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Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss.

ABSTRACT: Self-reports of 'hearing handicap' are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL.The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews.The 73-item field-test instrument was completed by 409 adults (22-91 years old) with varying degrees of AOHL and from different areas of the USA.Multitrait scaling analysis supported four multi-item scales and five individual items. Internal consistency reliabilities ranged from 0.93 to 0.96 for the scales. Construct validity was supported by correlations between the IHEAR-IT scales and scores on the 36-item Short Form Health Survey, version 2.0 (SF-36v2) mental composite summary (r?=?0.32-0.64) and the Hearing Handicap Inventory for the Elderly/Adults (HHIE/HHIA) (r???-0.70).The field test provides initial support for the reliability and construct validity of the IHEAR-IT for evaluating HRQOL of individuals with AOHL. Further research is needed to evaluate the responsiveness to change of the IHEAR-IT scales and identify items for a short-form.

SUBMITTER: Stika CJ

PROVIDER: S-EPMC5005284 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss.

Stika Carren J CJ Hays Ron D RD

International journal of audiology 20150701 7

<h4>Objective</h4>Self-reports of 'hearing handicap' are available, but a comprehensive measure of health-related quality of life (HRQOL) for individuals with adult-onset hearing loss (AOHL) does not exist. Our objective was to develop and evaluate a multidimensional HRQOL instrument for individuals with AOHL.<h4>Design</h4>The Impact of Hearing Loss Inventory Tool (IHEAR-IT) was developed using results of focus groups, a literature review, advisory expert panel input, and cognitive interviews.< ...[more]

PMID: 27104754

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Project description:BackgroundWomen diagnosed with early stage (I or II) breast cancer face a highly challenging decision - whether or not to undergo adjuvant chemotherapy. We developed a decision quality instrument for chemotherapy for early stage breast cancer and sought to evaluate its performance.MethodsCross-sectional, mailed survey of recent breast cancer survivors, providers, and healthy controls and a retest survey of survivors. The decision quality instrument includes questions on knowledge and personal goals. It results in a knowledge score and concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, validity, and reliability of the survey instrument were examined.ResultsResponses were received from 352 patients, 89 providers and 35 healthy controls. The decision quality instrument was feasible to implement with few missing data. The knowledge scores had good retest reliability (intraclass correlation coefficient (ICC) =0.75). Knowledge scores discriminated between providers and patients (mean difference 31.1%, 95% CI 26.9, 35.3) and between patients and healthy controls (mean difference 11.2, 95% CI 5.4, 17.1). Most providers reported that the knowledge items covered essential content. Two of the five goal items had a ceiling effect, and one goal had low content validity. The goal items had moderate retest reliability (ICC's 0.57 to 0.78). In the multivariable model of treatment, none of the patient goals was associated with receipt of chemotherapy. Age and hormone receptor status were the only variables independently associated with chemotherapy. Most patients (77.6%) had treatment concordant with that predicted by the model. Patients who had concordant treatment had similar levels of confidence and regret as those who did not.ConclusionsThe Decision Quality Instrument is a reliable and valid measure of patient knowledge about chemotherapy, but its ability to measure concordance with patient goals is limited. In this sample, patient goals were not associated with treatment, and most patients reported they were not asked their preference, suggesting that goals were not adequately considered in decision making.

Project description:IntroductionPressure ulcer-specific patient-reported outcome (PRO) instruments should be used to inform patient care and provide a strong evidence base for interventions aimed at preventing pressure ulcers. The aim was to carry out a comprehensive evaluation of the psychometric properties of a PRO instrument designed to assess symptoms and functional outcomes in patients at high-risk of developing pressure ulcers, the PU-QOL-P instrument.MethodsWe modified the original PU-QOL instrument to be suitable for patients at high risk of pressure ulcer development based on feedback from patients, specialist nurses and PRO methodologists. The modified PU-QOL-P instrument was administered to a sub-set of patients participating in the PRESSURE 2 trial. Patients completed PU-QOL-P and SF12 instruments at baseline, weeks 1 and 3, and 30 days post-treatment. We undertook psychometric evaluation of the modified PU-QOL-P to test scale targeting, scaling assumptions, reliability, validity and responsiveness.ResultsThe analysis sample consisted of 617 patients that completed both instruments at baseline. We found that the PU-QOL-P instrument, consisting of nine PU-specific outcomes: three symptom and six function scales, meets established criteria for reliability, construct validity, and responsiveness. Internal consistency reliability was high with all scale Cronbach alpha > 0.795 (range 0.795-0.970). The factor analysis mostly supported the six-function scale structure. Scaling assumptions were satisfied; all item-total correlations above 0.30. Convergent validity was confirmed by significant correlations between hypothesized scales as expected. PU-QOL-P scales were responsive to change: mean scale scores from baseline to 30 days post-treatment were statistically significant for all scales apart the daily activities scale (effect sizes ranged from moderate to high). As expected, worse symptoms and functioning was observed in patients who had a category 1 or 2 PU compared to patients who did not have a PU.ConclusionsThe PU-QOL-P provides a standardised method for assessing pressure ulcer-specific symptoms and functional outcomes for quantifying the benefits of associated interventions from the patient's perspective. It can be used in research with adults at risk of pressure ulcer development in all UK healthcare settings.

