A Finnish Version of RAND-36-Item Health Survey Versus Structured Interview 8 Years Postoperatively.
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ABSTRACT: Background/aim
The aim was to assess the 8-year health status after minicholecystectomy (MC) versus laparoscopic cholecystectomy (LC) for gallstone disease (GS) by using the RAND-36 Health Survey.Patients and methods
Initially, 88 patients with symptomatic GS disease were randomized to undergo either MC (n=44) or LC (n=44). RAND-36 survey was performed 8 years postoperatively.Results
In three RAND-36 domains (social functioning, role physical, role emotional) MC procedure was significantly better than LC. In MC patients, the 8-year postoperative scores of social functioning (p<0.001), role physical (p=0.002) and role emotional (p<0.001) were significantly higher than the age- and gender -adjusted Finnish reference scores.Conclusion
The Finnish version of the RAND-36 survey can be used as a valid and reliable method for measuring the quality of life and long-term outcome of cholecystectomy patients following surgery.
SUBMITTER: Saimanen I
PROVIDER: S-EPMC8045101 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe translated and culturally adapted German version of the Veterans Rand 36 Items Health Survey (VR-36), and its short form, the VR-12 counterpart, were validated in a German sample of orthopedic (n = 399) and psychosomatic (n = 292) inpatient rehabilitation patients.MethodsThe instruments were analyzed regarding their acceptance, distributional properties, validity, responsiveness and ability to discriminate between groups by age, sex and clinically specific groups. Eligible study participants completed the VR-36 (n = 169) and the VR-12 (n = 177). They also completed validated patient-reported outcome measures (PROs) including the Euroqol-5 Dimensions 5 Level (EQ-5D-5L); Depression, Anxiety and Stress Scale (DASS); Hannover Functional Abilities Questionnaire (HFAQ); and CDC Healthy Days. The VR-12 and the VR-36 were compared to the reference instruments MOS Short Form-12 Items Health Survey (SF-12) version 1.0 and MOS Short Form-36 Items Health Survey (SF-36) version 1.0, using percent of completed items, distributional properties, correlation patterns, distribution measures of known groups validity, and effect size measures.ResultsItem non-response varied between 1.8%/1.1% (SFVR-36/RESF-36) and 6.5%/8.6% (GHVR-36/GHSF-36). PCS was normally distributed (Kolmogorov-Smirnov tests: p > 0.05) with means, standard deviations and ranges very similar between SF-36 (37.5 ± 11.7 [13.8-66.1]) and VR-36 (38.5 ± 10.1 [11.7-67.8]), SF-12 (36.9 ± 10.9 [15.5-61.6]) and VR-12 (36.2 ± 11.5 [12.7-59.3]). MCS was not normally distributed with slightly differing means and ranges between the instruments (MCSVR-36: 36.2 ± 14.2 [12.9-66.6], MCSSF-36: 39.0 ± 15.6 [2.0-73.2], MCSVR-12: 37.2 ± 13.8 [8.4-70.2], MCSSF-12: 39.0 ± 12.3 [17.6-65.4]). Construct validity was established by comparing correlation patterns of the MCSVR and PCSVR with measures of physical and mental health. For both PCSVR and MCSVR there were moderate (≥ 0.3) to high (≥ 0.5) correlations with convergent (PCSVR: 0.55-0.76, MCSVR: 0.60-0.78) and small correlations (< 0.1) with divergent (PCSVR: < 0.12, MCSVR: < 0.16) self-report measures. Known-groups validity was demonstrated for both VR-12 and VR-36 (MCS and PCS) via comparisons of distribution parameters with significant higher mean PCS and MCS scores in both VR instruments found in younger patients with fewer sick days in the last year and a shorter duration of rehabilitation.ConclusionsThe psychometric analysis confirmed that the German VR is a valid and reliable instrument for use in orthopedic and psychosomatic rehabilitation. Yet further research is needed to evaluate its usefulness in other populations.
