title: Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL.
abstract: BACKGROUND
  Colonic diverticular disease is typically conceived as acute diverticulitis attacks surrounded by periods of clinical silence. However, evolving data indicate that many patients have persistent symptoms and diminished health-related quality of life (HRQOL) long after acute attacks. We developed a disease-targeted HRQOL measure for symptomatic uncomplicated diverticular disease (SUDD)-the diverticulitis quality of life (DV-QOL) instrument.
  
  
  METHODS
  We conducted a systematic literature review to craft a conceptual model of SUDD HRQOL. This was complemented by three focus groups including 45 SUDD patients. We developed items based on our literature search, focus groups, and cognitive debriefings. We administered the items to SUDD patients with persistent symptoms following a confirmed diverticulitis event. We created scales based on factor analysis and evaluated the scales for reliability and validity.
  
  
  RESULTS
  Concept elicitation revealed a range of illness experiences attributed to SUDD. Coding of 20,490 transcribed words yielded a 52-code network with four primary, condition-related concepts: (1) physical symptoms (e.g., bloating); (2) behaviors (e.g., restrictions); (3) cognitions and concerns (e.g., fear); and (4) impact and consequences (e.g., absenteeism, anxiety). Based on patient language, we developed the 17-item DV-QOL instrument. In a cross-sectional validation sample of 197 patients, DV-QOL discriminated between patients with recent versus distant diverticulitis events and correlated highly with Short Form 36 and hospital anxiety and depression scores.
  
  
  CONCLUSIONS
  Patients with SUDD attribute a wide range of negative psychological, social, and physical symptoms to their condition, both during and after acute attacks; DV-QOL captures these symptoms in a valid, reliable manner.
authors: Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Building 115, Room 215, Los Angeles, CA, 90073, USA, bspiegel@mednet.ucla.edu.
authors: Brennan M R
authors: BM
authors: Spiegel
authors: Mark W
authors: MW
authors: Reid
authors: Roger
authors: R
authors: Bolus
authors: Cynthia B
authors: CB
authors: Whitman
authors: Jennifer
authors: J
authors: Talley
authors: Stanley
authors: S
authors: Dea
authors: Kamyar
authors: K
authors: Shahedi
authors: Hetal
authors: H
authors: Karsan
authors: Chassidy
authors: C
authors: Teal
authors: Gil Y
authors: GY
authors: Melmed
authors: Erica
authors: E
authors: Cohen
authors: Garth
authors: G
authors: Fuller
authors: Linnette
authors: L
authors: Yen
authors: Paul
authors: P
authors: Hodgkins
authors: M Haim
authors: MH
authors: Erder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D004241:Diverticulum, Colon / Q000503:physiopathology; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires