21
VASCUQOL6 a disease specific PROM in SWEDVASC Christine Wann-Hansson, RN, Associate professor Department of care science, Malmö university
VASCUQOL6 a disease specific PROM in SWEDVASC
Christine Wann-Hansson RN Associate professor
Department of care science Malmouml university
VASCUQOL- A DISEASE SPECIFIC QUALITY OF LIFE INSTRUMENT FOR PATIENTS WITH PERIPHERAL ARTERIAL DISEASE - ORIGINAL 25 ITEMS WITH A 7-POINT RESPONSE SCALE AND FIVE SUBSCALES
Morgan MBF Crayford T Murrin B et al Developing the Vascular
Quality of Life Questionnaire A new disease-specific quality of
life measure for use in lower limb ischemia J Vasc Surg
200133679-87
The validity reliability sensitivity and responsiveness of the Swedish version of Vascuqol was tested at two vascular surgical clinics in Sweden
Nordanstig J1 Karlsson J Pettersson M Wann-Hansson C Psychometric properties of the disease-specific health-related quality of life instrument VascuQoL in a Swedish setting Health Qual Life Outcomes 2012 Apr 301045 doi 1011861477-7525-10-45
From the same data we developed a short form rdquovascuqol 6rdquo
Item selection was based on item-total correlation analysis exploratory factor analysis disease burden responsiveness and cognitive interviews
Rash analysis
GPS-monitored outdoor walking test
Vascuqol 6 has 6 items reflecting symptoms pain activity (2 items) social activities and emotional aspects
4 ndashpoint response scale which can be summarized to an overall score 6-24 (lower score = worse health)
Nordanstig Joakim Wann-Hansson Christine Karlsson Jan Lundstroumlm Mats Pettersson Monica Morgan Mark BF Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease Journal of Vascular Surgery vol 59 issue 3 March 2014 p 700-707e1
YET VASCUQOL 6 IS A THEORETICAL CONSTRUCTION
Since February 2014 Vascuqol-6 index is registered in SWEDVASC
Further testing of the instrument is ongoinghelliphellip
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
VASCUQOL- A DISEASE SPECIFIC QUALITY OF LIFE INSTRUMENT FOR PATIENTS WITH PERIPHERAL ARTERIAL DISEASE - ORIGINAL 25 ITEMS WITH A 7-POINT RESPONSE SCALE AND FIVE SUBSCALES
Morgan MBF Crayford T Murrin B et al Developing the Vascular
Quality of Life Questionnaire A new disease-specific quality of
life measure for use in lower limb ischemia J Vasc Surg
200133679-87
The validity reliability sensitivity and responsiveness of the Swedish version of Vascuqol was tested at two vascular surgical clinics in Sweden
Nordanstig J1 Karlsson J Pettersson M Wann-Hansson C Psychometric properties of the disease-specific health-related quality of life instrument VascuQoL in a Swedish setting Health Qual Life Outcomes 2012 Apr 301045 doi 1011861477-7525-10-45
From the same data we developed a short form rdquovascuqol 6rdquo
Item selection was based on item-total correlation analysis exploratory factor analysis disease burden responsiveness and cognitive interviews
Rash analysis
GPS-monitored outdoor walking test
Vascuqol 6 has 6 items reflecting symptoms pain activity (2 items) social activities and emotional aspects
4 ndashpoint response scale which can be summarized to an overall score 6-24 (lower score = worse health)
Nordanstig Joakim Wann-Hansson Christine Karlsson Jan Lundstroumlm Mats Pettersson Monica Morgan Mark BF Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease Journal of Vascular Surgery vol 59 issue 3 March 2014 p 700-707e1
YET VASCUQOL 6 IS A THEORETICAL CONSTRUCTION
Since February 2014 Vascuqol-6 index is registered in SWEDVASC
Further testing of the instrument is ongoinghelliphellip
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
The validity reliability sensitivity and responsiveness of the Swedish version of Vascuqol was tested at two vascular surgical clinics in Sweden
Nordanstig J1 Karlsson J Pettersson M Wann-Hansson C Psychometric properties of the disease-specific health-related quality of life instrument VascuQoL in a Swedish setting Health Qual Life Outcomes 2012 Apr 301045 doi 1011861477-7525-10-45
From the same data we developed a short form rdquovascuqol 6rdquo
Item selection was based on item-total correlation analysis exploratory factor analysis disease burden responsiveness and cognitive interviews
Rash analysis
GPS-monitored outdoor walking test
Vascuqol 6 has 6 items reflecting symptoms pain activity (2 items) social activities and emotional aspects
4 ndashpoint response scale which can be summarized to an overall score 6-24 (lower score = worse health)
Nordanstig Joakim Wann-Hansson Christine Karlsson Jan Lundstroumlm Mats Pettersson Monica Morgan Mark BF Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease Journal of Vascular Surgery vol 59 issue 3 March 2014 p 700-707e1
YET VASCUQOL 6 IS A THEORETICAL CONSTRUCTION
Since February 2014 Vascuqol-6 index is registered in SWEDVASC
Further testing of the instrument is ongoinghelliphellip
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
From the same data we developed a short form rdquovascuqol 6rdquo
Item selection was based on item-total correlation analysis exploratory factor analysis disease burden responsiveness and cognitive interviews
Rash analysis
