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Open Access 01-12-2018 | Research article

Can the health related quality of life measure QOLIBRI- overall scale (OS) be of use after stroke? A validation study

Authors: Guri Heiberg, Synne Garder Pedersen, Oddgeir Friborg, Jørgen Feldbæk Nielsen, Henriette Stabel Holm, Nicole Steinbüchel von, Cathrine Arntzen, Audny Anke

Published in: BMC Neurology | Issue 1/2018

Abstract

Background

Brief measures of health-related quality of life (HRQOL) that assess both patient-reported functioning and well-being after stroke are scarce. The objective of this study was to examine reliability and validity of one of these measures, the patient-reported Quality of Life after Brain Injury–Overall Scale (QOLIBRI-OS), in patients after stroke.

Methods

Stroke survivors were examined prospectively using survey methods.

Core survey data (n = 125) and retest data (n = 36) were obtained at 3 and 12 months, respectively. Item properties (distribution, floor and ceiling effects), psychometric properties (reliability and model fit), and validity (correlations with established measures of anxiety, depression and HRQOL) of the QOLIBRI-OS were examined.

Results

Missing responses on the questionnaire were low (0.5%). All items were positively skewed. No floor effects were present, whereas five out of six items showed ceiling effects. The summary QOLIBRI-OS score exhibited no floor or ceiling effects, and had excellent internal consistency (Cronbach’s α =0.93). All item-total correlations were high (0.73–0.88). The test-retest reliability of single items varied from 0.74 to 0.91 and was 0.93 for the overall score. The confirmatory factor analysis yielded an excellent fit for a five-item version and provided tentative support for the original six-item version. The convergent validity correlations were in the hypothesized directions, thus supporting the construct validity.

Conclusions

The brief QOLIBRI-OS is a valid and reliable brief health-related outcome measure that is appropriate for screening HRQOL in patients after stroke.

Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the global burden of disease study 2010. Lancet. 2014;383(9913):245–55.CrossRefPubMedPubMedCentral

Adamson J, Beswick A, Ebrahim S. Is stroke the most common cause of disability? J Stroke Cerebrovasc Dis. 2004;13:171–7.CrossRefPubMed

McClimans LM, Browne J. Choosing a patient-reported outcome measure. Theor Med Bioeth. 2011;32:47–60.CrossRefPubMed

Kasner SE. Clinical interpretation and use of stroke scales. Lancet Neurol. 2006;5:603–12.CrossRefPubMed

Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013;346:f167.CrossRefPubMed

von Steinbuechel N, Petersen C, Bullinger M, Grp Q. Assessment of health-related quality of life in persons after traumatic brain injury--development of the Qolibri, a specific measure. Acta Neurochir Suppl. 2005;93:43–9.CrossRefPubMed

Buck D, Jacoby A, Massey A, Ford G. Evaluation of measures used to assess quality of life after stroke. Stroke. 2000;31:2004–10.CrossRefPubMed

Owolabi MO. What are the consistent predictors of generic and specific post-stroke health-related quality of life? Cerebrovasc Dis. 2010;29:105–10.CrossRefPubMed

Almborg AH, Berg S. Quality of life among Swedish patients after stroke: psychometric evaluation of SF-36. J Rehabil Med. 2009;41:48–53.CrossRefPubMed

10.

Carod-Artal FJ. Determining quality of life in stroke survivors. Expert Rev Pharmacoecon Outcomes Res. 2012;12:199–211.CrossRefPubMed

11.

Fitzpatrick R, Fitzpatrick R, Davey C, Davey C, Buxton MJ, Buxton MJ, et al. Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess. 1998;2(i–iv):1–74.PubMed

12.

Kimberlin CL, Winterstein AG. Validity and reliability of measurement instruments used in research. Am J Heal Syst Pharm. 2008;65:2276–84.CrossRef

13.

McLeod LD, Coon CD, Martin SA, Fehnel SE, Hays RD. Interpreting patient-reported outcome results: US FDA guidance and emerging methods. Expert Rev Pharmacoecon Outcomes Res. 2011;11:163–9.CrossRefPubMedPubMedCentral

14.

Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30:1362–9.CrossRefPubMed

15.

Vellone E, Savini S, Fida R, Dickson VV, Melkus GD, Carod-Artal FJ, et al. Psychometric evaluation of the stroke impact scale 3.0. J Cardiovasc Nurs. 2015;30:229–41.CrossRefPubMed

16.