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Project description:Background/aimNational healthcare organizers require feedback from patients to improve medical treatment methods. Three-dimensional laparoscopy cholecystectomy (3D-LC) is a modern technique in surgery. However, there are no studies with patient feedback from validated questionnaires assessing the postoperative treatment results in 3D-LC.Patients and methodsInitially 200 patients with symptomatic cholelithiasis were randomized into 3D-LC or mini-laparotomy cholecystectomy (MC) groups. RAND-36-Item Health Survey was performed preoperatively and 4 weeks following surgery relating the survey scores between the 3D-LC and MC groups.ResultsSimilar postoperative RAND-36 scores were reported for both groups preoperatively and at 4 weeks following surgery, and no significant differences in RAND-36 domains were shown. When the patients in both study groups were combined, Mental Health (p<0.001), Bodily Pain (p=0.01) and General Health (p=0.016) domain scores were significantly higher, indicating a significantly positive change in quality of life 4 weeks postoperatively, while those for the Role-Physical domain were significantly lower, indicating reduced physical activity during the 4 weeks following surgery. In comparison to the Finnish reference RAND-36 scores, scores at 4 weeks were significantly higher for the Mental Health domain (MC group, p<0.001 and 3D-LC group, p=0.001) whilst scores were significantly lower in four other domains: Physical Functioning, Social Functioning, Bodily Pain and Role-Physical.ConclusionThis study shows, for the first time using the RAND-36-Item Health Survey, relatively similar short-term outcomes in patients 4 weeks following cholecystectomy by 3D-LC and MC. Although scores for three RAND-36 domains were significantly higher postoperatively, indicating a significantly positive change in quality of life, a longer follow-up after cholecystectomy is needed for final conclusions to be drawn.
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Project description:BackgroundThis study aims to evaluate data quality, scaling properties, and reliability of the Swedish RAND-36 in a general population sample and to present reference data for the Swedish population.MethodsTesting of data quality, scaling assumptions and reliability followed methods recommended for the International Quality of Life Assessment Project, previously used for psychometric testing of SF-36 and RAND-36. Data were collected via regular mail for a random stratified sample of the general population in a Swedish county. Weighted means for RAND-36 scores were used and differences by sex, age, education, and occupational groups were tested.ResultsThe response rate was 42%, and the sample comprised 3432 persons (45% men, 55% women) with a median age of 56.9 years. The internal consistency reliability was satisfactory, with Cronbach's alphas > 0.80 for all eight scales. The percentage of missing items was low, ranging between 1.3% and 3.2%. No floor effects (≥15%) were noted, while ceiling effects were observed for physical functioning, role-functioning/physical, pain, role-functioning/emotional, and social functioning. Item-scale correlations were satisfactory (r ≥ 0.40). Correlations among the physical health scales were strong (range 0.58-0.68) as were the correlations among the mental health scales (range 0.58-0.73). Men reported significantly better health-related quality of life (HRQoL) on all scales, although the gender differences were small. Comparisons among age groups showed approximately equal scores among those 20-29, 30-39, and 40-49 years, while significant decreases in physical health were observed in the older age groups. Substantially worse physical health scores were observed in the oldest age group (80+). Significant differences among age groups were noted also for the mental health scales; however, better energy/fatigue and emotional well-being scores were seen in the older age groups, except for the oldest (80+). Those with university education reported significantly better scores on all scales compared to those with mandatory education.ConclusionsThe study suggests that the Swedish version of RAND-36 is an acceptable and reliable instrument for measuring HRQoL in the general population. The study provides reference data that can be used for norm-based comparisons.
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Project description:BackgroundThe Veterans RAND 12-Item Health Survey (VR-12) is a generic patient-reported outcome measure derived from the widely used 36- and 12-item Short Form Health Surveys. We aimed to estimate a Canadian preference-based scoring algorithm for the VR-12, enabling the derivation of health utility values for generating quality-adjusted life years (QALYs).MethodsWe conducted a discrete-choice experiment in a sample of the Canadian population in January and February 2019. Participants - recruited from a consumer research panel - completed an online survey, in English or French, that included 11 discrete-choice questions, each comprising 2 health profiles. We defined the health profiles using 8 VR-12 items and a duration attribute. Using conditional logit regressions, where each level of the respective VR-12 items was interacted with duration, we applied the coefficients to estimate health utility values interpretable on a scale of 0 (dead) to 1 (full health). Negative values reflect states considered worse than dead.ResultsA total of 3380 individuals completed the survey. Of these, 1688 (49.9%) were females, and 3101 (91.7%) completed the English version of the survey. Across all models, "feel downhearted and blue all of the time" and "pain interferes with your normal work extremely" were associated with the largest decrements in health utility. Excluding the 685 respondents (20.3%) who provided inconsistent responses had a negligible effect on the results. The recommended model, weighted to match population demographics, had health utility values ranging from -0.589 to 1.000.InterpretationHealth utility values that reflect the preferences of the Canadian population can now be derived from responses to the VR-12. These values can be used to generate QALYs in future analyses.
