Validation of an English Version of the Padova Quality of Life Instrument to Assess Quality of Life Following Ileal Pouch Anal Anastomosis

  • Marco Scarpa
  • Charles J. Victor
  • Brenda I. O’Connor
  • Zane Cohen
  • Robin S. McLeod
2008 ssat poster presentation manuscript
First Online:
Received:
Accepted:

Abstract

Objective

Ileal pouch anal anastomosis (IPAA) is the procedure of choice for most patients requiring surgery for ulcerative colitis and familial adenomatous polyposis because of its perceived improvement in health-related quality of life (HRQL). The aims of this cross-sectional study were to validate an English version of the Padova Inflammatory Bowel Disease Quality of Life questionnaire (PIBDQL) in patients undergoing IPAA and to investigate the pre- and postoperative predictors of long-term HRQL.

Materials and Methods

In May 2005, the English version of the PIBDQL, Short Inflammatory Bowel Disease Questionnaire, and the SF-36 were mailed to 1,379 patients who underwent IPAA at the Mount Sinai Hospital between 1982 and 2004. The test–retest reliability, internal consistency, construct validity, and discriminative ability of the English version of the PIBDQL were assessed.

Results

Nine hundred fifty-five patients (69%) (475 female, 480 male; mean, age 43 years) returned the questionnaires. The mean PIBDQL score was 21.1 (3.4), suggesting good quality of life. Test–retest reliability [intraclass correlation coefficient (ICC) = 0.784] and internal consistency (Cronbach’s α = 0.83) were good. Construct validity and discriminative ability of the English version of PIBDQL were adequate. Multivariate analysis revealed that women (p < 0.01) and Crohn’s disease patients (p < 0.01) had significantly worse PIBDQL scores.

Conclusions

The English version PIBDQL is a reliable and valid disease-specific instrument for assessing quality of life in patients with IPAA. In this series, female gender and CD were significant predictors of worse HRQL.

Keywords

Restorative proctocolectomy Quality of life Questionnaires Ulcerative colitis Indeterminate colitis Familial adenomatous polyposis 
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References

