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Obesity Surgery
Published in: Obesity Surgery 2/2018

01-02-2018 | Original Contributions

Development and Evaluation of the Quality of Life for Obesity Surgery (QOLOS) Questionnaire

Authors: Astrid Müller, Ross D. Crosby, Janine Selle, Alexandra Osterhus, Hinrich Köhler, Julian W. Mall, Thorsten Meyer, Martina de Zwaan

Published in: Obesity Surgery | Issue 2/2018

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Abstract

Background and Aim

Even though health-related quality of life (HRQOL) is considered an important component of bariatric surgery outcome, there is a lack of HRQOL measures relevant for preoperative and postoperative patients. The objective of the current study was to develop a new instrument assessing HRQOL prior to and following bariatric surgery, entitled Quality of Life for Obesity Surgery (QOLOS) Questionnaire.

Methods

Topics for the QOLOS were initially generated via open-ended interviews and focus groups with 19 postoperative bariatric surgery patients. Qualitative analysis resulted in 250 items, which were rated by patients (n = 101) and experts (n = 69) in terms of their importance. A total of 120 items were retained for further evaluation and administered to 220 preoperative patients and 219 postoperative patients. They also completed a battery of other assessments to analyze issues of construct validity.

Results

Analyses resulted in a 36-item section 1 QOLOS form targeting both preoperative and postoperative aspects across seven domains (eating disturbances, physical functioning, body satisfaction, family support, social discrimination, positive activities, partnership) and a 20-item section 2 QOLOS form focusing on postoperative concerns only (domains: excess skin, eating adjustment, dumping, satisfaction with surgery). Subscales of both sections showed acceptable to excellent internal consistency (Cronbach’s α 0.72 to 0.95) and good convergent and discriminant validity.

