Quality-of-life assessment in dementia: the use of DEMQOL and DEMQOL-Proxy total scores.
Purpose: There is a need to determine whether health-related quality-of-life (HRQL) assessments in dementia capture what is important, to form a coherent basis for guiding research and clinical and policy decisions. This study investigated structural validity of HRQL assessments made using the DEMQO...
| Publicado en: | Quality of Life Research Vol. 25; no. 12; pp. 3107 - 3119 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Dec2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119356027&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119356027 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09629343 GPQ jtl: Quality of Life Research issn: 09629343 maglogo: N pubinfo: dt: Dec2016 vid: 25 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 119356027 119356027 NLM27318488 119356027 10.1007/s11136-016-1343-1 NLM27318488 119356027 ppf: 3107 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Quality-of-life assessment in dementia: the use of DEMQOL and DEMQOL-Proxy total scores. aug: au: Chua, Kia-Chong Brown, Anna Little, Ryan Matthews, David Morton, Liam Loftus, Vanessa Watchurst, Caroline Tait, Rhian Romeo, Renee Banerjee, Sube affil: Institute of Psychiatry, Psychology and Neuroscience , King's College London , De Crespigny Park London SE5 8AF UK sug: subj: Dementia Psychosocial Factors Sickness Impact Profile Aged Reproducibility of Results Male Guardianship, Legal Female Human Clinical Assessment Tools Aged: 65+ years Male Female ab: Purpose: There is a need to determine whether health-related quality-of-life (HRQL) assessments in dementia capture what is important, to form a coherent basis for guiding research and clinical and policy decisions. This study investigated structural validity of HRQL assessments made using the DEMQOL system, with particular interest in studying domains that might be central to HRQL, and the external validity of these HRQL measurements.Methods: HRQL of people with dementia was evaluated by 868 self-reports (DEMQOL) and 909 proxy reports (DEMQOL-Proxy) at a community memory service. Exploratory and confirmatory factor analyses (EFA and CFA) were conducted using bifactor models to investigate domains that might be central to general HRQL. Reliability of the general and specific factors measured by the bifactor models was examined using omega (ω) and omega hierarchical (ω h) coefficients. Multiple-indicators multiple-causes models were used to explore the external validity of these HRQL measurements in terms of their associations with other clinical assessments.Results: Bifactor models showed adequate goodness of fit, supporting HRQL in dementia as a general construct that underlies a diverse range of health indicators. At the same time, additional factors were necessary to explain residual covariation of items within specific health domains identified from the literature. Based on these models, DEMQOL and DEMQOL-Proxy overall total scores showed excellent reliability (ω h > 0.8). After accounting for common variance due to a general factor, subscale scores were less reliable (ω h < 0.7) for informing on individual differences in specific HRQL domains. Depression was more strongly associated with general HRQL based on DEMQOL than on DEMQOL-Proxy (-0.55 vs -0.22). Cognitive impairment had no reliable association with general HRQL based on DEMQOL or DEMQOL-Proxy.Conclusions: The tenability of a bifactor model of HRQL in dementia suggests that it is possible to retain theoretical focus on the assessment of a general phenomenon, while exploring variation in specific HRQL domains for insights on what may lie at the 'heart' of HRQL for people with dementia. These data suggest that DEMQOL and DEMQOL-Proxy total scores are likely to be accurate measures of individual differences in HRQL, but that subscale scores should not be used. No specific domain was solely responsible for general HRQL at dementia diagnosis. Better HRQL was moderately associated with less depressive symptoms, but this was less apparent based on informant reports. HRQL was not associated with severity of cognitive impairment. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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