Continence specialists use of quality of life information in routine practice: a national survey of practitioners
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To survey continence specialists (CSs) about their assessment practice including their use of quality of life (QoL) information, perceived barriers, benefits and training needs.
Cross-sectional national postal survey of 624 practicing CSs in the UK. The questionnaire included open and closed questions relating to assessment practice.
Completed questionnaires were returned by 299 (49%) CSs. Although 80% routinely assessed QoL, fewer than 54% demonstrated awareness of published questionnaires. The majority used structured questions (41%) many of which were non-standardised single items (26%) or locally developed questionnaires (19%). Only 22% used standardised patient-completed questionnaires such as the King’s Health Questionnaire and the Incontinence Quality of Life questionnaire. Perceived assessment barriers included the availability of appropriate questionnaires, patient disability, limited guidance, resources and time. Of those routinely assessing QoL, 77% wanted more support; the most useful media cited being the internet, followed by professional guidance and training courses.
Although QoL measurement is highly valued, there was wide variation in assessment practice with few adopting standardised approaches. Most CSs require greater guidance and support that takes account of their diverse needs. Familiar assessment barriers exist which the use of web-based information, in association with professional guidance might help overcome. Clear mechanisms are required to direct standardised and appropriate assessment practice.
KeywordsRoutine practice Health professionals
- 3.Department-of-Health. (2000). Good practice in continence services. UK Department of Health. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005851. Accessed 2 Mar 2009.
- 4.Scottish-Intercollegiate-Guidelines-Network SIGN 79. (2004). Management of urinary incontinence in primary care. A national clinical guideline. Edinburgh: Scottish-Intercollegiate-Guidelines-Network.Google Scholar
- 5.Winder, A. (1996). Assessment and investigation of urinary incontinence. In C. Norton (Ed.), Nursing for continence (2nd ed., pp. 33–75). Beaconsfield: Beaconsfield Publishers Ltd.Google Scholar
- 6.Getliffe, K., & Dolman, M. (1997). Normal and abnormal bladder function. In K. Getliffe & M. Dolman (Eds.), Promoting continence: A clinical and research resource (pp. 22–67). London: Bailliere Tindall.Google Scholar
- 11.Burke, L., Stifano, T., Dawisha, S. (2006). Guidance for industry—patient-reported outcome measures: Use in medical product development to support labelling claims. Rockville, MD: U.S Department of Health and Human Sciences, Food and Drug Administration.Google Scholar
- 13.McDowell, I. (2006). Measuring health: A guide to rating scales and questionnaires (3rd ed.). New York: Oxford University Press.Google Scholar
- 14.Bowling, A. (1995). Measuring disease: A review of disease-specific quality of life measurement scales. Buckingham: Open University Press.Google Scholar
- 20.Fitzpatrick, R., Davey, C., Buxton, M. J., Jones, D. R. (1998). Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment 2, I–Iv, 1–74.Google Scholar
- 22.Gough, I. R., & Dalgleish, L. I. (1991). What value is given to quality of life assessment by health professionals considering response to palliative chemotherapy for advanced cancer? Cancer, 68, 220–225. doi: 10.1002/1097-0142(19910701)68:1<220::AID-CNCR2820680140>3.0.CO;2-H. PubMedCrossRefGoogle Scholar
- 27.National Institute of Health and Clinical Excellence (NICE). (2006). Guideline. Urinary incontinence: The management of urinary incontinence in women. Draft for consultation. http://guidance.nice.org.uk/page.aspx?o=311453. Accessed 2 Mar 2009.
- 28.Dillman, D. A. (2000). Mail and internet surveys. The tailored design method (2nd ed.). Chichester: John Wiley and Sons Inc.Google Scholar
- 29.McColl, E., Jacoby, A., Thomas, L., et al. (2001). Design and use of questionnaires: A review of best practice applicable to surveys of health service staff and patients. Health Technology Assessment, 5(31).Google Scholar
- 30.Ritchie, J., & Spencer, L. (1994). Chapter 9. Qualitative data analysis for applied policy research. In A. Bryman & R. G. Burgess (Eds.), Analyzing qualitative data. London: Routledge.Google Scholar
- 32.Patrick, D. L., Martin, M. L., Bushnell, D. M., Yalcin, I., Wagner, T. H., & Buesching, D. P. (1999). Quality of life of women with urinary incontinence: Further development of the incontinence quality of life instrument (I-QoL). Urology, 53, 71–76. doi: 10.1016/S0090-4295(98)00454-3.PubMedCrossRefGoogle Scholar
- 34.The WHOQol Group. (1994). The development of the World Health Organisation Quality of Life Assessment Instrument (The WHOQoL). In J. Orley & W. Kuyken (Eds.), Quality of life assessment: International perspectives (pp. 41–47). Berlin: Springer-Verlag.Google Scholar
- 35.Ware, J. E. (1997). SF-36 Health Survey Manual and Interpretation Guide. The medical outcomes trust. Boston, USA: Nimrod Press.Google Scholar
- 37.Donovan, J. L., Kay, H. E., Peters, T. J., et al. (1997). Using ICSQoL to measure the impact of lower urinary tract symptoms on quality of life: Evidence from the ICS-“BHP” study. International Continence Society—Benign Prostate Hyperplasia. British Journal of Urology, 80, 712–721.PubMedGoogle Scholar
- 39.Shumaker, S. A., Wyman, J. F., Uebersax, J. S., McClish, D., & Fantl, J. A. (1994). Health-related quality of life measures for women with urinary incontinence: The incontinence impact questionnaire and the urogenital distress inventory. Quality of Life Research, 3, 291–306. doi: 10.1007/BF00451721.PubMedCrossRefGoogle Scholar
- 40.Taylor, K. M., Macdonald, K. G., Bezjak, A., Ng, P., De Petrillo, A. D. (1996). Physician’s perspective on quality of life: An exploratory study of oncologists. Quality of Life Research, 5, 5–14. doi: 10.1007/BF00435963.
- 41.Streiner, D., & Norman, G. (2003). Health measurement scales: A practical guide to their development and use (3rd ed.). Oxford: Oxford Medical Publications.Google Scholar
- 42.Hibbard, J. H. (2003). Engaging healthcare consumers to improve the quality of care. Medical Care, 41, I-61–I-70. doi: 10.1097/00005650-200301001-00007.
- 43.Velikova, G., Booth, L., Smith, A. B., Brown, P. M., Lynch, P., Brown, J. M., et al. (2004). Measuring quality of life in routine oncology practice improves communication and patient well-being: A randomized controlled trial. Journal of Clinical Oncology, 22, 714–724. doi: 10.1200/JCO.2004.06.078.PubMedCrossRefGoogle Scholar
- 45.Jacobsen, P. B., Davis, K., Cella, D. (2002). Assessing quality of life in research and clinical practice. Oncology (Williston Park), 16(9, Suppl 10), 133–139.Google Scholar
- 47.Bellamy, N. (2005). Science of assessment. Annals of the Rheumatic Diseases, 64(Suppl 2), ii42–ii45. doi: 10.1136/ard.2004.031567.