  1. 1.
    Fazio VW, O’Riordain MG, Lavery IC, et al. Long term functional outcome and quality of life after stapled restorative proctocolectomy. Ann Surg 1999;230(4):575–586. doi: 10.1097/00000658-199910000-00013.PubMedCrossRefGoogle Scholar
  2. 2.
    Robb B, Pritts T, Gang G, et al. Quality of life in patients undergoing ileal pouch anal anastomosis at the University of Cincinnati. Am J Surg 2002;183:343–360. doi: 10.1016/S0002-9610(02)00804-8.CrossRefGoogle Scholar
  3. 3.
    Parks AG, Nicholls RJ. Proctocolectomy without ileostomy fro ulcerative colitis. BMJ 1978;2:85–88.PubMedCrossRefGoogle Scholar
  4. 4.
    Fazio VW, Tekkis PP, Remzi F, et al. Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery. Ann Surg 2003;238:605–617.PubMedGoogle Scholar
  5. 5.
    McLeod RS, Baxter NN. Quality of life of patients with inflammatory bowel disease after surgery. World J Surg 1998;28:375–381. doi: 10.1007/s002689900400.CrossRefGoogle Scholar
  6. 6.
    Pemberton JH, Phillips SF, Ready RR, et al. Quality of life after Brooke ileostomy and ileal pouch-anal anastomosis. Comparison of performance status. Ann Surg 1989;209:620–628. doi: 10.1097/00000658-198905000-00015.PubMedCrossRefGoogle Scholar
  7. 7.
    Karlbolm U, Raab Y, Ejerblad S, et al. Factors influencing the functional outcome of restorative proctocolectomy in ulcerative colitis. Br J Surg 2000;87:1401–1408. doi: 10.1046/j.1365-2168.2000.01533.x.CrossRefGoogle Scholar
  8. 8.
    Provenzale D, Shearin M, Phillips-Bute BG, et al. Health-related quality of life after ileoanal pull-through evaluation and assessment of new health status measures. Gastroenterology 1997;113:7–14. doi: 10.1016/S0016-5085(97)70074-X.PubMedCrossRefGoogle Scholar
  9. 9.
    Delaney CP, Dadvand B, Remzi FH, et al. Functional outcome, quality of life and complication after ileal pouch-anal anastomosis in selected septuagenarians. Dis Colon Rectum 2002;45(7):890–894. doi: 10.1007/s10350-004-6323-9.PubMedCrossRefGoogle Scholar
  10. 10.
    Delaney CP, Fazio VW, Remzi FH, et al. Prospective, age related analysis of surgical results functional outcome and quality of life after ileal pouch-anal anastomosis. Ann Surg 2003;238:221–228.PubMedGoogle Scholar
  11. 11.
    Delaney CP, Remzi FH, Gramlich T, et al. Equivalent function, quality of life and pouch survival rates after ileal pouch-anal anastomosis for indeterminate and ulcerative colitis. Ann Surg 2002;236:43–48. doi: 10.1097/00000658-200207000-00008.PubMedCrossRefGoogle Scholar
  12. 12.
    Tiainen J, Matikainen M. Health related quality of life after J pouch-anal anastomosis for ulcerative colitis: long term results. Scand J Gastroenterol 1999;34(6):601–605. doi: 10.1080/003655299750026065.PubMedCrossRefGoogle Scholar
  13. 13.
    Muir AJ, Edwards LJ, Sanders MS, et al. A prospective evaluation of health related quality of life after ileal pouch anal anastomosis for ulcerative colitis. Am J Gastroenterol 2001;95(5):1480–1485. doi: 10.1111/j.1572-0241.2001.03801.x.CrossRefGoogle Scholar
  14. 14.
    Coffey JC, Winter DC, Neary P, et al. Quality of life after ileal pouch-anal anastomosis: an evaluation of diet and other factors using the Cleveland global Quality of life instrument. Dis Colon Rectum 2002;45(1):30–38.PubMedGoogle Scholar
  15. 15.
    Irvine EJ. Quality of life: measurement in inflammatory bowel disease. Scand J Gastroenterol Suppl 1993;199:36–39. doi: 10.3109/00365529309098355.PubMedCrossRefGoogle Scholar
  16. 16.
    McLeod RS. Quality of life measurement in the assessment of surgical outcome. Adv Surg 1999;33:293–309.PubMedGoogle Scholar
  17. 17.
    Ko CY, Rusin LC, Schoetz DJ, et al. Long term outcomes of ileal pouch anal anastomosis: the association of bowel function and quality of life 5 years after surgery. J Surg Res 2001;98:102–107. doi: 10.1006/jsre.2001.6171.PubMedCrossRefGoogle Scholar
  18. 18.
    Hauser W, Dietz N, Steder-Neukamm U, Janke KH, Stallmach A. Biopsychosocial determinants of health-related quality of life after ileal pouch anal anastomosis for ulcerative colitis. Inflamm Bowel Dis 2004;10(4):399–407. doi: 10.1097/00054725-200407000-00011.PubMedCrossRefGoogle Scholar
  19. 19.
    Barton JG, Paden MA, Lane M, Postier RG. Comparison of postoperative outcomes in ulcerative colitis and familial polyposis after ileal-anal pouch anastomosis. Am J Surg 2001;182(6):616–620. doi: 10.1016/S0002-9610(01)00795-4.PubMedCrossRefGoogle Scholar
