Development and Evaluation of the Quality of Life for Obesity Surgery (QOLOS) Questionnaire

Even though health-related quality of life (HRQOL) is considered an important component of bariatric surgery outcome, there is a lack of HRQOL measures relevant for preoperative and postoperative patients. The objective of the current study was to develop a new instrument assessing HRQOL prior to and following bariatric surgery, entitled Quality of Life for Obesity Surgery (QOLOS) Questionnaire.

Topics for the QOLOS were initially generated via open-ended interviews and focus groups with 19 postoperative bariatric surgery patients. Qualitative analysis resulted in 250 items, which were rated by patients (n = 101) and experts (n = 69) in terms of their importance. A total of 120 items were retained for further evaluation and administered to 220 preoperative patients and 219 postoperative patients. They also completed a battery of other assessments to analyze issues of construct validity.

Analyses resulted in a 36-item section 1 QOLOS form targeting both preoperative and postoperative aspects across seven domains (eating disturbances, physical functioning, body satisfaction, family support, social discrimination, positive activities, partnership) and a 20-item section 2 QOLOS form focusing on postoperative concerns only (domains: excess skin, eating adjustment, dumping, satisfaction with surgery). Subscales of both sections showed acceptable to excellent internal consistency (Cronbach's α 0.72 to 0.95) and good convergent and discriminant validity.

The QOLOS represents a reliable and valid instrument to assess HRQOL in preoperative and postoperative patients. Future studies should test the questionnaire in larger samples consisting of patients undergoing different types of surgery.