Correlates of a Single-Item Quality-of-Life Measure in People Aging with Disabilities

Hilary C Siebens, Dmitry Tsukerman, Rodney H Adkins, Jason Kahan, Bryan Kemp, Hilary C Siebens, Dmitry Tsukerman, Rodney H Adkins, Jason Kahan, Bryan Kemp

Abstract

Objective: Practical quality-of-life (QOL) screening methods are needed to help focus clinical decision-making on what matters to individuals with disabilities.

Design: A secondary analysis of a database from a large study of adults aging with impairments focused on four diagnostic groups: cerebral palsy (n = 134), polio (n = 321), rheumatoid arthritis (n = 99), and stroke (n = 82). Approximately 20% of cases were repeated measures of the same individuals 3-5 yrs later. Functional levels, depression, and social interactions were assessed. The single-item, subjective, seven-point Kemp Quality of Life Scale measured QOL. For each diagnostic group, Kemp Quality of Life Scale responses were divided into low, average, and high QOL subgroups. Analysis of variance and Tukey honestly significant difference tests compared clinical characteristics among these subgroups.

Results: Duration of disability varied among the four groups. Within each group, QOL subgroups were similar in age, sex, and duration of disability. Low mean QOL was associated with lower functional level, higher depression scores, and lower social interaction (P < 0.001) in all four groups. In contrast, high mean QOL was associated with higher social interaction (P < 0.001).

Conclusion: The Kemp Quality of Life Scale relates significantly to clinically relevant variables in adults with impairments. The scale's utility in direct clinical care merits further examination.

Figures

FIGURE 1
FIGURE 1
Likert scale with anchors for response to KQOL.

