The HPQ-Development and First Administration of a Questionnaire for Hypoparathyroid Patients

Deborah Wilde, Lara Wilken, Bettina Stamm, Martina Blaschke, Christina Heppner, Mira-Lynn Chavanon, Andreas Leha, Christoph Herrmann-Lingen, Heide Siggelkow, Deborah Wilde, Lara Wilken, Bettina Stamm, Martina Blaschke, Christina Heppner, Mira-Lynn Chavanon, Andreas Leha, Christoph Herrmann-Lingen, Heide Siggelkow

Abstract

Hypoparathyroidism patients suffer a variety of complaints often leading to reduced quality of life. Currently, no specific standard instrument exists to measure corresponding disease manifestations. We therefore aimed to develop a disease-characteristic questionnaire for hypoparathyroid patients. We used an analytical-empirical approach for questionnaire construction based on retrospective analysis of four well-established but non-disease-specific questionnaires (Symptom Checklist 90, revised [SCL-90-R]; Giessen Complaint List [GBB]; Short-Form-36 Health Survey [SF-36]; von Zerssen Symptom List [B-L Zerssen]) and two additional unpublished or local questionnaires (SHGdQ and GPQ) in a German hypoparathyroidism self-help group (n = 60). Retrospective data were compared with corresponding general population norms. The new questionnaire was administered prospectively over 1 year to patients with postoperative hypoparathyroidism and two control groups to validate specificity. Exploratory factor analysis (EFA) and reliability testing were applied to identify relevant scales and reduce overlapping items. In the self-help group, SCL-90-R revealed elevated symptom load in four complaint areas (p = 0.003 to p < 0.001). The SF-36 mental summary score (p < 0.001) and further scales were lowered. In the GBB, four of five scales (p = 0.009 to p < 0.001) were elevated. In the B-L Zerssen, 6 of 24 items revealed complaint areas. Based on these findings, the new 40-item "Hypoparathyroid Patient Questionnaire" (HPQ 40) was developed, tested prospectively, and further analyzed. EFA revealed five scales (pain and cramps, gastrointestinal symptoms, depression and anxiety, neurovegetative symptoms, loss of vitality), all with Cronbach's alpha >0.7. The questionnaire was revised accordingly and shortened to 28 questions to avoid redundancy. We present a new disease-characteristic questionnaire for hypoparathyroidism patients. Prospective testing revealed five major complaint areas and promising psychometric properties. This questionnaire can be tested for usefulness in further clinical trials. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Keywords: HYPOPARATHYROIDISM; QUALITY OF LIFE; QUESTIONNAIRE; SYMPTOM SCALE.

© 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Figures

Figure 1
Figure 1
Summary of the study design. Retrospective part with analysis of six questionnaires in total (SCL‐90‐R, GBB, B‐L Zerssen, GPQ, SF‐36, self‐help‐group‐derived questionnaire [SHGdQ]), development and prospective testing of the HPQ 40, and revision to HPQ 28.
Figure 2
Figure 2
Scores of the SCL‐90‐R scales (somatization, obsessive–compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism) and the global severity index (GSI) of the self‐help group in 2013 in comparison with the general population norms. *Significant difference (p < 0.05).
Figure 3
Figure 3
Scores of the GBB scales (exhaustion tendency, gastric symptoms, pain in the limbs, heart complaints) and global score of discomfort (GSD) for patients of the self‐help group in 2013 in comparison with the general population norms. *Significant difference (p < 0.05).
Figure 4
Figure 4
Scores of the SF‐36 scales (physical functioning, physical role functioning, bodily pain, general health perception, vitality, social functioning, emotional role functioning, mental health) of the self‐help group in 2015 in comparison with the general population norms. *Significant difference (p < 0.05).

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