title: Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire: results from focus groups with visually impaired persons.
abstract: OBJECTIVE
  To identify the content area for a questionnaire designed to measure vision-targeted health-related quality of life and to determine whether problems with vision-related functioning are qualitatively similar across different common eye diseases.
  
  
  METHODS
  Twenty-six condition-specific focus groups were conducted with 246 patients from 5 geographic regions to identify the content area for a questionnaire for use among persons with diabetic retinopathy, glaucoma, macular degeneration, cytomegalovirus retinitis, and cataract. A standard protocol was used to structure each focus group discussion. Sessions were audiotaped, transcribed, and coded in preparation for a content analysis.
  
  
  METHODS
  Five university-based ophthalmology practices and 1 nonprofit eye care foundation.
  
  
  METHODS
  Eligible participants had to have 1 of the following eye conditions: age-related cataracts, age-related macular degeneration, diabetic retinopathy, primary open angle glaucoma, cytomegalovirus retinitis, or low vision from any cause. All eligible persons were older than 21 years, spoke English, and had sufficient cognitive function to provide informed consent.
  
  
  RESULTS
  Among the 246 participants, 2623 problems with vision-related functioning were mentioned. The mean number of problems per person ranged from 13.5 for those with diabetic retinopathy to 7.9 for persons with glaucoma. For the sample overall, reading problems were mentioned most frequently, followed by driving, general problems with seeing clearly, and mental health complaints caused by vision. Although the proportion of persons who reported each problem varied by condition, at least some persons with each eye disease reported each problem. The 3 most common descriptors associated with each problem were difficulty or ease of performance (13%), psychological distress associated with performance of the activity (11%), and complete inability to participate in a visual activity (11%).
  
  
  CONCLUSIONS
  An item-generation strategy for a new questionnaire using a standardized focus group method identified content areas and aspects of visual disability that are not included in currently available vision-specific instruments that assess the impact of common eye diseases on visual functioning in every-day life. Although participants mentioned problems that were unique to their disease, across conditions the problems mentioned were similar. These findings provide empirical evidence of content validity for a vision-targeted, health-related quality-of-life survey designed for use across conditions.
authors.affiliation: RAND Health Program, RAND, Santa Monica, Calif 90401, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Mangione
authors.forename: S
authors.initials: S
authors.lastname: Berry
authors.forename: K
authors.initials: K
authors.lastname: Spritzer
authors.forename: N K
authors.initials: NK
authors.lastname: Janz
authors.forename: R
authors.initials: R
authors.lastname: Klein
authors.forename: C
authors.initials: C
authors.lastname: Owsley
authors.forename: P P
authors.initials: PP
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000503:physiopathology; D017726:Cytomegalovirus Retinitis / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology; D005128:Eye Diseases / Q000503:physiopathology*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology; D006305:Health Status Indicators; D006801:Humans; D007802:Language; D008268:Macular Degeneration / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009316:National Institutes of Health (U.S.); D009885:Ophthalmology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D014792:Visual Acuity / Q000502:physiology*; D019987:Persons with Visual Disabilities