ABSTRACT
Aims: Health-related quality of life (HRQoL) of Type 2 diabetes mellitus (T2DM) is a growing concern globally given the increase in T2DM prevalence. Generic HRQoL instruments are important to allow cross-cultural, cross-population and cross-study comparisons. The short version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used generic questionnaire. Hence, we aimed to evaluate the psychometric properties of the WHOQOL-BREF among patients with T2DM in Singapore. Study Design: Patients at a diabetes outpatient specialist clinic in Singapore were recruited via convenience sampling. Classical Test Theory methods were used to evaluate data quality, scaling assumptions, targeting, internal consistency reliability and construct validity (structural, convergent and discriminant) and criterion validity using HbA1c control (good versus poor). Principal Component Analyses (PCA) and Confirmatory Factory Analyses (CFA) were performed to assess unidimensionality (domain-level) as well as conformity with the original four-factor structure. Exploratory Factor Analysis (EFA) was done if CFA indicated lack of fit. Results: 212 subjects were analyzed of whom 50% were Chinese, 28% Indians, 11% Malays and 10% others. 63% were males with mean (SD) age 45.8 (11.9) years. Data quality was superior, scaling assumptions were met, targeting was satisfactory and internal consistency was achieved. PCAs were compatible with unidimensionality, except in the Physical domain. Domain level CFA indicated that unidimensionality had poor fit and overall CFA did not support the original 4-factor structure. EFA runs showed that the Physical and Environment domains overlapped while the Social and Psychological domains could not be recovered. Therefore construct (structural) validity was not established. Criterion validity was not achieved as all domains could not discriminate between those with good versus poor HbA1c control. Conclusion: Construct and criterion validity of WHOQOL-BREF posed some concerns. Thus, we recommend that an adequately-powered random sample of T2DM patients in Singapore be studied to confirm the findings of our study.
ABSTRACT
Justificativa e objetivos: Os efeitos do IMC na dispersão subaracnóidea de bupivacaína são controversos. O presente estudo avaliou a ED95 de bupivacaína subaracnóidea em cesarianas eletivas em mulheres obesas...
Background and objectives: The effect of BMI on the spread of intrathecal bupivacaine is controversial. This study assessed the ED95 of intrathecal bupivacaine for elective cesarean delivery in obese...
Justificativa y objetivos: Los efectos del IMC en la dispersión intratecal de bupivacaína son controvertidos. El presente estudio evaluó la ED95 de bupivacaína intratecal en cesáreas de elección en mujeres obesas...
Subject(s)
Humans , Female , Pregnancy , Anesthesia, Obstetrical , Anesthesia, Spinal , Bupivacaine , Cesarean Section , ObesityABSTRACT
Use of a third generation TSH assay enabled extremely low values of TSH to be detected through newborn screening. The use of a supplemental free thyroxine improved testing specificity. The hypothyroidism observed is believed to be secondary to suppression of the hypothalamic-pituitary-thyroid axis by placentally transferred maternal thyroxine.