Weitere Artikel dieser Ausgabe durch Wischen aufrufen
Disclaimer The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veteran Affairs.
Colonic diverticular disease is typically conceived as acute diverticulitis attacks surrounded by periods of clinical silence. However, evolving data indicate that many patients have persistent symptoms and diminished health-related quality of life (HRQOL) long after acute attacks. We developed a disease-targeted HRQOL measure for symptomatic uncomplicated diverticular disease (SUDD)—the diverticulitis quality of life (DV-QOL) instrument.
We conducted a systematic literature review to craft a conceptual model of SUDD HRQOL. This was complemented by three focus groups including 45 SUDD patients. We developed items based on our literature search, focus groups, and cognitive debriefings. We administered the items to SUDD patients with persistent symptoms following a confirmed diverticulitis event. We created scales based on factor analysis and evaluated the scales for reliability and validity.
Concept elicitation revealed a range of illness experiences attributed to SUDD. Coding of 20,490 transcribed words yielded a 52-code network with four primary, condition-related concepts: (1) physical symptoms (e.g., bloating); (2) behaviors (e.g., restrictions); (3) cognitions and concerns (e.g., fear); and (4) impact and consequences (e.g., absenteeism, anxiety). Based on patient language, we developed the 17-item DV-QOL instrument. In a cross-sectional validation sample of 197 patients, DV-QOL discriminated between patients with recent versus distant diverticulitis events and correlated highly with Short Form 36 and hospital anxiety and depression scores.
Patients with SUDD attribute a wide range of negative psychological, social, and physical symptoms to their condition, both during and after acute attacks; DV-QOL captures these symptoms in a valid, reliable manner.
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:
Parks, T. G. (1975). Natural history of diverticular disease of the colon. Clinical Gastroenterology, 4, 53–69.
Kozak, L. J., DeFrances, C. J., & Hall, M. J. (2006). National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data. Vital & Health Statistics, 13(2006), 1–209.
Peery, A. F., Dellon, E. S., Lund, J., et al. (2012). Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology, 143(1179–87), e1–e3. PubMed
Tursi, A., & Papagrigoriadis, S. (2009). Review article: The current and evolving treatment of colonic diverticular disease. Alimentary Pharmacology & Therapeutics, 30, 532–546. CrossRef
Cohen, E., Fuller, G., Bolus, R., et al. (2012, May). Evidence for post-diverticulitis irritable bowel syndrome (PDV-IBS): Longitudinal analysis reveals higher incidence of IBS in DV cases vs. controls. Poster presented at Digestive Disease Week, San Diego, CA.
Shahedi, K., Fuller, G., Bolus, R., et al. (2012, May). Progression from incidental diverticulosis to acute diverticulitis. Poster presented at Digestive Disease Week, San Diego, CA.
Tursi, A., Brandimarte, G., Giorgetti, G. M., et al. (2005). Assessment of small intestinal bacterial overgrowth in uncomplicated acute diverticulitis of the colon. World Journal of Gastroenterology, 11, 2773–2776. PubMed
Cohen, E., Fuller, G., Bolus, R., et al. (2013). Increased risk for irritable bowel syndrome after acute diverticulitis. Clinical Gastroenterology and Hepatology, 11, 1614–1619.
Vu, M., Fuller, G., Bolus, R., et al. (2012, May). Post diverticulitis (DV) depression: Longitudinal analysis reveals higher incidence in cases vs. controls. Poster presented at Digestive Disease Week (DDW), San Diego, CA.
Khanna, P., Agarwal, N., Khanna, D., et al. (2014). Development of an online library of patient-reported outcome measures in gastroenterology: The GI-PRO database. The American Journal of Gastroenterology, 109, 234–248.
Spiegel, B. M., Bolus, R., Agarwal, N., et al. (2010). Measuring symptoms in the irritable bowel syndrome: Development of a framework for clinical trials. Alimentary Pharmacology & Therapeutics, 32, 1275–1291. CrossRef
Ericsson, A. S. H. (1993). Protocol analysis: Verbal reports as data (2nd ed.). Cambridge: MIT Press.
Willis, G. (1994). Cognitive interviewing and questionnaire design: A training manual. Hyattsville, MD: National Center for Health Statistics.
Ware, J. E. & Sherbourne, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.
Zigmond, A. S. & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.
- Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL
Brennan M. R. Spiegel
Mark W. Reid
Cynthia B. Whitman
Gil Y. Melmed
M. Haim Erder
- Springer International Publishing
Neuer Inhalt/© Stellmach, Neuer Inhalt/© BBL, Neuer Inhalt/© Maturus, Pluta Logo/© Pluta, Neuer Inhalt/© hww, digitale Transformation/© Maksym Yemelyanov | Fotolia