Nephrology Dialysis Transplantation, Vol 14, Issue 6 1503-1510, Copyright © 1999 by Oxford University Press
G Mingardi, L Cornalba, E Cortinovis, R Ruggiata, P Mosconi and G Apolone
Background: Interest in measuring health-related
quality of life (HRQoL) has increased together with an awareness that such
humanistic outcomes require valid and reliable measures. In the last decade
short, simple and multidimensional generic and disease-specific
questionnaires have been developed. Among the several generic
questionnaires available, the Short Form 36 Items Health Survey (SF-36) was
translated and validated in several languages, and applied to different
settings and diseases. Methods: Within the framework
of a larger, prospective, multicentre study (DIA-QOL project) the SF-36 was
administered to 304 patients to test its characteristics in terms of
patient acceptability, and psychometric and clinical validity. Standard
psychometric techniques were used to evaluate its validity in terms of
convergence, divergence and internal consistency reliability (Cronbach's
alpha). Correlations between clinical variables and HRQoL scores were
performed to test the questionnaire's capability to capture differences
across patients groups. Results: Overall, the findings
show that, in this sample, the SF-36's performance was very good.
Acceptability was satisfactory, with a response rate higher than 80%. All
the questionnaire scales met the psychometric standards suggested in terms
of grouping and scaling assumptions. The internal reliability coefficients
actually replicate the satisfactory findings reported previously for the
original SF-36. In terms of the ability of the questionnaire scales to
discriminate between groups expected to differ in a given health concept in
relation to clinical variables the results were also good. On average,
females reported lower scores, the impact of ageing was more evident for
physical scales. Diabetic patients score significantly worse on the
physical function scale and patients with mental health problems score
significantly lower on the mental health scale. No significant association
was found with the index KtV, haemoglobin levels, body mass index,
parathyroid hormone and type of dialysis. A strong association was indeed
found between SF-36 scales measuring physical health concepts and the serum
albumin level. This association held after adjusting for the confounding
effect of age. Comparison of the health profile of the present sample with
others from the US and UK and from a representative sample of the Italian
general population highlights the potential of such questionnaire in
dialysis setting. Conclusions: The SF-36 questionnaire
is easy to use in Italian dialysis patients and SF-36 scores are related to
important clinical aspect. This approach can help in caring for dialysis
patients and can be useful in outcome assessment programmes. Key
words: dialysis; health outcome assessment; health-related
quality of life; SF-36 health survey
ORIGINAL ARTICLES
Health-related quality of life in dialysis patients. A report from an Italian study using the SF-36 health survey
Ospedali Riuniti di Bergamo, Bergamo, Italy; Ospedale di Circolo Predabissi, Vizzolo Predabissi, Milano, Italy; Policlinico Ponte S Pietro, Ponte S Pietro, Bergamo, Italy; Istituto di Ricerche Farmacologiche 'Mario Negri', Laboratory of Clinical Oncology Research, Via Eritrea 62, Milano, Italy; Corresponding author
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