSS version 17.0 were used for statistical analysis.

RESULTS

65.3% were male and 34.7% female with mean age 60.4 years. 68% had a diagnosis of asthma and 30.7% COPD. Statistically significant differences (p<0.05) between diagnosis and the 'activity' domain were found. None were found between gender, smoking, ex-smoking or hypertension and the domains. The income levels were inversely related (p=0.038) with the total score. Statistically significant differences between age and the 'activity' (p<0.01) and 'impact' (p<0.05) domains and the SGRQ total score were found (p<0.01). The forced expiratory volume in one second (FEV1%pred) only correlated with the 'activity' domain (p<0.01) and with the total score (p<0.01).

CONCLUSIONS

No variable correlated with all domains and the total score of the instrument. Some presented no statistically significant difference.