Conclusion

The QOLOS represents a reliable and valid instrument to assess HRQOL in preoperative and postoperative patients. Future studies should test the questionnaire in larger samples consisting of patients undergoing different types of surgery.
Literature
1.
Bullinger M, Quitmann J. Quality of life as patient-reported outcomes: principles of assessment. Dialogues Clin Neurosci. 2014;16(2):137–45.PubMedPubMedCentral
2.
3.
Raaijmakers LC, Pouwels S, Thomassen SE, et al. Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms. Eur J Clin Nutr. 2017;71(4):441–9.CrossRefPubMed
4.
Andersen JR, Aasprang A, Karlsen TI, et al. Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surg Obes Relat Dis. 2015;11(2):466–73.CrossRefPubMed
5.
Sarwer DB, Lavery M, Spitzer JC. A review of the relationships between extreme obesity, quality of life, and sexual function. Obes Surg. 2012;22(4):668–76.CrossRefPubMed
6.
Alvares RS, Beleigoli AM, Cancado AG, et al. Quality of life and weight loss in the long term after gastric bypass. Obes Surg. 2017;27(4):1069–70.CrossRefPubMed
7.
Reynolds CL, Byrne SM, Hamdorf JM. Treatment success: investigating clinically significant change in quality of life following bariatric surgery. Obes Surg. 2017;27(7):1842–8.CrossRefPubMed
8.
Peterhänsel C, Nagl M, Wagner B, et al. Predictors of changes in health-related quality of life 6 and 12 months after a bariatric procedure. Obes Surg. 2017;27(8):2120–8.CrossRefPubMed
9.
Biter LU, van Buuren MMA, Mannaerts GHH, Apers JA, Dunkelgrun M, Vijgen G, 2017. Quality of life 1 year after laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial focusing on gastroesophageal reflux disease. Obes Surg . doi: 10.​1007/​s11695-017-2688-4.
10.
Monteiro F, Ponce DA, Silva H, et al. Physical function, quality of life, and energy expenditure during activities of daily living in obese, post-bariatric surgery, and healthy subjects. Obes Surg. 2017;27(8):2138–44.CrossRefPubMed
11.
Osterhues A, von Lengerke T, Mall JW, de Zwaan M, Müller A, 2017. Health-related quality of life, anxiety, and depression in bariatric surgery candidates compared to patients from a psychosomatic inpatient hospital. Obes Surg. doi: 10.​1007/​s11695-017-2629-2.
12.
Ware JE, Snow K, Kosinski M, et al. SF-36 Health Survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Center; 1993.
13.
Kolotkin RL, Crosby RD. Manual for the impact of weight on quality of life measure (IWQOL and IWQOL-Lite). Obesity and Quality of Life Consulting: Durham, NC; 2008.
14.
De Luca M, Angrisani L, Himpens J, et al. Indications for surgery for obesity and weight-related diseases: position statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg. 2016;26(8):1659–96.CrossRefPubMed
15.
Runkel N, Colombo-Benkmann M, Hüttl TP, et al. Evidence-based German guidelines for surgery for obesity. Int J Color Dis. 2011;26(4):397–404.CrossRef
16.
Hachem A, Brennan L. Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 2016;26(2):395–409.CrossRefPubMed
17.
de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6(1):79–85.CrossRefPubMed
18.
Gilmartin J, Bath-Hextall F, Maclean J, et al. Quality of life among adults following bariatric and body contouring surgery: a systematic review. JBI Database System Rev Implement Rep. 2016;14(11):240–70.CrossRefPubMed
19.
Coulman KD, Howes N, Hopkins J, et al. A comparison of health professionals’ and patients’ views of the importance of outcomes of bariatric surgery. Obes Surg. 2016;26(11):2738–46.CrossRefPubMedPubMedCentral
20.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.CrossRefPubMed
21.
Stroh C, Weiner R, Benedix F, et al. Adipositas- und metabolische Chirurgie in Deutschland 2012 - Ergebnisse der Qualitatssicherungsstudie zur operativen Therapie der Adipositas (GBSR). [bariatric and metabolic surgery in Germany 2012 - results of the quality assurance study on surgery for obesity (data of the German Bariatric Surgery Registry)]. Zentralbl Chir. 2014;139(2):e1–5.CrossRefPubMed
22.
Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8(5):487–99.CrossRefPubMed
23.
Oria HE, Moorehead MK. Updated bariatric analysis and reporting outcome system (BAROS). Surg Obes Relat Dis. 2009;5(1):60–6.CrossRefPubMed
24.
Weiner S, Sauerland S, Fein M, et al. The Bariatric Quality of Life index: a measure of well-being in obesity surgery patients. Obes Surg. 2005;15(4):538–45.CrossRefPubMed
25.
Tayyem RM, Atkinson JM, Martin CR. Development and validation of a new bariatric-specific health-related quality of life instrument “bariatric and obesity-specific survey (BOSS)”. J Postgrad Med. 2014;60(4):357–61.CrossRefPubMed
26.
Klassen AF, Cano SJ, Alderman A, et al. The BODY-Q: a patient-reported outcome instrument for weight loss and body contouring treatments. Plast Reconstr Surg Glob Open. 2016;4(4):e679.CrossRefPubMedPubMedCentral
27.
Klassen AF, Cano SJ, Scott A, et al. Satisfaction and quality-of-life issues in body contouring surgery patients: a qualitative study. Obes Surg. 2012;22(10):1527–34.CrossRefPubMed
28.
Klassen AF, Cano SJ, Scott A, et al. Assessing outcomes in body contouring. Clin Plast Surg. 2014;41(4):645–54.CrossRefPubMed
29.
Ivezaj V, Kessler EE, Lydecker JA, et al. Loss-of-control eating following sleeve gastrectomy surgery. Surg Obes Relat Dis. 2017;13(3):392–8.CrossRefPubMed
30.
Devlin MJ, King WC, Kalarchian MA, et al. Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up. Int J Eat Disord. 2016;49(12):1058–67.CrossRefPubMedPubMedCentral