Caël S, Decavel P, Binquet C, Benaim C, Puyraveau M, Chotard M, et al. Stroke impact scale version 2: validation of the French version. Phys Ther. 2015;95:778–90.CrossRefPubMed

17.

Petersen C, Morfeld M, Bullinger M. Testing and validation of the German version of the stroke impact scale. Fortschr Neurol Psychiatr. 2001;69:284–90.CrossRefPubMed

18.

Muus I, Christensen D, Petzold M, Harder I, Johnsen SP, Kirkevold M, et al. Responsiveness and sensitivity of the stroke specific quality of life scale Danish version. Disabil Rehabil. 2011;33:2425–33.CrossRefPubMed

19.

Levine DA, Galecki AT, Langa KM, Unverzagt FW, Kabeto MU, Giordani B, et al. Trajectory of cognitive decline after incident stroke. JAMA. 2015;314:41–51.CrossRefPubMedPubMedCentral

20.

Duncan F, Wu S, Mead GE. Frequency and natural history of fatigue after stroke: a systematic review of longitudinal studies. J Psychosom Res. 2012;73:18–27.CrossRefPubMed

21.

Jenkinson C, Fitzpatrick R, Crocker H, Peters M. The stroke impact scale: Validation in a UK setting and development of a SIS short form and SIS index. Stroke. 2013;44:2532–5.CrossRefPubMed

22.

von Steinbuechel N, Wilson L, Gibbons H, Muehlan H, Schmidt H, Schmidt S, et al. QOLIBRI overall scale: a brief index of health-related quality of life after traumatic brain injury. J Neurol Neurosurg Psychiatry. 2012;83:1041–7.

23.

Truelle J-L, Koskinen S, Hawthorne G, Von Wild K, Von Steinbuechel N. Traumatic brain injury quality of life tool: QOLIBRI. Brain Inj. 2012;26:421.

24.

Wong GKC, Lam SW, Ngai K, Wong A, Mok V, Poon WS. Quality of life after brain injury (QOLIBRI) overall scale for patients after aneurysmal subarachnoid hemorrhage. J Clin Neurosci. 2014;21:954–6.CrossRefPubMed

25.

Nunnari D, Bramanti P, Marino S. Cognitive reserve in stroke and traumatic brain injury patients. Neurol Sci. 2014;35:1513–8.CrossRefPubMed

26.

Nortje J, Menon DK. Traumatic brain injury: physiology, mechanisms, and outcome. Curr Opin Neurol. 2004;17:711–8.CrossRefPubMed

27.

Guidetti S, Ytterberg C, Ekstam L, Johansson U, Eriksson G. Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the stroke impact scale. J Rehabil Med. 2014;46:963–8.CrossRefPubMed

28.

Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials - a literature review and synthesis. Stroke. 2007;38:1091–6.CrossRefPubMed

29.

Soberg HL, Roe C, Anke A, Arango-Lasprilla JC, Skandsen T, Sveen U, et al. Health-related quality of life 12 months after severe traumatic brain injury: a prospective nationwide cohort study. J Rehabil Med. 2013;45:785–91.CrossRefPubMed

30.

Soberg HL, Roe C, Brunborg C, von Steinbüchel N, Andelic N. The Norwegian version of the QOLIBRI–a study of metric properties based on a 12 month follow-up of persons with traumatic brain injury. Health Qual Life Outcomes. 2017;15:14.CrossRefPubMedPubMedCentral

31.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale (HADS). Acta Psychiatr Scand. 1983;67:361–70.CrossRefPubMed

32.

Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. J Psychosom Res. 2002;52:69–77.CrossRefPubMed

33.

Oyane NMF, Bjelland I, Pallesen S, Holsten F, Bjorvatn B. Seasonality is associated with anxiety and depression: the Hordaland health study. J Affect Disord. 2008;105:147–55.CrossRefPubMed

34.

Pallant JF, Tennant A. An introduction to the Rasch measurement model: an example using the hospital anxiety and depression scale (HADS). Br J Clin Psychol. 2007;46(Pt 1):1–18.CrossRefPubMed

35.

Sagen U, Vik TG, Moum T, Mørland T, Finset A, Dammen T. Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Åsberg depression rating scale. J Psychosom Res. 2009;67:325–32.CrossRefPubMed

36.