References

    1. Esselman P, Berbrayer D, Friedly J, et al. Chronic care education in medical schools—A focus on functional health and quality of life. Am J Phys Med Rehabil 2009; 88: 798– 804
    1. Kirshner KL, Curry RH: Educating health care professionals to care for patients with disabilities. JAMA 2009; 302: 1334– 5
    1. Andrews FM, Withey SB: Social Indicators of Well-Being—Americans’ Perception of Life Quality. New York, Plenum, 1976, pp. 455
    1. Dijkers MP: Individualization in quality of life measurement: Instruments and approaches. Arch Phys Med Rehabil 2003; 84: S3– 14
    1. Higginson IJ, Carr AJ: Using quality of life measures in the clinical setting. BMJ 2001; 322: 1297– 300
    1. Gill TM, Feinstein AR: A critical appraisal of the quality of quality-of-life measurements. JAMA 1994; 272: 619– 26
    1. World Health Organization: Quality of Life Assessment—An Annotated Bibliography. Geneva, Switzerland, Division of Mental Health, World Health Organization, 1994
    1. McDowell I, Newell C: Measuring Health—A Guide to Rating Scales and Questionnaires, 2nd ed New York, NY, Oxford University Press, 1996, pp. 1– 523
    1. The WHOQOL Group: The World Health Organization Quality of Life Assessment (WHOQOL): Position Paper from the World Health Organization. Soc Sci Med 1995; 41: 1403– 9
    1. O’Boyle CA, McGee H, Hickey A, et al. Individual quality of life in patients undergoing hip replacement. Lancet 1992; 339: 1088– 91
    1. Carr AJ, Higginson IJ: Are quality of life measures patient centred? BMJ 2001; 322: 1357– 60
    1. Carr AJ, Bison B, Robinson PG: Measuring quality of life—Is quality of life determined by expectations or experience? BMJ 2001; 322: 1240– 3
    1. Schwartz CE: Applications of response shift theory and methods to participation measurement: A brief history of a young field. Arch Phys Med Rehabil 2010; 91: S38– 43
    1. Slevin ML, Plan H, Lynch D, et al. Who should measure quality of life, the doctor or the patient? Br J Cancer 1988; 57: 109– 12
    1. Rothwell PM, McDowell Z, Wong CK, et al. Doctors and patients don’t agree: Cross sectional study of patients’ and doctors’ perceptions and assessments of disability in multiple sclerosis. BMJ 1997; 314: 1580– 3
    1. Sneeuw KCA, Aaronson NK, Sprangers MAG, et al. Comparison of patient and proxy EORTC QLQ-C30 ratings in assessing the quality of life of cancer patients. J Clin Epidemiol 1998; 51: 617– 31
    1. Addington-Hall J, Kalra L: Who should measure quality of life? BMJ 2001; 322: 1417– 20
    1. Stineman MG, Ross RN, Maislin G, et al. Recovery preference exploration: Analysis of patient feedback after imagined scenarios. Am J Phys Med Rehabil 2007; 86: 272– 81
    1. Ruta DA, Garratt AM, Leng M, et al. A new approach to the measurement of quality of life—The Patient-Generated Index. Med Care 1994; 32: 1109– 26
    1. Albrecht GL, Devlieger PJ: The disability paradox: High quality of life against all odds. Soc Sci Med 1999; 48: 977– 88
    1. Hallan S, Åsberg A, Indredavik B, et al. Quality of life after cerebrovascular stroke: A systematic study of patients’ preferences for different functional outcomes. J Intern Med 1999; 246: 309– 16
    1. Vincent KA, Carr AJ, Walburn J, et al. Construction and validation of quality of life questionnaire for neuromuscular disease (INQoL). Neurology 2007; 68: 1051– 7
    1. Ware JE, Sherbourne CD: The MOST 36-item Short Form Health Survey (SF-36): Conceptual framework and item selection. Med Care 1992; 30: 473– 83
    1. Saxena S, Carlson D, Billington R, et al. The WHO quality of life assessment instrument (WHOQOL-Bref): The importance of its items for cross-cultural research. Qual Life Res 2001; 10: 711– 21
    1. Pomeroy IM, Tennant A, Young CA: Rasch analysis of the WHOQOL-BREF in post polio syndrome. J Rehabil Med 2013; 45: 873– 80
    1. Hays RD, Hahn H, Marshall G: Use of the SF-36 and other health-related quality of life measures to assess persons with disabilities. Arch Phys Med Rehabil 2002; 83: S4– 9
    1. Dijkers MP: Quality of life in individuals with spinal cord injury: A review of conceptualization, measurement, and research findings. J Rehabil Res Dev 2005; 42: 87– 110
    1. Jang Y, Hsieh C-l, Wang Y-H, et al. A validity study of the WHOQOL-BREF assessment in persons with traumatic spinal cord injury. Arch Phys Med Rehabil 2004; 85: 1890– 5
    1. Kemp B, Ettelson D: Quality of Life while living and aging with a spinal cord injury and other impairments. Top Spinal Cord Inj Rehabil 2001; 6: 116– 27
    1. Kemp B: Quality of life, coping, and depression, in Kemp B, Mosqueda L. (eds): Aging with a Disability. Baltimore, MD, Johns Hopkins University Press, 2004. 307 pp., see pp. 48–67
    1. Kemp BJ, Bateham AL: The role of distress and social involvement in quality of life among people with spinal cord injury. Top Spinal Cord Inj Rehabil 2010; 16: 72– 80
    1. Kemp B: Quality of Life: What it Really Requires; How to Get It and Keep It. 2012. . pp. 1–262. See also Accessed October 8, 2013
    1. Kemp B: Rehabilitation Research and Training Center on Aging with Physical Impairments. Final Report. Downey, CA, Rancho Los Amigos National Rehabilitation Center, University of Southern California, Los Amigos Research & Education Institute, Inc, 2010, pp. 1– 248
    1. Fillenbaum GG: Chapter 7—Administration of the OARS Multidimensional Functional Assessment Questionnaire, in Multidimensional Functional Assessment of Older Adults. Hillsdale, NJ, Lawrence Erlbaum, 1988;179 pp., see pp. 61–82
    1. Kemp BJ, Adams BM: The Older Adult Health and Mood Questionnaire: A measure of geriatric depressive disorder. J Geriatr Psychiatry Neurol 1995; 8: 162– 7
    1. Kahan JS, Mitchell JM, Kemp BJ, et al. The results of a 6-month treatment for depression on symptoms, life satisfaction, and community activities among individuals aging with a disability. Rehabil Psychol 2006; 31: 13– 22
    1. Kahan J, Kemp B, Bateham D, et al. The Social Interaction Inventory: Development, reliability, and validity, in Kemp B, Adkins RH, Mitchell J, et al. (eds): Final Report of the Rehabilitation Research and Training Center on Aging with Physical Impairments 2010. Retrieved from Los Amigos Research and Education Institute, Inc pp. 194– 214
    1. Kemp B, Tsukerman D, Kahan J, et al. Predicting psychosocial outcomes using a brief measure of quality of life in a sample of people with spinal cord injury. Top Spinal Cord Inj Rehabil 2014; 20: 191– 6
    1. Skevington SM: Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL. Pain 1998; 76: 395– 406
    1. Abresch RT, Carter GT, Jensen MP, et al. Assessment of pain and health-related quality of life in slowly progressive neuromuscular disease. Am J Hosp Palliat Care 2002; 19: 39– 48
    1. Daly EJ, Trivedi MH, Wisniewski SR, et al. Health-related quality of life in depression: A STAR*D report. Ann Clin Psychiatry 2010; 22: 43– 55
    1. Gutierrez DD, Thompson L, Kemp B, et al. The relationship of shoulder pain intensity to quality of life, physical activity, and community participation in persons with paraplegia. J Spinal Cord Med 2007; 30: 251– 5
    1. Mulroy SJ, Thompson L, Kemp B, et al. Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: A randomized controlled trial. Phys Ther 2011; 91: 305– 24
    1. Detmar SB, Muller MJ, Schornagel JH, et al. Health-related quality of life assessments and patient-physician communication: A randomized control trial. JAMA 2002; 288: 3027– 34
    1. Breek JC, de Vries J, van Heck GL, et al. Assessment of disease impact in patients with intermittent claudication: Discrepancy between health status and quality of life. J Vasc Surg 2005; 41: 443– 50
    1. Kahneman D: Thinking, Fast and Slow. New York, Farrar, Straus and Giroux, 2011, pp. 1– 499 p. 399

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel