Objective. To design and test the reliability and validity of a brief, treatment-focused version of the Diabetes Quality of Life (DQOL) questionnaire for use with both type 1 and type 2 diabetes. Research design and methods.Questionnaire packets including the DQOL, measures of current diabetes self-care behaviors, and demographic and health characteristics were mailed to 1,080 adults with type 1 or type 2 diabetes. A total of 498 patients returned completed packets. A threestage statistical process was used to understand the underlying structure of the DQOL and to identify items most predictive of self-care behaviors and satisfaction with diabetes control.Results. Principal components analysis, conducted on 26 items predictive of the main criteria, identified five key underlying factors. For each component, best subset regression analysis was conducted to identify nonredundant questions that best explained self-care behaviors and satisfaction with diabetes control.A combined set of 15 questions was reliable (alpha = 0.85) and valid, though several questions were more relevant to type 1 or type 2 diabetes. For patients with type 1 diabetes, the 15-item brief inventory was equally or more effective at predicting self-care behaviors (shortened scale R 2 = 0.360; full scale R 2 = 0.254) and satisfaction with diabetes control (shortened scale R 2 = 0.562; full scale R 2 = 0.580) than the original 60-item DQOL. For type 2 diabetic patients, only satisfaction with diabetes control was well-predicted, but the 15-item inventory accounted for as much variance as the original 60-item DQOL (shortened scale R 2 = 0.513; full scale R 2 = 0.492). Conclusions. The 15-item DQOLBrief Clinical Inventory provides a total health-related quality of life score that predicts self-reported diabetes care behaviors and satisfaction with diabetes control as effectively as the full version of the instrument. In addition, it provides a vehicle for quickly screening patients for readiness and specific treatment-related concerns. It takes about 10 minutes to administer and can be used to identify quality of life issues that might not arise during the typical patientprovider encounter.
The aim of this study was to compare the SF-36 and two disease-specific instruments--St. George's Respiratory Questionnaire (SGRQ) and Chronic Respiratory Disease Questionnaire (CRDQ) among chronic obstructive pulmonary disease (COPD) patients using healthcare utilization data. The three instruments were administered twice by telephone interview to 40 COPD patients separated by a 3-month interval. Healthcare utilization data were obtained for the 3 months immediately prior to each administration. Reliabilities for sub-scales on the three instruments ranged from 0.70 to 0.90 for the SF-36, from 0.78 to 0.85 for the SGRQ, and from 0.64 to 0.91 for the CRDQ. In general, the study sample had poor physical health, and somewhat better mental health. None of the demographic variables were significantly associated with either health status or utilization. Among the three instruments, the SF-36 explained the most variance in healthcare utilization. The aggregate scores such as the summary scores of the SF-36 and the total score of the SGRQ did not perform as well as the individual sub-scales of the respective instruments in explaining the variation in utilization. The conclusion that the SF-36 provides the best association to healthcare utilization data from among the three instruments studied should be interpreted with caution given the small sample size and relatively brief duration of the study.
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