Project description:ImportanceUtility is a single-value, preference-based measure of health-related quality of life that represents the desirability of a health state relative to being dead or in perfect health. Clinical, funding, and policy decisions rely on measured changes in utility. The benefit of hearing loss treatments may be underestimated because existing utility measures fail to capture important changes in quality of life associated with hearing loss.ObjectiveTo develop a comprehensive profile of items that describe how quality of life is associated with hearing loss and its treatments that can be used to generate hearing-related quality of life measures, including a novel utility measure.Design, setting, and participantsThis qualitative study, performed from August 1, 2018, to August 1, 2019, in tertiary referral centers, comprised a systematic literature review, focus groups, and semistructured interviews. The systematic review evaluated studies published from 1982 to August 1, 2018. Focus groups included 8 clinical experts experienced in the measurement, diagnosis, treatment, and rehabilitation of hearing loss. Semistructured interviews included 26 adults with hearing loss recruited from an institutional data set and outpatient hearing aid and otology clinics using stratified convenience sampling to include individuals of diverse ages, urban and rural residency, causes of hearing loss, severity of hearing loss, and treatment experience.Main outcomes and measuresA set of items and subdomains that collectively describe the association of hearing loss with health-related quality of life.ResultsThe literature search yielded 2779 articles from the MEDLINE, Embase, Cochrane, PsycINFO, and CINAHL databases. Forty-five studies including 1036 individuals (age range, 18-84 years) were included. The focus group included 4 audiologists and 4 otologists. Hour-long semistructured interviews were conducted with 26 individuals (13 women; median age, 54 years; range, 25-83 years) with a broad range of hearing loss causes, configurations, and severities. From all 3 sources, a total of 125 items were generated and organized into 29 subdomains derived from the World Health Organization's International Classification of Functioning, Disability and Health.Conclusions and relevanceThe association of hearing loss with quality of life is multidimensional and includes subdomains that are not considered in the estimation of health utility by existing utility measures. The presented comprehensive profile of items can be used to generate or evaluate measures of hearing-related quality of life, including utility measures.

Project description:BackgroundA high quality treatment decision means patients are informed and receive treatment that matches their goals. This research examined the reliability and validity of the Depression Decision Quality Instrument (DQI), a survey to measure the extent to which patients are informed and received preferred treatment for depression.MethodsParticipants were aged 18 and older from 17 US cities who discussed medication or counseling with a physician in the past year, and physicians who treated patients with depression who practiced in the same cities. Participants were mailed a survey that included the Depression-DQI, a tool with 10 knowledge and 7 goal and concern items. Patients were randomly assigned to either receive a patient decision aid (DA) on treatment of depression or no DA. A matching score was created by comparing the patient's preferred treatment to their self-reported treatment received. Concordant scores were considered matched, discordant were not. We examined the reliability and known group validity of the Depression-DQI.ResultsMost patients 405/504 (80%) responded, 79% (320/405) returned the retest survey, and 60% (114/187) of physicians returned the survey. Patients' knowledge scores on the 10-item scale ranged from 14.6 to 100% with no evidence of floor or ceiling effects. Retest reliability for knowledge was moderate and for goals and concerns ranged from moderate to good. Mean knowledge scores differentiated between patients and physicians (M = 63 [SD = 15] vs. M = 81 [SD = 11], p < 0.001), and between patients who did and didn't receive a DA (M = 64 [SD = 16] vs. M = 61 [SD = 14], p = 0.041). 60.5% of participants received treatment that matched their preference. Based on the multivariate logistic regression, 'avoiding taking anti-depressants' was the only goal that was predictive of taking mediation (OR = 0.73 [0.66, 0.80], p < 0.01). Shared Decision Making Process scores were similar for those who matched their preference and those who didn't (M = 2.18 [SD = 0.97] vs. M = 2.06 [SD = 1.07]; t(320) = - 1.06, p = 0.29). Those who matched had lower regret scores (matched M = 1.72 [SD = 0.74] vs. unmatched M = 2.32 [SD = 0.8]; t(301) = - 6.6, p < .001).ConclusionsThe Depression DQI demonstrated modest reliability and validity. More work is needed to establish validity of the method to determine concordance.Trial registrationNCT01152307.

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Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss.

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Development and psychometric evaluation of a health-related quality of life instrument for individuals with adult-onset hearing loss.

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