Reliability and validity of physical and mental health summary scores from the Medical Outcomes Study HIV Health Survey.
ABSTRACT Health-related quality of life measures are used to evaluate patient outcomes in clinical trials of new treatments for human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Summary index scores, rather than profiles of scale scores, would simplify data analysis and interpretation of findings from clinical trials and comparison across studies.
Baseline MOS HIV Health Survey scores from two clinical trials of new antiretroviral medications in HIV/AIDS patients (total n = 2253) and an observational study (n = 162) were used to develop physical health summary (PHS) and mental health summary (MHS) scores. Exploratory and confirmatory factor analysis were used to identify the factor structure of the summary scores based on MOS HIV Health Survey scales. Physical health summary and MHS scores were derived and the factor structure proved invariant across the two groups.
Reliability of the PHS score was 0.90 to 0.92 and MHS score was 0.91 to 0.94. Mean PHS and MHS scores differed in patient groups defined by HIV disease stage, HIV disease severity, Karnofsky performance status scores, and global ratings of health status. Mean PHS and MHS scores in patient reporting worsening health status were significantly lower than scores of patients reporting stable or improving health status.
The PHS and MHS were reproducible across different samples of HIV/AIDS patients and are reliable and valid measures for demonstrating treatment impact on patient functioning and well-being.
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ABSTRACT: This study reports on the cultural and language translation of measures for use with Zulu speakers in South Africa. The translation process was purposefully used to integrate our diverse 14 person study team by employing Community Based Participatory Research (CBPR) strategies. Measures included: the Medical Outcomes Study HIV Health Survey (MOS-HIV), Center for Epidemiologic Studies Depression Scale (CES-D), and Perceived Stress Scale (PSS). The translation was made complex by the variation in Zulu dialects across regions and even between two cities only forty-five minutes apart. Carefully conceived translations can simultaneously produce good translationsand deepen team members' understanding of each-other.
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ABSTRACT: Background Global health investment has reduced HIV mortality and transmission. However, little is known of patient-reported outcomes alongside ART rollout. This study aimed to measure wellbeing using patient-reported outcome measures (PROMS) among outpatients at PEPFAR-funded facilities.Methods In a multicentre 2 country cross-sectional study, adults attending 12 facilities in Kenya and Uganda gave self-reported data on quality of life (physical and mental wellbeing dimensions), functional and a measure of multidimensional problems (physical, psychological, social and spiritual).ResultsAmong the 1,337 participants, multidimensional problems were more common in psychological, spiritual and social domains than in physical. In multivariable analysis using GEE to adjust for facility effect, the mental health subscale of quality of life was lower for people with limited functional status (B¿=¿¿5.27, 95% CI ¿5.99, 1. ¿4.56 p¿<¿0.001) and higher for wealthier people (B¿=¿0.91, 95% CI 0.48, 1.33, p¿<¿0.001). The physical health subscale of quality of life was lower for those with limited functional status (B¿=¿¿8.58, 95% CI ¿9.46 to ¿7.70, p¿<¿0.001) and those who had a caregiver present (B¿=¿¿1.97, 95% CI ¿3.72 to ¿0.23, p¿=¿0.027), higher for wealthier people (B¿=¿1.14, 95% CI 0.65, 1.64, p¿<¿0.001), and positively associated with CD4 count (B¿=¿1.61, 95% CI 1.08¿2.14, p¿<¿0.001). Multidimensional problems were more burdensome for people with limited functional status (B¿=¿¿2.06, 95% CI ¿2.46 to ¿1.66, p¿<¿0.001), and less burdensome with more education (B¿=¿0.63, 95% CI 0.25¿1.00, p¿=¿0.001) or ART use (B¿=¿0.94, 95% CI 0.34¿1.53, p¿=¿0.002).Conclusions Multidimensional problems are highly prevalent, and worse with declining function. Importantly, ART use does not appear to be protective for self-reported physical and mental dimensions of quality of life. Assessment and management of self-reported wellbeing must form part of HIV care and treatment services to ensure maximum benefit from ART investment.BMC Infectious Diseases 11/2014; 14(1):613. DOI:10.1186/s12879-014-0613-1 · 2.56 Impact Factor
- Clinical Gerontologist 08/2014; 37(5):458-474. DOI:10.1080/07317115.2014.937844 · 0.66 Impact Factor