WOMAC and SF-36: instruments for evaluating the health-related quality of life of elderly people with total hip arthroplasty. A descriptive study

Abstract

CONTEXT AND OBJECTIVES: Quality-of-life results have increasingly been evaluated among patients undergoing joint replacements. The objective of this study was to compare two assessment instruments for health-related quality of life (one generic and the other specific), among elderly patients undergoing total hip arthroplasty. DESIGN AND SETTING: Cross-sectional descriptive study in a reference hospital in the region of Campinas. METHODS:The subjects were 88 elderly outpatients aged 60 years or over who underwent primary total hip arthroplasty. Two instruments for assessing health-related quality of life were applied: the generic Medical Study 36-item Short-Form Health Survey (SF-36) and the specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Cronbach's alpha and the ceiling and floor effects of the instruments were evaluated. RESULTS:The scores from both instruments showed that issues of a physical nature affected these elderly people's quality of life most. The pain and stiffness dimensions of WOMAC showed ceiling effects and only the functional capacity and pain dimensions of the SF-36 did not show the ceiling effect. The SF-36 presented floor effects in the dimensions of physical and emotional aspects. Cronbach's alpha was considered satisfactory in both instruments (α > 0.70). CONCLUSIONS:The floor and ceiling effects that were observed suggest that these instruments may present some limitations in detecting changes to the majority of the SF-36 dimensions, except for functional capacity and pain, and to the pain and stiffness dimensions of WOMAC, when applied to elderly people with total hip arthroplasty. RESUMO

PROMIS Versus Legacy Patient-Reported Outcome Measures in Patients Undergoing Surgical Treatment for Symptomatic Acetabular Dysplasia

“…27,28,46 Despite legacy scores being validated for use across multiple hip osteoarthritis abnormalities, 18,23,32 the mHHS and a significant portion of the HOOS were not developed using modern psychometric approaches. Additionally, several legacy measures including the WOMAC, 35 36-Item Short Form Health Survey (SF-36), 35 HHS, 41 and several HOOS subdomains 16,32 have been shown to have significant floor or ceiling effects after total hip arthroplasty, thus failing to distinguish between patients after treatment for hip osteoarthritis. This may lead to shortcomings in the discriminative ability of a test to detect clinically relevant changes in populations with very high or very low outcome scores and can negatively affect sample size requirements.…”

Informação Como Instrumento Da Assistência Ao Paciente Submetido a Cirurgia Ortopédica

“…A osteoartrite se destaca como uma das doenças articulares mais comuns na população idosa e é uma das principais causas de morbidade e incapacidade nesse grupo. A revisão operatória geralmente está relacionada à falha dos implantes, que pode ocorrer por razões mecânicas (tempo prolongado de uso da prótese, luxação, fratura óssea periprótese) ou biológicas (inflamação, infecção) (1,6,(11)(12) . Dor, limitação funcional e restrição às atividades cotidianas estavam presentes em mais da metade dos pacientes, seguidas por rigidez e formigamento.…”

“…O ato cirúrgico envolve responsabilidades do hospital, da equipe de saúde, do paciente e familiares em diversos graus, e para resultados pós-operatórios positivos, o adequado preparo do paciente tem fundamental importância (1)(2)(3)(4)(5) .…”

Total Ankle Replacement for Osteoarthritis Following Pilon Fracture of the Tibia

“…This questionnaire has been validated for use in patients undergoing total hip replacement (THR) surgery. 16,25,27 Complications were recorded.…”