title: Quality of life evaluation in wounds: validation of the Freiburg Life Quality Assessment-wound module, a disease-specific instrument.
abstract: Many patients with chronic wounds suffer not only directly from their wounds but also from high financial, social and psychological impairments, significantly reducing their quality of life. In order to provide an instrument both applicable to different patient populations and sensitive to areas of impact specific to certain skin diseases, the modular instrument 'Freiburg Life Quality Assessment' has been developed. Each disease-specific version of the instrument consists of a core module of generic items and items specific for a distinct skin disease. Objective of the study was to assess reliability, sensitivity to change, and validity of the module for chronic ulcers. The instrument was implemented in a longitudinal observational study on vacuum-seal therapy (n = 175), in a cross-sectional observational study involving patients with chronic leg ulcers (n = 384) and in a randomised clinical trial on keratinocyte transplantation (n = 198). The instrument showed good internal consistency (Cronbach's alpha ≥0·85). There were minor floor effects ≤4·3%, but no ceiling effects. Retest-reliability and convergent validity with the EuroQol quality of life questionnaire (EQ-5D) (visual analogue scale) were satisfactory. Change scores correlated with change in other quality-of-life instruments (r = 0·59-0·61), but not with change in wound status.
authors.affiliation: German Center for Health Services Research in Dermatology, Institute for Health Services Research in Dermatology and Nursing, University Clinics of Hamburg, Martinistraße 52, D-20246 Hamburg, Germany. m.augustin@uke.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Augustin
authors.forename: Katharina
authors.initials: K
authors.lastname: Herberger
authors.forename: Stephan J
authors.initials: SJ
authors.lastname: Rustenbach
authors.forename: Ines
authors.initials: I
authors.lastname: Schäfer
authors.forename: Ina
authors.initials: I
authors.lastname: Zschocke
authors.forename: Christine
authors.initials: C
authors.lastname: Blome
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation; D007871:Leg Ulcer / Q000209:etiology / Q000451:nursing / Q000523:psychology*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D054843:Negative-Pressure Wound Therapy; D009730:Nursing Assessment / Q000379:methods*; D015403:Nursing Evaluation Research; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*