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Project description:OBJECTIVES:To compare the value of clinically measured gait speed with that of the self-reported Medical Outcomes Study 36-item Short-Form Survey Physical Function Index (SF-36 PF) in predicting future preclinical mobility disability (PCMD) in older women. DESIGN:Prospective cohort study. SETTING:Forty clinical centers in the United States. PARTICIPANTS:Women aged 65 to 79 enrolled in the Women's Health Initiative Clinical Trials with gait speed and SF-36 assessed at baseline (1993-1998) and follow-up Years 1, 3, and 6 (N = 3,587). MEASUREMENTS:Women were categorized as nondecliners or decliners based on changes (from baseline to Year 1) in gait speed and SF-36 PF scores. Logistic regression models were used to estimate incident PCMD (gait speed <1.0 m/s) at Years 3 and 6. Area under the receiver operating characteristic curve (AUC) was used to compare the predictive value of SF-36 PF with that of measured gait speed. RESULTS:Slower baseline gait speed and lower SF-36 PF scores were associated with higher adjusted odds of PCMD at Years 3 and 6 (all P < .001). For gait speed, decliners were 2.59 times as likely to have developed PCMD as nondecliners by Year 3 and 2.35 times as likely by Year 6. Likewise, for SF-36, decliners were 1.42 times as likely to have developed PCMD by Year 3 and 1.49 times as likely by Year 6. Baseline gait speed (AUC = 0.713) was nonsignificantly better than SF-36 (AUC = 0.705) at predicting PCMD over 6 years (P = .21); including measures at a second time point significantly improved model discrimination for predicting PCMD (all P < .001). CONCLUSION:Gait speed identified PCMD risk in older women better than the SF-36 PF did, although the results may be limited given that gait speed served as a predictor and to define the PCMD outcome. Nonetheless, monitoring trajectories of change in mobility are better predictors of future mobility disability than single measures.
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Project description:BackgroundAn observer-rated questionnaire for alexithymia based on the original 17-item Beth Israel Hospital Psychosomatic Questionnaire for Alexithymia (BIQ) was developed by Sifneos in 1973 and modified into a 12-item version of BIQ by Taylor et al. in 1997. However, it has rarely been used in a clinical or research context and studies have not given satisfactory inter-rater reliability for the 12-item version.ObjectiveTo develop a structured interview in Japanese for the12-item modified version of BIQ (m-SIBIQ) to determine the reliability and validity of the m- scores and its factor structure model.MethodsNinety-two Japanese young adults were interviewed. The inter-rater reliability of the m-SIBIQ was assessed by exploratory factor analysis. For the concurrent and convergent validities, correlation analysis was done between the scores of m-SIBIQ and the self-reported questionnaires: 20-Item Toronto Alexithymia Scale (TAS-20), NEO Five-Factor Inventory (NEO-FFI), Emotional Empathy Scale (EES), Interpersonal Reactivity Index (IRI), Beck Depression Inventory-II (BDI-II), and State-Trait Anxiety Inventory (STAI). Goodness of fit of the structure model of the m-SIBIQ was evaluated using confirmatory factor analysis, and the results were examined through stepwise multiple regression analysis.ResultsGood reliability was obtained for the total score of m-SIBIQ: Cronbach's α.950 (p<.001) and ICC.75(p<.05). The validity of the factor structure was obtained by confirmatory factor analysis using covariance. The model of the alexithymia constructs was configured by the operative thinking (la pensée opératoire) and affect awareness components. The stepwise multiple regression analysis extracted the total score of m-SIBIQ as significantly, negatively correlated with the Openness to experience score of NEO-FFI and significantly, positively correlated with the emotionally chilly score of EES and the score of difficulty describing feelings (DDF) of TAS-20. There were no correlations between the m-SIBIQ and BDI-II scores.ConclusionFor Japanese young adults, the m-SIBIQ is a reliable and valid instrument for overcoming weaknesses of the self-reported procedures by bringing to light the alexithymia construct and principal dimensions.
