Development and validation of the neck dissection impairment index: a quality of life measure.
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.
Taylor
Rodney J
RJ
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA.
Chepeha
Judith C
JC
Teknos
Theodoros N
TN
Bradford
Carol R
CR
Sharma
Pramod K
PK
Terrell
Jeffrey E
JE
Hogikyan
Norman D
ND
Wolf
Gregory T
GT
Chepeha
Douglas B
DB
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*