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Subjective quality of life assessment: A new instrument, the “SQLP”
Abstracts
397
the intervention group for B vs A, there were significant (p s 605) increases in overall MHIQ score and PSQ. Comparisons between the control and intervention groups revealed no differences at B or A for the overall MHIQ score but decreased PSQ (p < .02) for the intervention group compared to the control group at both B and A. We conclude that knowledge of favorable intervention results may not alter the control group’s perception of quality of life and may increase the intervention group’s perception thereof; however, knowledge of favorable results may not offset the impact of side effects of the intervention when study-specific questions are asked.
ASSESSING
PATIENT
A49 SATISFACTION IN RANDOMIZED CLINICAL MEASUREMENT ISSUES
TRIALS:
SOME DESIGN AND
Davld Moher and Karen Sulllvan University of Ottawa Ottawa, Ontario, Canada Reducing hospital length of stay (LOS) has recently become an important outcome for clinical trials. However, it is not known whether reducing LOS adversely affects satisfaction with medical care. We conducted two randomized clinical trials (n = 446) to evaluate whether a medical team coordinator (MTC) could reduce hospital length of stay. Interest was also focused on whether reducing LOS would adversely effect patient satisfaction. Patients were randomly assigned to receive a MTC or standard medical care in two of four services in a clinical teaching unit. Patients (n = 125) completed one of two patient satisfaction questionnaires on the third day or fourth day of hospitalization. Length of stay was reduced in both trials (1 P < 0.05 and 1 P = 0.06 respectively). This reduced LOS was also associated with very significant increases in patient satisfaction (2P < 0.0001). We discuss several measurement and design issues that came to light during these trials; (1) patient satisfaction appears to be a very responsive outcome showing deflection and discriminatory characteristics; (2) assessment of patient satisfaction is important when the primary outcome is LOS; (3) at what point during the patients hospital stay does the assessment of patient satisfaction provide the most sensitive response; (4) difficulties associated with patient’s completing satisfaction questionnaires; (5) and the development of a patient satisfaction scale.
SUBJECTIVE
QUALITY
Paul Gerln, Alice Dazord,
A50 OF LIFE ASSESSMENT:
A NEW INSTRUMENT,
Jean-Pierre Bolsael, Franck Chauvln,’ Unite de Pharmacologic Cliniqoe ‘Centre Leon Berard Lyon, France
THE “SQLP”
and Alaln Lelzorovlcz
It is important to clearly define the concept of the quality of life, since ambiguous concepts can alter the results. In clinical trials, quality of life assessment is usually based on a health model which results in a restrictive view. The key to this problem is the clear distinction between the two components of the quality of life, i.e., subjective and objective. The latter component is the only one considered in the current medical approach. Addressing the subjective component introduces a number of methodological problems not found when the objective quality of life is assessed, and thus requires a specific model which can be derived from the model of “life goals” used by sociologists. Such a model was used to design a new questionnaire, the Subjective Quality of Life Profile (SQLP) questionnaire. The main features of the model are: i) the individual’s own personal value are the only ones which are reliable for use as a reference; ii) it is not possible to add up scores from different domains to obtain a single value, and the subjective quality of life should be considered as a multi-factorial entity; iii) changes in the quality of life induce by a treatment are due to interactions between the treatment effects on the disease process and the subjects physiology, and his/ her value(s). SQLP is a self-questionnaire that has been extensively used and validated in hypertensive, post-myocardial infarction, cancer, cardiac surgery, and diabetic patients. Results of this validation will be presented.
397
the intervention group for B vs A, there were significant (p s 605) increases in overall MHIQ score and PSQ. Comparisons between the control and intervention groups revealed no differences at B or A for the overall MHIQ score but decreased PSQ (p < .02) for the intervention group compared to the control group at both B and A. We conclude that knowledge of favorable intervention results may not alter the control group’s perception of quality of life and may increase the intervention group’s perception thereof; however, knowledge of favorable results may not offset the impact of side effects of the intervention when study-specific questions are asked.
ASSESSING
PATIENT
A49 SATISFACTION IN RANDOMIZED CLINICAL MEASUREMENT ISSUES
TRIALS:
SOME DESIGN AND
Davld Moher and Karen Sulllvan University of Ottawa Ottawa, Ontario, Canada Reducing hospital length of stay (LOS) has recently become an important outcome for clinical trials. However, it is not known whether reducing LOS adversely affects satisfaction with medical care. We conducted two randomized clinical trials (n = 446) to evaluate whether a medical team coordinator (MTC) could reduce hospital length of stay. Interest was also focused on whether reducing LOS would adversely effect patient satisfaction. Patients were randomly assigned to receive a MTC or standard medical care in two of four services in a clinical teaching unit. Patients (n = 125) completed one of two patient satisfaction questionnaires on the third day or fourth day of hospitalization. Length of stay was reduced in both trials (1 P < 0.05 and 1 P = 0.06 respectively). This reduced LOS was also associated with very significant increases in patient satisfaction (2P < 0.0001). We discuss several measurement and design issues that came to light during these trials; (1) patient satisfaction appears to be a very responsive outcome showing deflection and discriminatory characteristics; (2) assessment of patient satisfaction is important when the primary outcome is LOS; (3) at what point during the patients hospital stay does the assessment of patient satisfaction provide the most sensitive response; (4) difficulties associated with patient’s completing satisfaction questionnaires; (5) and the development of a patient satisfaction scale.
SUBJECTIVE
QUALITY
Paul Gerln, Alice Dazord,
A50 OF LIFE ASSESSMENT:
A NEW INSTRUMENT,
Jean-Pierre Bolsael, Franck Chauvln,’ Unite de Pharmacologic Cliniqoe ‘Centre Leon Berard Lyon, France
THE “SQLP”
and Alaln Lelzorovlcz
It is important to clearly define the concept of the quality of life, since ambiguous concepts can alter the results. In clinical trials, quality of life assessment is usually based on a health model which results in a restrictive view. The key to this problem is the clear distinction between the two components of the quality of life, i.e., subjective and objective. The latter component is the only one considered in the current medical approach. Addressing the subjective component introduces a number of methodological problems not found when the objective quality of life is assessed, and thus requires a specific model which can be derived from the model of “life goals” used by sociologists. Such a model was used to design a new questionnaire, the Subjective Quality of Life Profile (SQLP) questionnaire. The main features of the model are: i) the individual’s own personal value are the only ones which are reliable for use as a reference; ii) it is not possible to add up scores from different domains to obtain a single value, and the subjective quality of life should be considered as a multi-factorial entity; iii) changes in the quality of life induce by a treatment are due to interactions between the treatment effects on the disease process and the subjects physiology, and his/ her value(s). SQLP is a self-questionnaire that has been extensively used and validated in hypertensive, post-myocardial infarction, cancer, cardiac surgery, and diabetic patients. Results of this validation will be presented.