title: Development and validation of the neck dissection impairment index: a quality of life measure.
abstract: OBJECTIVE
  To validate a health-related quality-of-life (QOL) instrument for patients following neck dissection and to identify the factors that affect QOL following neck dissection.
  
  
  METHODS
  Cross-sectional validation study.
  
  
  METHODS
  The outpatient clinic of a tertiary care cancer center.
  
  
  METHODS
  Convenience sample of 54 patients previously treated for head and neck cancer who underwent a selective neck dissection or modified radical neck dissection (64 total neck dissections). Patients had a minimum postoperative convalescence of 11 months. Thirty-two underwent accessory nerve-sparing modified radical neck dissection, and 32 underwent selective neck dissection.
  
  
  METHODS
  A 10-item, self-report instrument, the Neck Dissection Impairment Index (NDII), was developed and validated. Reliability was evaluated with test-retest correlation and internal consistency using the Cronbach alpha coefficient. Convergent validity was assessed using the 36-Item Short-Form Health Survey (SF-36) and the Constant Shoulder Scale, a shoulder function test. Multiple variable regression was used to determine variables that most affected QOL following neck dissection
  
  
  RESULTS
  The 10-item NDII test-retest correlation was 0.91 (P<.001) with an internal consistency Cronbach alpha coefficient of.95. The NDII correlated with the Constant Shoulder Scale (r = 0.85, P<.001) and with the SF-36 physical functioning (r = 0.50, P<.001) and role-physical functioning (r = 0.60, P<.001) domains. Using multiple variable regression, the variables that contributed most to QOL score were patient's age and weight, radiation treatment, and neck dissection type.
  
  
  CONCLUSIONS
  The NDII is a valid, reliable instrument for assessing neck dissection impairment. Patient's age, weight, radiation treatment, and neck dissection type were important factors that affect QOL following neck dissection.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Taylor
authors.forename: Judith C
authors.initials: JC
authors.lastname: Chepeha
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Teknos
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Sharma
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Terrell
authors.forename: Norman D
authors.initials: ND
authors.lastname: Hogikyan
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
mesh_terms: D000368:Aged; D005163:Factor Analysis, Statistical; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006305:Health Status Indicators; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011788:Quality of Life; D015203:Reproducibility of Results; D012782:Shoulder / Q000502:physiology*