The use, feasibility and psychometric properties of an individualised quality-of-life instrument: a systematic review of the SEIQoL-DW.

PURPOSE: To review published studies regarding the use, feasibility and psychometric performance of the schedule for the evaluation of individual quality of life-direct weighting (SEIQoL-DW) in clinical research. METHODS: Systematic literature review. Studies using the SEIQoL-DW were included if they were published in English and employed a quantitative design. A pre-defined checklist was used to analyse the reported results. RESULTS: Thirty-nine relevant articles were identified. The SEIQoL-DW has been included in studies relating to a variety of populations, including those who are severely ill. The results of convergent and discriminant validity support our hypotheses in which SEIQoL-DW was expected to correlate moderately to high with measures of global QoL, life satisfaction and mental health and weakly with measures of functional status and health. CONCLUSION: The SEIQoL-DW appears to be a feasible and valid instrument. The lack of association between the Index score and health, functional status, demographic and clinical parameters may be explained by the instrument's focus on global QoL and by that of the idiographic measurement approach reflecting the capacity of a patient to value domains other than health in life, despite having health problems. Nevertheless, continued psychometric evaluation in large populations with a longitudinal design is recommended.

Testing the validity of a translated pharmaceutical therapy-related quality of life instrument, using qualitative 'think aloud' methodology.

BACKGROUND AND OBJECTIVE: In pharmacy practice, there is a need for valid and reliable instruments to study patient-reported outcomes. One potential candidate is a pharmaceutical therapy-related quality of life (PTRQoL) instrument. This study explored the face and content validity, including cognitive aspects of question answering of a PTRQoL instrument, translated from English to Swedish. METHOD: A sample of 16 customers at Swedish community pharmacies, was asked to fill in the PTRQoL instrument while constantly reporting how they reasoned. The resulting interviews and concurrent probing, were audio-taped, transcribed verbatim and analysed using constant comparison method. RESULTS AND DISCUSSION: The relation between the measurement and its theoretical underpinning was challenged. Respondents neglected to read the instructions, used response options in an unpredictable way, and varied in their interpretations of the items. CONCLUSION: The combination of 'think-aloud', retrospective probing and qualitative analysis informed on the validity of the PTRQoL instrument and was valuable in questionnaire development. The study also identified specific problems that could be relevant for other instruments probing patients' medicines-related attitudes and behaviour.

Single application of a fluorescent test cream by healthy volunteers: assessment of treated and neglected body sites.

BACKGROUND: Management of dermatological self-treatment is demanding. Imperfect application of creams and ointments and poor adherence to topical treatment are common, resulting in unsatisfactory treatment outcome. OBJECTIVES: To assess the technique and precision of test subjects' self-application of a test cream. Treated and neglected skin sites were measured after intended widespread single application of a fluorescent test cream. METHODS: Twenty healthy volunteers (10 women, 10 men) were included. They were asked to treat their whole skin surface with the fluorescent test cream, except the head and neck and skin covered by underwear. Treated and untreated sites were subsequently measured under Wood's ultraviolet radiation. RESULTS: Thirty-one per cent of the skin surface that was a target for application did not show any fluorescence and thus was assumed to have been untreated. Typical neglected sites included the central back, the upper breast, the axilla with surrounding skin, the legs and the feet, particularly the sole. The posterior aspect of both trunk and extremities, not easily inspected, was more often neglected. In the treated sites the fluorescence was typically uneven. CONCLUSIONS: Qualified and motivated persons with no obvious physical limitations practised imperfect self-application of a test cream mimicking a therapeutic cream product. As much as 31% of the skin surface was neglected. Sites especially prone to nonapplication were identified. This might imply that dermatological patients on long-term self-treatment may practise local application very poorly, a problem of major therapeutic and economic importance. A fluorescent test cream can be used for research, and as an educational tool in the training of dermatological patients on how to apply local treatment.