Quality of Life Research

, Volume 24, Issue 1, pp 163–179

Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL

  • Brennan M. R. Spiegel
  • Mark W. Reid
  • Roger Bolus
  • Cynthia B. Whitman
  • Jennifer Talley
  • Stanley Dea
  • Kamyar Shahedi
  • Hetal Karsan
  • Chassidy Teal
  • Gil Y. Melmed
  • Erica Cohen
  • Garth Fuller
  • Linnette Yen
  • Paul Hodgkins
  • M. Haim Erder
Article

DOI: 10.1007/s11136-014-0753-1

Cite this article as:
Spiegel, B.M.R., Reid, M.W., Bolus, R. et al. Qual Life Res (2015) 24: 163. doi:10.1007/s11136-014-0753-1

Abstract

Background

Colonic diverticular disease is typically conceived as acute diverticulitis attacks surrounded by periods of clinical silence. However, evolving data indicate that many patients have persistent symptoms and diminished health-related quality of life (HRQOL) long after acute attacks. We developed a disease-targeted HRQOL measure for symptomatic uncomplicated diverticular disease (SUDD)—the diverticulitis quality of life (DV-QOL) instrument.

Methods

We conducted a systematic literature review to craft a conceptual model of SUDD HRQOL. This was complemented by three focus groups including 45 SUDD patients. We developed items based on our literature search, focus groups, and cognitive debriefings. We administered the items to SUDD patients with persistent symptoms following a confirmed diverticulitis event. We created scales based on factor analysis and evaluated the scales for reliability and validity.

Results

Concept elicitation revealed a range of illness experiences attributed to SUDD. Coding of 20,490 transcribed words yielded a 52-code network with four primary, condition-related concepts: (1) physical symptoms (e.g., bloating); (2) behaviors (e.g., restrictions); (3) cognitions and concerns (e.g., fear); and (4) impact and consequences (e.g., absenteeism, anxiety). Based on patient language, we developed the 17-item DV-QOL instrument. In a cross-sectional validation sample of 197 patients, DV-QOL discriminated between patients with recent versus distant diverticulitis events and correlated highly with Short Form 36 and hospital anxiety and depression scores.

Conclusions

Patients with SUDD attribute a wide range of negative psychological, social, and physical symptoms to their condition, both during and after acute attacks; DV-QOL captures these symptoms in a valid, reliable manner.

Keywords

Patient-reported outcomesHealth-related quality of lifeDiverticulosisDiverticulitis

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Brennan M. R. Spiegel
    • 1
    • 2
    • 3
    • 8
  • Mark W. Reid
    • 1
    • 8
  • Roger Bolus
    • 2
    • 8
  • Cynthia B. Whitman
    • 8
  • Jennifer Talley
    • 1
    • 8
  • Stanley Dea
    • 4
  • Kamyar Shahedi
    • 4
  • Hetal Karsan
    • 5
  • Chassidy Teal
    • 5
  • Gil Y. Melmed
    • 6
  • Erica Cohen
    • 1
    • 6
  • Garth Fuller
    • 3
    • 8
  • Linnette Yen
    • 7
  • Paul Hodgkins
    • 7
  • M. Haim Erder
    • 7
  1. 1.Department of GastroenterologyVA Greater Los Angeles Healthcare SystemLos AngelesUSA
  2. 2.Division of Digestive DiseasesDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of Health Policy and ManagementUCLA Fielding School of Public HealthLos AngelesUSA
  4. 4.Department of GastroenterologyUCLA-Olive View Medical CenterLos AngelesUSA
  5. 5.Atlanta Gastroenterology AssociatesAtlantaUSA
  6. 6.Department of GastroenterologyCedars-Sinai Medical CenterLos AngelesUSA
  7. 7.Shire Development LLCWayneUSA
  8. 8.Cedars-Sinai Center for Outcomes Research and Education (CS-CORE)Los AngelesUSA