Gorecki C, Brown JM, Cano S, Lamping DL, Briggs M, Coleman S, Dealey C, McGinnis E, Nelson AE, Stubbs N, Wilson L, Nixon J, et al.
Health and quality of life outcomes. Date of publication 2013 Jun 13;volume 11():95.
1. Health Qual Life Outcomes. 2013 Jun 13;11:95. doi: 10.1186/1477-7525-11-95.
Development and validation of a new patient-reported outcome measure for patients
with pressure ulcers: the PU-QOL instrument.
Gorecki C(1), Brown JM, Cano S, Lamping DL, Briggs M, Coleman S, Dealey C,
McGinnis E, Nelson AE, Stubbs N, Wilson L, Nixon J.
Author information:
(1)Clinical Trials Research Unit (CTRU), University of Leeds, Leeds LS2 9JT, UK.
c.gorecki@leeds.ac.uk
BACKGROUND: Patient-reported outcome (PRO) data are integral to patient care,
policy decision making and healthcare delivery. PRO assessment in pressure ulcers
is in its infancy, with few studies including PROs as study outcomes. Further,
there are no pressure ulcer PRO instruments available.
METHODS: We used gold-standard methods to develop and evaluate a new PRO
instrument for people with pressure ulcers (the PU-QOL instrument). Firstly a
conceptual framework was developed forming the basis of PU-QOL scales. Next an
exhaustive item pool was used to produce a draft instrument that was pretested
using mixed methods (cognitive interviews and Rasch Measurement Theory). Finally,
we undertook psychometric evaluation in two parts. This first part was item
reduction, using PU-QOL data from 227 patients. The second part was reliability
and validity evaluation of the item-reduced version using both Traditional and
Rasch methods, on PU-QOL data from 229 patients.
RESULTS: The final PU-QOL contains 10 scales for measuring symptoms, physical
functioning, psychological well-being and social participation specific to
pressure ulcers. It is intended for administration and patients rate the amount
of "bother" attributed during the past week on a 3-point response scale. Scale
scores are generated by summing items, with lower scores indicating better
outcome. The PU-QOL instrument was found to be acceptable, reliable (Cronbach's
alpha values ranging 0.89-0.97) and valid (hypothesised correlations between
PU-QOL and SF-12 scores (r>0.30) and PU-QOL scales and sociodemographic variables
(r<0.30) were consistent with predictions).
CONCLUSIONS: The PU-QOL instrument provides a standardised method for assessing
PROs, reflecting the domains in a pressure ulcer-specific conceptual framework.
It is intended for evaluating patient orientated differences between
interventions and in particular the impact from the perspective of patients.
DOI: 10.1186/1477-7525-11-95
PMCID: PMC3698102
PMID: 23764247 [Indexed for MEDLINE]