TY - JOUR
T1 - Design and initial implementation of HerQLes
T2 - A hernia-related quality-of-life survey to assess abdominal wall function
AU - Krpata, David M.
AU - Schmotzer, Brian J.
AU - Flocke, Susan
AU - Jin, Judy
AU - Blatnik, Jeffrey A.
AU - Ermlich, Bridget
AU - Novitsky, Yuri W.
AU - Rosen, Michael J.
N1 - Funding Information:
This research was supported by the Behavioral Measurement Core Facility of the Case Comprehensive Cancer Center ( P30 CA43703 ).
PY - 2012/11
Y1 - 2012/11
N2 - Background: Success of a surgical intervention is often measured by hard clinical outcomes. In ventral hernia repair (VHR) these include wound morbidity and hernia recurrence. These outcomes fail to account for a surgical intervention's effect on a patient's quality of life (QofL). Our objective was to design a hernia-specific QofL instrument with a focus on abdominal wall function, evaluate its measurement properties, and assess the impact of VHR on QofL using this new instrument. Study Design: A 16-question QofL survey tool, HerQLes, was constructed. Patients presenting for elective VHR completed the survey. Rasch modeling was used to evaluate the items; fit statistics, person-item mapping, separation index, and reliability were examined. Associations between baseline characteristics and QofL were assessed. Results: Eighty-eight patients completed the survey before assessment for VHR. Mean age was 57.2 years (±12.4 years), mean American Society of Anesthesiologists score was 2.8 (±0.5), and mean body mass index was 34.9 kg/m2 (±9.3 kg/m2). Based on Rasch modeling, 12 of 16 items met model fit criteria. The 4 poorly fitting items were eliminated from further analysis. The 12 items retained have good internal consistency reliability (0.86). On a 0- to 100-point scale, mean QofL score was 47.2 (±15.6). Patients with higher grade hernias had lower HerQLes scores (p = 0.06). Patients showed significant improvement in abdominal wall function and QofL 6 months after VHR (p < 0.01). Conclusions: Quality-of-life is an important component of surgical management of ventral hernias. The 12-question QofL survey, HerQLes, is reliable and valid. At baseline, patients with more complex hernias tended to have a decreased abdominal wall function and QofL. Six months after surgical repair, HerQLes scores change in the predicted direction. We believe HerQLes is potentially a valuable tool to assess patient-centered abdominal wall functional improvements after VHR.
AB - Background: Success of a surgical intervention is often measured by hard clinical outcomes. In ventral hernia repair (VHR) these include wound morbidity and hernia recurrence. These outcomes fail to account for a surgical intervention's effect on a patient's quality of life (QofL). Our objective was to design a hernia-specific QofL instrument with a focus on abdominal wall function, evaluate its measurement properties, and assess the impact of VHR on QofL using this new instrument. Study Design: A 16-question QofL survey tool, HerQLes, was constructed. Patients presenting for elective VHR completed the survey. Rasch modeling was used to evaluate the items; fit statistics, person-item mapping, separation index, and reliability were examined. Associations between baseline characteristics and QofL were assessed. Results: Eighty-eight patients completed the survey before assessment for VHR. Mean age was 57.2 years (±12.4 years), mean American Society of Anesthesiologists score was 2.8 (±0.5), and mean body mass index was 34.9 kg/m2 (±9.3 kg/m2). Based on Rasch modeling, 12 of 16 items met model fit criteria. The 4 poorly fitting items were eliminated from further analysis. The 12 items retained have good internal consistency reliability (0.86). On a 0- to 100-point scale, mean QofL score was 47.2 (±15.6). Patients with higher grade hernias had lower HerQLes scores (p = 0.06). Patients showed significant improvement in abdominal wall function and QofL 6 months after VHR (p < 0.01). Conclusions: Quality-of-life is an important component of surgical management of ventral hernias. The 12-question QofL survey, HerQLes, is reliable and valid. At baseline, patients with more complex hernias tended to have a decreased abdominal wall function and QofL. Six months after surgical repair, HerQLes scores change in the predicted direction. We believe HerQLes is potentially a valuable tool to assess patient-centered abdominal wall functional improvements after VHR.
KW - HerQLes
KW - Hernia-Related Quality-of-Life Survey
KW - QofL
KW - SF-36
KW - Short Form-36
KW - VHR
KW - quality of life
KW - ventral hernia repair
UR - http://www.scopus.com/inward/record.url?scp=84867866645&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2012.06.412
DO - 10.1016/j.jamcollsurg.2012.06.412
M3 - Article
C2 - 22867715
AN - SCOPUS:84867866645
SN - 1072-7515
VL - 215
SP - 635
EP - 642
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 5
ER -