Hqlocomcontent219 another consideration is its

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Unformatted text preview: www.hqlo.com/content/2/1/9 another consideration is its reliability, which means the degree to which the instrument is free from random error and all items measure the same underlying attribute [14]. Further, the requirement for a useful outcome measure is the responsiveness in detecting small but important clinical changes of quality of life in patients following vascular interventions [13]. Finally the ideal quality of life instrument must also be acceptable to patients, simple and easy to use and preferably short. Comparisons among quality of life instruments and their psychometric characteristics and performance are needed to provide recommendations about their usefulness as outcome measures for these particular groups of patients. The aim of this study was to compare two generic quality of life questionnaires, the Nottingham Health Profile (NHP) and the Short Form 36 Health Survey (SF-36) regarding the internal consistency reliability, validity, responsiveness and suitability as outcome measures in patients with lower limb ischaemia in a longitudinal perspective. Methods Patients Ninety consecutive patients from a Swedish vascular unit in southern Sweden were invited to participate in this study. The assessment took place before and 12 months after revascularization. Out of 90 patients, 24 (27%) dropped out during the follow-up period, of whom 14 suffered from CLI. Six patients (7%) died, 15 (17%) did not wish to participate and 3 (3%) had other concurrent diseases. The inclusion criteria were patients admitted for active treatment of documented lower limb ischaemia, having no communication problems and having no other disease restricting their walking capacity [1]. The severity of ischaemia was graded according to suggested standards for grading lower limb ischaemia [15]. Sixty-two (68.8%) patients were treated with a surgical bypass, 24 (26.6%) had a percutaneous angioplasty (PTA) and 4 (4.6%) had a surgical thromboendatherectomy (TEA) (Table 1). Routine medical history, risk factors and clinical examinations, which included ankle blood pressure (ABP) and ankle-brachial pressure index (ABPI), were obtained before and one year after revascularization in accordance with the Swedish Vascular Registry (Swedvasc) [16]. The questionnaire also contains questions about sex, age, housing and civil status. Demographic characteristics and clinical data were obtained from the patients' medical records. Nottingham Health Profile The Nottingham Health Profile (NHP) was developed to be used in epidemiological studies of health and disease [17]. It consists of two parts. Part I contains 38 yes/no items in 6 dimensions: pain, physical mobility, emotional Page 2 of 11 (page number not for citation purposes) Health and Quality of Life Outcomes 2004, 2 http://www.hqlo.com/content/2/1/9 Table 1: Demographic characteristics of the patient groups before revascularization (n = 90). Claudicants n = 48 Age m (SD)1 Sex %2 Male/female Cohabitation n (%)2 Living alone Living with family/relatives Severity of disease n (%) Intermittent claudication Ischaemia rest pain Ischaemia ulcers Ischaemia gangrene Type of intervention n (%)2 Angioplasty/STENT Bypass Thromboendatherectomy Level of disease n (%) Iliac Femoral (above knee) Distal (below knee) Leg side of disease n (%) Unilateral Bilateral Risk factors n (%)2 Smoking Hypertension Heart disease Diabetics Hyperlipaemia Stroke/TIA Chronic lung disease Kidney disease, kreat >150 *Reoperations during...
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