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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Development and validation of a new patient-reported outcome measure for patients with pressure ulcers: the PU-QOL instrument

Authors: Claudia Gorecki, Julia M Brown, Stefan Cano, Donna L Lamping, Michelle Briggs, Susanne Coleman, Carol Dealey, Elizabeth McGinnis, Andrea E Nelson, Nikki Stubbs, Lyn Wilson, Jane Nixon

Published in: Health and Quality of Life Outcomes | Issue 1/2013

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Abstract

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.
Appendix
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Metadata
Title
Development and validation of a new patient-reported outcome measure for patients with pressure ulcers: the PU-QOL instrument
Authors
Claudia Gorecki
Julia M Brown
Stefan Cano
Donna L Lamping
Michelle Briggs
Susanne Coleman
Carol Dealey
Elizabeth McGinnis
Andrea E Nelson
Nikki Stubbs
Lyn Wilson
Jane Nixon
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-95

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