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Measuring instruments of quality of life in intensive care units: are the measuring instruments used validated?
Introdução à Medicina II Turma 13
Key Words:
- Intensive Care Unit (ICU)
- Quality of Life (QOL)
- Measuring instruments of QOL in ICU
Introdução à Medicina II Turma 13
Previously
The lack of standardized approah makes it extremelly difficult
to draw a conclusive picture of their value in assessing the impact
of different treatments in patients. [1]
[1] Maurizio A.Leone, Ettore Beghu, Claudia Righini, Giovanni Apolone, Paole Mosconi. Epilepsy and quality of life in adults: A review of instruments. Epilepsy Res; 2005 Aug-Sep.66(1-3):23-44.
1. To find out which are the most used instruments for
measuring QOL
2. To describe the most used measuring instruments
3. To assess the measure´s psychometric rigour in
terms of validity, reliability, practicality and
responsiveness
Introdução à Medicina II Turma 13
Aims
• Query• Search Method• Inclusion Criteria• Exclusion Criteria• Study Selection• Data Analysis
Using the references of the included articles, assess the
measure´s psychometric rigor in terms of validity, reliability, practically and
responsiveness
Introdução à Medicina II Turma 13
1st
Stage
2nd Stag
e
Instruments most used to measure QOL
Search methodQuery: “Quality of life” AND (“Intensive Care” OR
“Intensive Medicine” OR “Critical Care”)
1st
Stage
2nd Stag
e
Pubmed ISI Scopus Total
712 640 694
2046
105 67 73245
Search Engines
total articles
included articles
Search outcome
Introdução à Medicina II Turma 13
28 32
18
81610
73
SCOPUSISI
PUBMED
Included articles’ intersection
Search outcome
Introdução à Medicina II Turma 13
Information (variables) extracted from included articles:
• Journal (where it was published)
• Publication year
• Instrument(s) used to measure QOL
• Participants – children, adults or both
• Region
• Medical area of the study
Introdução à Medicina II Turma 13
Data abstraction
Introdução à Medicina II Turma 13
Results
Critical Care
Crit Care Med
Intensive Care Med
Others(80 journals)
0 20 40 60 80 100 120
Journals
Number of Articles
Introdução à Medicina II Turma 13
Results
2003 2004 2005 2006 20070
5
10
15
20
25
30
35
Publication Year
Years
Num
ber
of
Art
icle
s
Introdução à Medicina II Turma 13
Results
22; 12%
48; 27%
4; 2%
3; 2%4; 2%
17; 10%
9; 5%3; 2%
5; 3%
6; 3%
4; 2%3; 2%
3; 2%
46; 26%
Euro-QOL
SF-36
Royal Alexandra Hospital for Children
Child Health Questionnaire
Made by author
Non-refered
Acute Physiology and Chronic Health Evaluation II
Barthel Index
Semi-structured interviews
rand36
Nottingham Health Profile
SF-12
Hospital Anxiety and Depression Scale
outros
Results
Introdução à Medicina II Turma 13
Studies conducted in Europe and America used more often SF-36 than
EQ-5D. (p(EQ-5D)=0,260 p(SF-36) = 0,103)
Instrument x Region
18.90%
28.40%52.70%
Europe
EQ-5DSF-36Others
10.80%
43.20%46.00%
America
EQ-5DSF-36Others
Introdução à Medicina II Turma 13
Results
77%
10%
4% 8%
Age distribution
AdultsChildrenAdults and ChildrenNot Available
Results
Attention paid to children and adults regarding the measuring of QOL is
the same regardless of region. (p=0,692)
Introdução à Medicina II Turma 13
Age x Region
9.60%
90.40%
Europe
ChildrenAdults
12.10%
87.90%
America
ChildrenAdults
Introdução à Medicina II Turma 13
Results
16%
10%
5%
5%65%
Medical Area
Respiratory Disease
Cardiac Disease
Trauma
Cirurgy
Others
Introdução à Medicina II Turma 13
Results
Cardiac disease was the main subject of research in Europe. In
America, research in respiratory disease was more relevant
(p=0,024).
Medical Area x Continent
52.60%47.40%
Europe
Cardiac disease
Respiratory disease
14.30%
85.70%
America
Cardiac Disease
Respiratory Disease
Coming up...
Introdução à Medicina II Turma 13
The most used instruments will be subject of further study. The references of
the articles included will be used to assess the measure psychometric’s rigour in
terms of validation, reliability, practically and responsiveness.
According to these standards, the different instruments will be evaluated.
So, the aim of this second phase will be to confirm, whether the instruments that
are more stringent, are the most used.