A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers

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Abstract

Quality of life has emerged as an essential health component that broadens the traditionally narrow concerns focused on only morbidity and life expectancy. Although a growing number of tools to measure quality of life are in circulation, there is a lack of guidelines as well as rigorous assessment for their use with pregnant and postpartum populations. It is also unclear whether these instruments could validly be employed to measure patient-reported outcomes in comparative effectiveness research of maternal care interventions. This paper reviews articles cited in CINAHL, COCHRANE, EMBASE, PSYCINFO, and PUBMED that addressed quality of life in pregnant and postpartum populations. Instruments used to measure quality of life in selected articles were assessed for their adherence to international guidelines for health outcomes instrument development and validation. The authors identified 129 articles that addressed quality of life in pregnant and/or postpartum women. Out of these, only 64 quality (generic and specific) scales were judged relevant to be included in this study. Analysis of measurement scales used in the pregnant and/or postpartum populations revealed important validity, reliability and psychometric inadequacies that negate their use in comparative effectiveness analysis in pregnant and post-partum populations. Valid, reliable, and responsive instruments to measure patient-reported outcomes in pregnant and postpartum populations are lacking. To demonstrate the effectiveness of various treatment and prevention programs, future research to develop and validate a robust and responsive quality of life measurement scale in pregnant and postpartum populations is needed.

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Most cited references 78

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ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence.

Kerry NL Avery, Jenny L Donovan, Tim Peters … (2004)

To develop and evaluate the International Consultation on Incontinence Questionnaire (ICIQ), a new questionnaire to assess urinary incontinence and its impact on quality of life (QoL). A developmental version of the questionnaire was produced following systematic literature review and views of an expert committee and patients. Several studies were undertaken to evaluate the psychometric properties of the questionnaire, including content, construct and convergent validity, reliability and sensitivity to change. The ICIQ was easily completed, with low levels of missing data (mean 1.6%). It was able to discriminate among different groups of individuals, indicating good construct validity. Convergent validity was acceptable, with most items demonstrating 'moderate' to 'strong' agreement with other questionnaires. Reliability was good, with 'moderate' to 'very good' stability in test-retest analysis and a Cronbach's alpha of 0.95. Items identified statistically significant reductions in symptoms from baseline following surgical and conservative treatment. Item reduction techniques were used to determine the final version and scoring scheme, which also demonstrated good psychometric properties. The final ICIQ comprises three scored items and an unscored self-diagnostic item. It allows the assessment of the prevalence, frequency, and perceived cause of urinary incontinence, and its impact on everyday life. The ICIQ is a brief and robust questionnaire that will be of use in outcomes and epidemiological research as well as routine clinical practice. Copyright 2004 Wiley-Liss, Inc.

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Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7).

Eric Walters, Richard C. Bump, Cecily Barber (2005)

To develop short forms of 2 valid and reliable condition-specific quality-of-life questionnaires for women with disorders of the pelvic floor including urinary incontinence, pelvic organ prolapse, and fecal incontinence (Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire). Data from the 100 women who contributed to the development and validation of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms were used to develop the short-form questionnaires. All subsets regression analysis was used to find the items in each scale that best predicted the scale score on the respective long form. When different items appeared equivalent, a choice was made on item content. After development, the short forms and the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms were administered preoperatively to 45 women with pelvic floor disorders scheduled to undergo surgery to evaluate the correlation between short and long forms in a second independent population. The short forms were readministered 3 to 6 months postoperatively to assess the responsiveness of the instruments. The short-form version of the Pelvic Floor Distress Inventory has a total of 20 questions and 3 scales (Urinary Distress Inventory, Pelvic Organ Prolapse Distress Inventory, and Colorectal-Anal Distress Inventory). Each short-form scale demonstrates significant correlation with their long-form scales (r=.86, r=.92, and r=.93, respectively, P<.0001). For the Pelvic Floor Impact Questionnaire short form, the previously developed short form for the Incontinence Impact Questionnaire-7 was used as a template. The 7 items identified in the previously developed Incontinence Impact Questionnaire-7 short form correlate highly with the Incontinence Impact Questionnaire long form (r=.96, P<.0001) as well as the long forms of the Colorectal-Anal Impact Questionnaire scale (r=.96, P<.0001) and the Pelvic Organ Prolapse Impact Questionnaire (r=.94, P<.0001). All subsets regression analysis did not identify any items or combination of items that correlated substantially better for any of the 3 scales. The scales of the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 maintained their excellent correlation to the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire long forms in the second independent sample (r=.88 to .94 for scales of Pelvic Floor Distress Inventory-20; r=.95 to .96 for scales of Pelvic Floor Impact Questionnaire-7, P<.0001 for all). The test-retest reliability of each scale was good to excellent (intraclass correlation coefficient 0.70 to 0.93, P<.001 for all scales). The scales and summary scores of the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 demonstrated moderate to excellent responsiveness 3 to 6 months after surgery. The Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 are valid, reliable, and responsive short forms of 2 condition-specific quality-of-life questionnaires for women with pelvic floor disorders.

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A new questionnaire to assess the quality of life of urinary incontinent women

C Kelleher, L Cardozo, V Khullar … (1997)

To design and validate a condition-specific quality of life questionnaire for the assessment of women with urinary incontinence, and to use the questionnaire to assess the quality of life of women with specific urodynamic diagnoses.

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Author and article information

Contributors

Mulubrhan F. Mogos

Euna M. August

Abraham A. Salinas-Miranda

Dawood H. Sultan

Hamisu M. Salihu

Journal

Journal ID (nlm-journal-id): 101313787

Journal ID (pubmed-jr-id): 37338

Journal ID (nlm-ta): Appl Res Qual Life

Journal ID (iso-abbrev): Appl Res Qual Life

Title: Applied research in quality of life

ISSN (Print): 1871-2584

ISSN (Electronic): 1871-2576

Publication date Nihms-submitted: 31 December 2012

Publication date (Electronic): 9 September 2012

Publication date (Print): 1 June 2013

Publication date PMC-release: 01 June 2013

Volume: 8

Issue: 2

Pages: 219-250

Affiliations

Maternal & Child Health Comparative Effectiveness Research Group, Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA

Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA

Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA

Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL 33612, USA

Article

Accession ID: PMC3667203 Pmcid ID: PMC3667203 Pmc-uid ID: 3667203 Manuscript ID: nihpa430971

DOI: 10.1007/s11482-012-9188-4

PMC ID: 3667203

PubMed ID: 23734167

SO-VID: 189c9de4-0a75-4774-a279-009171f79fba

History

Funding

Funded by: National Center on Minority Health and Health Disparities : NIMHD

Award ID: P20 MD003375 || MD

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A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers

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Asian Journal of Quality of Life (AjQoL)

Most cited references 78

ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence.

Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7).

A new questionnaire to assess the quality of life of urinary incontinent women

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Cited by 41

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