Development Of The Quality Of Life Scale For Patients With Malignant Obstructive Jaundice

Objective The survival time of patients with malignant obstructive jaundice is shorter than other patients. Their quality of life needs more concern, yet there is no specific measuring instrument. This study was designed to develope a scale of quality of life which fits patients with malignant obstructive jaundice. It will be a useful instrument for the medical staff to choose treatment methods and interventions.Methods The scale is composed of a common module and a specific module. The EORTC QLQ-C30 Chinese Version is used as the common module, whereas the specific module is what this study is targeted.The item pool was developed on the basis of literature review and clinical observation, according to the definition of quality of life from WHO. The preliminary specific module was developed by Delphi Method and patients'interview.The survey was conducted in 85 patients with malignant obstructive jaundice in a hepatobiliary surgery hospital. An 11-item specific module was developed by screening items through variation method, the correlation coefficient method, multiple stepwise regression analysis and factor analysis with SPSS10.0 software.The survey was conducted in 142 patients with malignant obstructive jaundice in a hepatobiliary surgery hospital in order to evalue the reliability and validity of the scale. The resurvey was conducted in 60 patients with malignant obstructive jaundice in the 3rd day after their admission in order to evalue the test-retest reliability of the scale. The resurvey was conducted in 55 patients with malignant obstructive jaundice in the last day after their admission in order to evalue the sensitivity of the scale. The main statistical methods used including correlate analysis, reliability analysis, t-test, rank sum test, factor analysis, ANOVA analysis.Results (1) A specific module including two domains and three simple items was developed. (2) The Alpha coefficient of the scale was 0.87, the common module was 0.85, the specific module was 0.77, and the domains were between 0.44 and 0.89. The split-half reliability of the common module was 0.90, the specific module was 0.73, and the domains were between 0.44 and 0.89. The test-retest correlation coefficient of the specific module was 0.92 (P<0.01), and the domains were between 0.62 and 0.95 (P<0.01). The comparison of test and retest means of domains indicated there were no statistically significant differences (p>0.05). It was inferred from the correlation analysis that there were strong correlation between items and their own domains; conversely there were weak correlation between items and other domains. The scale can differentinate the quality of life of patients undergoing operations. (3) The analysis of the survey for patients with malignant obstructive jaundice shows that age, gender, occupation, culture and serum bilirubin affect quality of life.Conclusions A malignant obstructive jaundice module was developed, which integrate QLQ-C30 as the scale of quality of life for patients with malignant obstructive jaundice. The scale has better readability, good reliability, validity and sensitivity. It can reflect the quality of life of patients with malignant obstructive jaundice, which is comprehensive, specific and accurate. It can be used as an instrument to measure the quality of life for patients with malignant obstructive jaundice.