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Reliability and Responsiveness of NutriQoL® Questionnaire

Abstract

Introduction

NutriQoL® (Nestlé Health Science, Vevay, Switzerland) is a questionnaire developed to assess the health-related quality-of-life (HRQoL) of patients with home enteral nutrition (HEN) irrespective of their underlying condition and route of administration. The aim of this work is assessing the questionnaire’s reliability and responsiveness to change.

Methods

Two cohorts of patients with HEN and their primary caregivers were enrolled to assess reliability and responsiveness, respectively. All participants had to be 18 years of age or older, without mental deterioration (≤3 or 4 errors in the Pfeiffer’s test) and with sufficient functional status (>40 points on Karnovsky’s performance status scale). When the patients’ ability to respond to the questionnaire was impaired due to underlying disease, their caregivers answered on their behalf. NutriQoL was administered in two and three visits to reliability and responsiveness cohorts, respectively. Test–retest reliability and internal consistency were assessed by the intra-class correlation coefficient (ICC) and the Cronbach’s α, respectively. Responsiveness was evaluated by standardized effect size and standardized response mean between basal visit and third visit. Finally, the minimal clinically important difference (MCID) was estimated.

Results

A total of 54 and 86 participants were recruited to the reliability and responsiveness cohort, respectively. Thirty-five caregivers were selected to assess the inter-observer reliability. ICC values confirmed the good reproducibility level (ICC >0.75) of the questionnaire in both “physical functioning and activities of daily living” and “social life” domains and total score. The assessment of internal consistency in both domains of the questionnaire showed good internal consistency in visit 2. ICC showed the excellent agreement level between caregiver and patient in the global NutriQoL score. Finally, patients classified as having a minimal change in their health reported a mean (standard deviation) MCID in NutriQoL score of 0.63 (11.51).

Conclusion

NutriQoL is a reliable and unique instrument to measure the HRQoL in HEN patients. NutriQoL detects changes in the health status of the patient. Nevertheless, further research is needed to determine the full extent of the questionnaire responsiveness.

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References

  1. 1.

    Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN guidelines on enteral nutrition: terminology, definitions and general topics. Clin Nutr. 2006;25(2):180–6.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    McNamara EP, Food P, Kennedy NP. Home tube feeding: an integrate multidisciplinary approach. J Hum Nutr Diet. 2001;14:13–9.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Bannerman E, Pendlebury J, Phillips F, et al. A crosssectional and longitudinal study of health-related quality of life after percutaneous gastrostomy. Eur J Gastroenterol Hepatol. 2000;12:1101–9.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Jordan S, Philpin S, Warring J, et al. Percutaneous endoscopic gastrostomies: the burden of treatment from a patient perspective. J Adv Nurs. 2006;56:270–81.

    Article  PubMed  Google Scholar 

  5. 5.

    Stevens CS, Lemon B, Lockwood GA, Waldron JN, Bezjak A, Ringash J. The development and validation of a quality-of-life questionnaire for head and neck cancer patients with enteral feeding tubes: the QOL-EF. Support Care Cancer. 2011;19(8):1175–82.

    Article  PubMed  Google Scholar 

  6. 6.

    Schneider SM, Pouget I, Staccini P, et al. Quality of life in long-term home enteral nutrition patients. Clin Nutr. 2000;19(1):23–8.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Wanden-Berghe C, Nolasco A, Sanz-Valero J, Planas M, Cuerda C, Group NADYA-SENPE. Health-related quality of life in patients with home nutritional support. J Hum Nutr Diet. 2009;22(3):219–25.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Bjuresäter K, Larsson M, Athlin E, et al. Patients living with home enteral tube feeding: side effects, health-related quality of life and nutritional care. Clin Nurs Studies. 2014;2(3):64–75.

    Google Scholar 

  9. 9.

    García de Yébenes Prous MJ, Rodriguez Salvanes F, Carmona Ortells L. Validación de cuestionarios. Reumatol Clin. 2009;5(4):171–7.

    Article  PubMed  Google Scholar 

  10. 10.

