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Published on: February 16, 2011
Conceptualizing and measuring health-related quality of life in critical care
Wan Chin Lim1, Nick Black1, Donna Lamping1
1Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, WC1H 9SH, United Kingdom.
Introduction:
When assessing health-related quality of life (HRQL), critical care outcomes research generally uses generic measures in the absence of a suitable critical care-specific measure. Our aims were to construct a conceptual framework of survivors' HRQL and assess the extent to which the 2 most commonly used generic measures (the Short Form 36 Health Survey and EuroQol-5D) covered the framework.
Methods:
A preliminary framework for survivors' HRQL was constructed based on a systematic literature review and on a secondary analysis of 40 existing in-depth interviews with adult, critical care survivors. Its adequacy was then tested using new in-depth interviews with a maximum variation sample of critical care survivors. The extent of coverage of the final framework by the 2 generic HRQL instruments was then evaluated in 2 ways: by comparison with critical care survivors' accounts from the new in-depth interviews and by eliciting survivors' views on the adequacy of the 2 generic HRQL instruments using cognitive debriefing.
Results:
The final framework recognized 3 aspects of health status that affected 9 areas of life. The 2 most commonly used generic measures had substantial gaps in their coverage of the framework of survivors' HRQL.
Conclusions:
The findings argue strongly for a new critical care-specific HRQL measure.
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