Measuring instruments of quality of life in intensive care units: are the measuring instruments used validated?

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Key Words:- Intensive Care Unit (ICU)- Quality of Life (QOL)- Measuring instruments of QOL in ICU

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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

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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

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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

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28 32 18

81610

73

SCOPUSISI

PUBMED

Included articles’ intersection

Search outcome

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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

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Data abstraction

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Results

Critical Care

Crit Care Med

Intensive Care Med

Others(80 journals)

0 20 40 60 80 100 120

Journals

Number of Articles

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Results

2003 2004 2005 2006 200705

101520253035

Publication Year

Years

Num

ber

of A

rtic

les

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Results

64%

27%

9%

Region

EuropeAmericaOthers

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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 authorNon-refered

Acute Physiology and Chronic Health Evaluation II

Barthel Index

Semi-structured interviews

rand36Nottingham Health Profile

SF-12

Hospital Anxiety and Depression Scale

outros

Results

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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%

EuropeEQ-5DSF-36Others

10.80%

43.20%46.00%

America

EQ-5DSF-36Others

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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)

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Age x Region

9.60%

90.40%

Europe

ChildrenAdults

12.10%

87.90%

America

ChildrenAdults

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Results

16%

10%

5%

5%65%

Medical Area

Respiratory DiseaseCardiac DiseaseTraumaCirurgyOthers

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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 diseaseRespiratory disease

14.30%

85.70%

America

Cardiac DiseaseRespiratory Disease

Coming up...

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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.