  20. 20.
    Martin A, Dinca M, Leone L, et al. Quality of life after proctocolectomy and ileo anal anastomosis for severe ulcerative colitis. Am J Gastroenterol 1998;93(2):166–169. doi: 10.1111/j.1572-0241.1998.00166.x.PubMedCrossRefGoogle Scholar
  21. 21.
    Scarpa M, Angriman I, Ruffolo C, et al. Health related quality of life after restorative proctocolectomy for ulcerative colitis: long-term results. World J Surg 2004;58(2):122–126.Google Scholar
  22. 22.
    Martin A, Leone L, Fries W, et al. Quality of life in inflammatory bowel disease. Ital J Gastroenterol 1995;27:450–454.PubMedGoogle Scholar
  23. 23.
    Scarpa M, Ruffolo C, Polese L, Martin A, D’Incà R, Sturniolo GC, D’Amico DF, Angriman I. Quality of life after restorative proctocolectomy for ulcerative colitis: different questionnaires lead to different interpretations. Arch Surg 2007;142(2):158–165. doi: 10.1001/archsurg.142.2.158.PubMedCrossRefGoogle Scholar
  24. 24.
    Brown CJ, MacLean AR, Cohen Z, MacRae HM, O’Connor BI, McLeod RS. Crohn’s disease and indeterminate colitis and the ileal pouch anal-anastomosis: outcomes and patterns of failure. Dis Colon Rectum 2005;48:1542–1549. doi: 10.1007/s10350-005-0059-z.PubMedCrossRefGoogle Scholar
  25. 25.
    Scarpa M, Ruffolo C, D’Incà R, Filosa T, Bertin E, Ferraro S, Polese L, Martin A, Sturniolo GC, Frego M, D’Amico DF, Angriman I. Health related quality of life after ileo-colonic resection for Crohn’s disease: long-term results. Inflamm Bowel Dis. 2007;13(4):462–469. doi: 10.1002/ibd.20080.PubMedCrossRefGoogle Scholar
  26. 26.
    Guyatt G, Mitchell A, Irvine EJ, Singer J, Williams N, Goodacre R, Tompkins C. A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterol 1989;96(3):804–810.Google Scholar
  27. 27.
    Irvine EJ, Zhou Q, Thompson AK. CCRPT Investigators. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. Am J Gastroenterol 1996;91(8):1571–1578.PubMedGoogle Scholar
  28. 28.
    Stewart AL, Hays RD, Ware JE. The MOS short form general health survey: reliability and validity in patient population. Med Care 1988;36:925–930.Google Scholar
  29. 29.
    Bland JM, Altman DG. Cronbach’s alpha. BMJ 1997;314:572.PubMedGoogle Scholar
  30. 30.
    Fazio VW, Ziv Y, Church JM, et al. Ileal pouch-anal anastomosis complications and function in 1005 patients. Ann Surg 1995;222:120–127. doi: 10.1097/00000658-199508000-00003.PubMedCrossRefGoogle Scholar
  31. 31.
    Michelassi F, Lee J, Rubin M, et al. Long term functional results after ileal pouch anal restorative proctocolectomy for ulcerative colitis. Ann Surg 2003;238(3):433–445.PubMedGoogle Scholar
  32. 32.
    Bambrick M, Fazio VW, Hull TL, Pucel G. Sexual function following restorative proctocolectomy in women. Dis Colon Rectum 1996;39(6):610–614. doi: 10.1007/BF02056936.PubMedCrossRefGoogle Scholar
  33. 33.
    Tiainen J, Matikainen M, Hilunen KM. Ileal J pouch-anal anastomosis, sexual dysfunction and fertility. Scand J Gastroenterol 1999;34(2):185–188. doi: 10.1080/00365529950173069.PubMedCrossRefGoogle Scholar
  34. 34.
    Streiner GL, Norman DR. Health Measurement Scales: A Practical Guide to their Development and Use. Oxford: Oxford University Press, 1990.Google Scholar
  35. 35.
    Polle SW, Dunker MS, Slors JF, Sprangers MA, Cuesta MA, Gouma DJ, Bemelman WA. Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial. Surg Endosc 2007;21(8):1301–1307. doi: 10.1007/s00464-007-9294-9.PubMedCrossRefGoogle Scholar
  36. 36.
    Cohen Z, Smith D, McLeod R. Reconstructive surgery for pelvic pouches. World J Surg 1998;22(4):342–346. doi: 10.1007/s002689900394.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2008

Authors and Affiliations

  • Marco Scarpa
    • 1
  • Charles J. Victor
    • 5
  • Brenda I. O’Connor
    • 2
    • 4
  • Zane Cohen
    • 2
    • 4
  • Robin S. McLeod
    • 2
    • 3
    • 4
    • 6
  1. 1.Department of SurgeryVeneto Oncological Institute (IOV-IRCCS)PadovaItaly
  2. 2.Department of SurgeryUniversity of TorontoTorontoCanada
  3. 3.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  4. 4.Digestive Disease Research Centre and Samuel Lunenfeld Research Institute, Mount Sinai HospitalUniversity of TorontoTorontoCanada
  5. 5.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  6. 6.Mount Sinai HospitalTorontoCanada

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