GPS-monitored outdoor walking test
Vascuqol 6 has 6 items reflecting symptoms pain activity (2 items) social activities and emotional aspects
4 ndashpoint response scale which can be summarized to an overall score 6-24 (lower score = worse health)
Nordanstig Joakim Wann-Hansson Christine Karlsson Jan Lundstroumlm Mats Pettersson Monica Morgan Mark BF Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease Journal of Vascular Surgery vol 59 issue 3 March 2014 p 700-707e1
YET VASCUQOL 6 IS A THEORETICAL CONSTRUCTION
Since February 2014 Vascuqol-6 index is registered in SWEDVASC
Further testing of the instrument is ongoinghelliphellip
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
YET VASCUQOL 6 IS A THEORETICAL CONSTRUCTION
Since February 2014 Vascuqol-6 index is registered in SWEDVASC
Further testing of the instrument is ongoinghelliphellip
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
THE TESTING PLAN
Test retest study - ongoing (In Malmouml and Gothenburg)
Cognitive interviews are performed (In Malmouml and Gothenburg)
A study regarding validity sensitivity and responsiveness from SWEDVASC data
However we have lost the items in Swedvaschellip
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Item 1 Because of the poor circulation in my legs the range of activities that I would have liked to do in the past two weeks has beenhelliphellip
Item 2 During the past two weeks my legs felt tired or weak (1 patient did not answer since he found it hard to understand the meaning with tired legs
understandable relevant relevant understandable
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
rdquoI find it very important that you can express how you feel as a patient hellipnot like before when they not bothered at all about what the patients think Itrsquos important that you as a patient are allowed to participate
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Item 3 During the last two weeks because of the poor circulation in my legs my ability to walk has beenhelliphellip
Item 4 During the past two weeks I have been concerned about having poor circulation in my legshellip
understandable relevant understandable relevant
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Above all I think that itrsquos unimportant to ask about two weeks I mean do I have these problems for many years the two weeks does not make any difference It would have been better to ask about last year I think Mostly you have had pain for a longer period It may be different but it has been so for me My perception is that I have suffer from this half a year But it differs probably between persons I think you should ask about a longer time period Two weeks is too short
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Item 5 during the past two weeks because of the poor circulation in my legs my ability to participate in social activities has been hellip
Item 6 During the past two weeks when I have had pain in my leg (or foot) it has given me
understandable relevant understandable relevant
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Yes itrsquos understandable and for me this is the best question Yes you have to ask people to be able to understand how much it actually hurts This question reflects that It is important to show and provehellip because it is taken a little bit careless like it probably donrsquot hurt that much I have had that treatment Therefor it is good with a question like this showing how much pain you actually have
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Age and gender in registered patients in Swedvasc until Aug 2014
Gender Female Man
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
DISEASE SEVERITY AND VASCUQOL-6 BASELINE
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
DISEASE SEVERITY AND VASCUQOL-6 B 30 DAYS
Rutherfordclass n V6 mean St dev V6 Md Min Max
Asymptomatic 288 183 48 19 6 24
Mild claudication 85 154 42 16 6 24
Moderate claudication
39 125 34 12 6 21
Severe claudication
10 98 29 105 6 14
Rest pain 17 102 38 9 6 28
Ischaemic ulceration
96 137 50 13 6 24
Severe ischaemic ulceration or gangrene
15 107 39 11 6 19
Total baseline30 d 660550 103160 3553 1016 6 2424
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
Difference 30 days after treatment
0=deterioration 1=improved
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
WHAT HAVE BEEN THE PROBLEMS SO FAR
Few patients have been registered ( roughly 40)
Hard to find sustainable routines
The patients are too frail canacutet speak and understand Swedish etc
The value and benefits with PROM is still not emphasized
Swedvasc is seen as the doctors register
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
FURTHER QUESTIONS TO DISCUSS
Vascuqol 6 as outcome measure for invasive vascular treatment
Vascuqol 6 as a marker of disease severity
Vascuqol 6 as a tool for case selection
Vascular as outcome measure for nursing activities
Reasons for missing data (bad routines patients too ill too old cognitive impairment etc)
Do we need the questions as well
Vascuqol 6 as a quality improvement measure
Which may be the best implementation strategies
THANK YOU
THANK YOU