31.
Mitchell JE, Christian NJ, Flum DR, et al. Postoperative behavioral variables and weight change 3 years after bariatric surgery. JAMA Surg. 2016;151(8):752–7.CrossRefPubMed
32.
Aaronson N, Alonso J, Burnam A, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11(3):193–205.CrossRefPubMed
33.
Selle J. Entwicklung eines gesundheitsbezogenen Lebensqualitätsfragebogens bei Adipositaschirurgie [development of a HRQOL questionnaire for bariatric surgery]. Doctoral thesis. Hannover Medical School: Hannover; 2017.
34.
Herpertz S, Müller A, Burgmer R, et al. Health-related quality of life and psychological functioning 9 years after restrictive surgical treatment for obesity. Surg Obes Relat Dis. 2015;11(6):1361–70.CrossRefPubMed
35.
Green DD, Engel SG, Mitchell JE. Psychological aspects of bariatric surgery. Curr Opin Psychiatry. 2014;27(6):448–52.CrossRefPubMed
36.
Müller A, Mitchell JE, Sondag C, et al. Psychiatric aspects of bariatric surgery. Curr Psychiatry Rep. 2013;15(10):397.CrossRefPubMed
37.
Driscoll S, Gregory DM, Fardy JM, et al. Long-term health-related quality of life in bariatric surgery patients: a systematic review and meta-analysis. Obesity (Silver Spring). 2016;24(1):60–70.CrossRef
38.
Aasprang A, Andersen JR, Vage V, et al. Five-year changes in health-related quality of life after biliopancreatic diversion with duodenal switch. Obes Surg. 2013;23(10):1662–8.CrossRefPubMedPubMedCentral
39.
40.
Morfeld M, Kirchberger I, Bullinger M. SF-36 Fragebogen zum Gesundheitszustand: Deutsche Version des Short Form-36 Health Survey. Göttingen: Hogrefe; 2011.
41.
Kolotkin RL, Crosby RD, Williams GR. Assessing weight-related quality of life in obese persons with type 2 diabetes. Diabetes Res Clin Pract. 2003;61(2):125–32.CrossRefPubMed
42.
Kolotkin RL, Crosby RD, Kosloski KD, et al. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9(2):102–11.CrossRefPubMed
43.
Mueller A, Holzapfel C, Hauner H, et al. Psychometric evaluation of the German version of the impact of weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Exp Clin Endocrinol Diabetes. 2011;119(2):69–74.CrossRefPubMed
44.
Hilbert A, Tuschen-Caffier B. Eating disorder examination—questionnaire. Deutsche Übersetzung. Verlag für Psychotherapie: Münster; 2006.
45.
Herrmann-Lingen C, Buss U, Snaith RP. Hospital anxiety and depression scale: Deutsche version. Bern: Huber; 2011.
46.
Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–85.CrossRefPubMed
47.
Hattie J, Cooksey RW. Procedures for assessing the validities of tests using the “known-groups” method. Appl Psychol Meas. 1984;8(3):295–305.CrossRef
48.
Giel KE, Thiel A, Teufel M, et al. Weight bias in work settings—a qualitative review. Obes Facts. 2010;3(1):33–40.CrossRefPubMed
49.
Giel KE, Zipfel S, Alizadeh M, et al. Stigmatization of obese individuals by human resource professionals: an experimental study. BMC Public Health. 2012;12:525.CrossRefPubMedPubMedCentral
50.
Sarwer DB, Fabricatore AN, Eisenberg MH, et al. Self-reported stigmatization among candidates for bariatric surgery. Obesity (Silver Spring). 2008;16(Suppl 2):S75–9.CrossRef
51.
Vartanian LR, Fardouly J. The stigma of obesity surgery: negative evaluations based on weight loss history. Obes Surg. 2013;23(10):1545–50.CrossRefPubMed
52.
Johnson F, Wardle J. Dietary restraint, body dissatisfaction, and psychological distress: a prospective analysis. J Abnorm Psychol. 2005;114(1):119–25.CrossRefPubMed
53.
van den Berg PA, Mond J, Eisenberg M, et al. The link between body dissatisfaction and self-esteem in adolescents: similarities across gender, age, weight status, race/ethnicity, and socioeconomic status. J Adolesc Health. 2010;47(3):290–6.CrossRefPubMedPubMedCentral
54.
de Zwaan M, Georgiadou E, Stroh CE, et al. Body image and quality of life in patients with and without body contouring surgery following bariatric surgery: a comparison of pre- and post-surgery groups. Front Psychol. 2014;5:1310.CrossRefPubMedPubMedCentral
55.
Fabricatore AN, Wadden TA, Sarwer DB, et al. Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg. 2005;15(3):304–9.CrossRefPubMed
56.
APA. Diagnostic and Statistical Manual of mental disorders. 5th ed. Washington DC: American Psychiatric Press; 2013.
57.
Whisman MA, Baucom DH. Intimate relationships and psychopathology. Clin Child Fam Psychol Rev. 2012;15(1):4–13.CrossRefPubMed
58.
Tack J, Arts J, Caenepeel P, et al. Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol. 2009;6(10):583–90.CrossRefPubMed
59.
van Beek AP, Emous M, Laville M, et al. Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management. Obes Rev. 2017;18(1):68–85.CrossRefPubMed
60.
Kalarchian MA, Marcus MD, Courcoulas AP, et al. Self-report of gastrointestinal side effects after bariatric surgery. Surg Obes Relat Dis. 2014;10(6):1202–7.CrossRefPubMedPubMedCentral
61.
Ramadan M, Loureiro M, Laughlan K, et al. Risk of dumping syndrome after sleeve gastrectomy and Roux-en-Y gastric bypass: early results of a multicentre prospective study. Gastroenterol Res Pract. 2016;2016:2570237.CrossRefPubMedPubMedCentral
Metadata
Title
Development and Evaluation of the Quality of Life for Obesity Surgery (QOLOS) Questionnaire
Authors
Astrid Müller
Ross D. Crosby
Janine Selle
Alexandra Osterhus
Hinrich Köhler
Julian W. Mall
Thorsten Meyer
Martina de Zwaan
Publication date
01-02-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2864-6

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