Rabin R, De Charro F. EQ-5D: a measure of health status from the EuroQol group. Ann Med. 2001;33:337–43.CrossRefPubMed

37.

van Reenen M, Janssen B. EQ-5D-5L User Guide - Basic information on how to use the EQ-5D-5L instrument. Version 21. 2015.

38.

Whynes DK. Correspondence between EQ-5D health state classifications and EQ VAS scores. Health Qual Life Outcomes. 2008;6:94.CrossRefPubMedPubMedCentral

39.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25:3186–91.CrossRefPubMed

40.

Pedersen SG, Heiberg GA, Nielsen JF, Friborg O, Stabel HH, Anke A, et al. Validity, reliability and Norwegian adaptation of the stroke-specific quality of life (SS-QOL) scale. SAGE Open Med. 2018;6:2050312117752031. https://doi.org/10.1177/2050312117752031.CrossRefPubMedPubMedCentral

41.

Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010;19:539–49.CrossRefPubMedPubMedCentral

42.

von Steinbüchel N, Wilson L, Gibbons H, Hawthorne G, Höfer S, Schmidt S, et al. Quality of life after brain injury (QOLIBRI): scale development and metric properties. J Neurotrauma. 2010;27:1167–85.CrossRefPubMed

43.

Muthén L, Muthén B. Mplus user’s guide. 6th ed; 2012.

44.

Terwee CB, Mokkink LB, Knol DL, Ostelo RWJG, Bouter LM, De Vet HCW. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res. 2012;21:651–7.CrossRefPubMed

45.

West SG, Taylor AB, Wu W. Model fit and model selection in structural equation modeling. In: Handbook of structural equation modeling. New York: Guilford Press; 2012. p. 209–31.

46.

Field A. Andy field - discovering statistics using SPSS. 2005.

47.

Field AP. Intraclass correlation. Encycl Stat Behav Sci. 2005;2:948–54.

48.

Sun J-H, Tan L, Yu J-T. Post-stroke cognitive impairment: epidemiology, mechanisms and management. Ann Transl Med. 2014;2:80.PubMedPubMedCentral

49.

Muehlan H, Wilson L, von Steinbüchel N, von Steinbüchel N. A Rasch Analysis of the QOLIBRI Six-Item Overall Scale. Assessment. 2016;23:124–30.CrossRefPubMed

50.

Donnellan C, Hickey A, Hevey D, O’Neill D. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry. 2010;25:1288–95.CrossRefPubMed

51.

Loo R. A caveat on using single-item versus multiple-item scales. J Manag Psychol. 2002;17:68–75.CrossRef

52.

Gardner DG, Cummings LL, Dunham RB, Pierce JL. Single-item versus multiple-item measurement scales: an empirical comparison. Educ Psychol Meas. 1998;58:898–915.CrossRef

53.

Hoeppner BB, Kelly JF, Urbanoski KA, Slaymaker V. Comparative utility of a single-item versus multiple-item measure of self-efficacy in predicting relapse among young adults. J Subst Abus Treat. 2011;41:305–12.CrossRef

54.

de Boer AGEM, van Lanschot JJB, Stalmeier PFM, van Sandick JW, Hulscher JBF, de Haes JCJM, et al. Is a single-item visual analogue scale as valid, reliable and responsive as multi-item scales in measuring quality of life? Qual Life Res. 2004;13:311–20.CrossRefPubMed

55.

Dunning K, Mulder M, Nijland R. Stroke impact scale. J Physiother. 2011;62:117.

56.

Nicholl J, LaFrance WC. Neuropsychiatric sequelae of traumatic brain injury. Semin Neurol. 2009;29:247–55.CrossRefPubMed

57.

Siponkoski ST, Wilson L, Von SN, Sarajuuri J, Koskinen S. Quality of life after traumatic brain injury: finnish experience of the qolibri in residential rehabilitation. J Rehabil Med. 2013;45:835–42.CrossRefPubMed

Title: Can the health related quality of life measure QOLIBRI- overall scale (OS) be of use after stroke? A validation study
Authors: Guri Heiberg
Synne Garder Pedersen
Oddgeir Friborg
Jørgen Feldbæk Nielsen
Henriette Stabel Holm
Nicole Steinbüchel von
Cathrine Arntzen
Audny Anke
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2018
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-018-1101-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Can the health related quality of life measure QOLIBRI- overall scale (OS) be of use after stroke? A validation study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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