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Project description:BackgroundSatisfaction with the medical interview has been rarely explored in primary care outside the UK, despite evidence suggesting that a trustful doctor-patient relationship is a key ingredient to facilitate treatment adherence and relief from illness-related distress.AimsThe aims of this study are to analyse the construct validity of the Italian version of the Medical Interview Satisfaction Scale (MISS-21) and its correlations with two outcome measures, the Inventory of Depressive Symptomatology - Self-Report and World Health Organization Quality Of Life Brief Version, in patients with mild-to-moderate depression, recruited in primary care practices.MethodThe factor structure underlying the MISS-21 was investigated with principal component analysis, and the internal consistency of the factors was evaluated with Cronbach's alpha. Network analysis was used to investigate the interrelationships among items. The importance of individual items in the network structure was determined with centrality analyses. Correlations of MISS-21 scores with changes in depression and quality of life were analysed with Spearman's correlation coefficient.ResultsThe MISS-21 proved to have a robust four-dimensional factor structure. Cronbach's alpha for the factors ranged from 0.77 to 0.93, suggesting good to excellent internal consistency. The four factors identified were positively correlated with improvement in depressive symptoms and three quality-of-life domains.ConclusionsThe MISS-21 has sound psychometric properties, and comprises four factors related to clinical outcomes, which makes it suitable for clinical and research applications. The central items in the network should be considered as possible targets for quality improvement interventions in primary care.
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Project description:BackgroundThe Kidney Disease Quality of Life 36-item short form survey (KDQOL-36) is a widely used, patient-reported outcome measure for patients on dialysis. Efforts to aid interpretation are needed.MethodsWe used a sample of 58,851 dialysis patients participating in the Medical Education Institute (MEI) KDQOL Complete program, and 443,947 patients from the US Renal Data System (USRDS) to develop the KDQOL-36 Summary Score (KSS) for the kidney-targeted KDQOL-36 scales (Burdens of Kidney Disease [BKD], Symptoms and Problems of Kidney Disease [SPKD], and Effects of Kidney Disease [EKD]). We also used the MEI and USRDS data to calculate normative values for the Short Form-12 Health Survey's Physical Component Summary (PCS) and Mental Component Summary (MCS), and the KDQOL-36's BKD, SPKD, and EKD scales for the United States dialysis population. We used confirmatory factor analysis (CFA) models for KDQOL-36 kidney-targeted items, evaluated model fit with the comparative fit index (CFI; >0.95 indicates good fit) and root-mean-squared error of approximation (RMSEA; <0.06 indicates good fit), and estimated norms by matching the joint distribution of patient characteristics in the MEI sample to those of the USRDS sample.ResultsA bifactor CFA model fit the data well (RMSEA=0.046, CFI=0.990), supporting the KSS (?=0.91). Mean dialysis normative scores were PCS=37.8 and MCS=50.9 (scored on a T-score metric); and KSS=73.0, BKD=52.8, SPKD=79.0, and EKD=74.1 (0-100 possible scores).ConclusionsThe KSS is a reliable summary of the KDQOL-36. The United States KDQOL-36 normative facilitate interpretation and incorporation of patient-related outcome measures into kidney disease care.
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Project description:BackgroundA number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs) to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents.MethodsA face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region.Results16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination.ConclusionWe have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.
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Project description:ObjectiveThe aim of this study was to translate, adapt and validate the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh.DesignCohort study.SettingNarail district, Bangladesh.ParticipantsA random sample of 2425 adults of age 18-90 years was recruited.Outcome measureValidation of the K10 was the major outcome. Sociodemographic factors were measured to assess if the K10 needed adjustment for factors such as age or gender. The Rasch measurement model was used for the validation, and RUMM 2030 and SPSS V.24 software were used for analyses.ResultsInitial inspection of the total sample showed poor overall fit. A sample size of 300, which is more satiated for Rasch analysis, also showed poor overall fit, as indicated by a significant item-trait interaction (χ2= 262.27, df=40, p<0.001) and item fit residual values (mean=-0.25, SD=2.49). Of 10 items, five items were disordered thresholds, and seven items showed misfit, suggesting problems with the response format and items. After removing three items ('feel tired', 'depressed' and 'worthless') and changing the Likert scale categories from five to four categories, the remaining seven items showed ordered threshold. A revised seven-item scale has shown adequate internal consistency, with no evidence of multidimensionality, no differential item functioning on age and gender, and no signs of local dependency.ConclusionsAnalysis of the psychometric validity of K10 using the Rasch model showed that 10 items are not appropriate for measuring psychological distress in rural Bangladesh. A modified version of seven items (K7) with four response categories would provide a psychometrically more robust scale than the original K10. The study findings suggest repeating the K7 version in other remote areas for further validation can substantiate an efficient screening tool for measuring psychological distress among the general Bangladeshi population.
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