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L.E. Dreer, G. McGwin, K.M. Scilley, A. Xie, G.C. Meek, C. Owsley; Development of a Nursing Home Vision–Specific Health Related Quality of Life Questionnaire . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2205.
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© ARVO (1962-2015); The Authors (2016-present)
To develop a questionnaire assessing self–reported vision–specific health related quality of life problems in a nursing home resident population.
Using relevant content identified through our previous structured interviews with nursing home residents (Quality of Life Research 2002;11:449–462), we drafted a 57–item questionnaire containing items that are relevant to those residing in nursing homes. The basic item structure, length of instrument, and response choices were similar to those of the NEI–VFQ. However, we modified the phrasing of some items to make them more meaningful to nursing home residents. Psychometric properties of the NH Vision–Specific HRQoL were then determined, including construct validity, criterion validity, and test–retest reliability.
The NH Vision–Specific HRQoL was evaluated in a sample of 186 nursing home residents 60 years or older residing in 17 facilities in the Birmingham, Alabama area (M age = 80, SD = 8.4; 76.3% female; 23.7% male). The 57–item NH Vision–Specific HRQoL has nine subscales (General Vision, Reading, Ocular Symptoms, Mobility, Psychological Distress, Activities of Daily Living, Activities and Hobbies, Adaptation & Coping, and Social Interaction), all with good internal consistency reliability (Cronbach α > .94). Scores on the subscales were for the most part moderately correlated with the ADVS subscales (.19 to .60, p<.05) and the VF–14 (.46 to .69, p<.001). Subscale scores were for the most part moderately correlated with better eye distance acuity (–.15 to –.27, p<.04) and near acuity (–.16 to –.39, p<.03) in that worse visual acuity was associated with lower subscale scores. Subscale scores were also correlated with depressive symptomatology (GDS: –.25 to –.43, p<.05), SF–36 (.13 to .50, p<.05), and activity level (.16 to .28, p<.05). Test–retest reliability ranged from .50 to .76 for all subscales, and was not impacted by cognitive status.
Overall, the questionnaire has good internal consistency reliability and validity, and adequate test–retest reliability given the frailty of this population. The questionnaire may ultimately be useful as a patient–centered outcome measure for evaluating the impact of ophthalmic interventions on vision–specific quality of life in nursing home residents.
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