    Hernández I, Porta M, Miralles M, et al. La cuantifiación de la variabilidad en las observaciones clínicas. Med Clin (Barc). 1990;95:424–9.

    Google Scholar 

  11. 11.

    Prieto L, Lamarca R, Casado A. La evaluación de la fiabilidad en las observaciones clínicas: el coeficiente de correlación intraclase. Med Clin (Barc). 1998;110:142–5.

    CAS  Google Scholar 

  12. 12.

    , et al. Health-related quality of life according to the main caregiver in patients with home nutritional support. Med Clin (Barc). 2008;131(8):281–4.

    PubMed  Google Scholar 

  13. 13.

    Terwee CB, Dekker FW, Wiersinga WM, et al. On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res. 2003;12:349–62.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Husted JA, Cook RJ, Farewell VT, et al. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53(5):459–68.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Revicki D, Hays RD, Cella D, et al. Recommended methods for determining responsiveness and minimally important differences for patient-reported outcomes. J Clin Epidemiol. 2008;61(2):102–9.

    Article  PubMed  Google Scholar 

  16. 16.

    Martínez de la Iglesia J, Dueñas Herrero R, Onís Vilches MC, Aguado Taberné C, Albert Colomer C, Luque Luque R. Spanish language adaptation and validation of the Pfeiffer’s questionnaire (SPMSQ) to detect cognitive deterioration in people over 65 years of age. Med Clin (Barc). 2001;117(4):129–34.

    Article  Google Scholar 

  17. 17.

    Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderl y patients. J Am Geriatr Soc. 1975;23:433–41.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncology. 1984;2:187–93.

    CAS  Google Scholar 

  19. 19.

    Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997;314:572.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    López de Ullibarri I, Pita S. Medidas de concordancia: el índice de Kappa. Cad Aten Primaria. 1999;6:169–71.

    Google Scholar 

  21. 21.

    Ghandi PK, Ried LD, Bibbey A, et al. SF-6D utility index as measure of minimally important difference in health status change. J Am Pharm Assoc (2003). 2012;52(1):34–42.

    Article  Google Scholar 

  22. 22.

    Osin M, Wongchinsri J, Ukrichon S, Hanvivadhanakul P, Kasitanon N, Siripaitoon B. Comprenhensibility, reliability, validity and responsiveness of the Thai version of the Health Assessment Questionnaire in Thai patients with rheumatoid arthritis. Arthritis Res Ther. 2009;11(4):R129.

    Article  Google Scholar 

  23. 23.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.

    CAS  Article  PubMed  Google Scholar 

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Acknowledgments

Sponsorship and article processing charges for this study were funded by Nestlé Health Science, Barcelona, Spain.

Medical writing assistance for this study was provided by Outcomes’10, Castellón de la Plana, Spain, and funded by Nestlé Health Science, Barcelona, Spain.

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.

Disclosures

Nestlé Health Science sponsored the study. The authors Maria Cristina Cuerda, Antonio Apezetxea, Lourdes Carrillo, Felipe Casanueva, Federico Cuesta, Jose Antonio Irles, and Maria Nuria Virgili state that they have no conflict of interest. Miquel Layola works at Nestlé Health Science. Luis Lizán works for an independent research organisation (Outcomes’10, S.L.) which has received fees for its contribution to the development and coordination of the original research project and to the writing of this manuscript.

Compliance with Ethics Guidelines

This study was performed according to the Code of Ethics of the World Medical Association (Declaration of Helsinki of 1964, as revised in 2013) and was approved by the Clinical Research Ethics Committee from the Hospital Clinic of Barcelona. All participants (patients and caregivers) gave their consent to participate in the study.

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Correspondence to Luis Lizán.

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Cuerda, M.C., Apezetxea, A., Carrillo, L. et al. Reliability and Responsiveness of NutriQoL® Questionnaire. Adv Ther 33, 1728–1739 (2016). https://doi.org/10.1007/s12325-016-0384-8

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Keywords

  • Gastroenterology
  • Health-related quality-of-life
  • Home enteral nutrition
  • Reliability
  • Responsiveness