Design Of Three New Condition-Specific Questionnaires To Assess Quality Of Life, Symptoms And Treatment Satisfaction Of Patients With Abdominal Aortic Aneurysm: The Aneurysm-Dqol, Aneurysm-Srq And Aneurysm-Tsq

OBJECTIVES: In the UK, abdominal aortic aneurysms (AAA) affect 5-10% of men and 1.5% of women >65yrs. Previous reports of symptoms and quality of life (QoL) were conflicting when no AAA-specific tools were available. The present work aimed to design three AAA-specific questionnaires: the Aneurysm-Dependent Quality of Life Questionnaire (Aneurysm-DQoL), Aneurysm Symptom Rating Questionnaire (Aneurysm-SRQ), and Aneurysm Treatment Satisfaction Questionnaire (Aneurysm-TSQ).

METHODS: 41 patients with AAA from five NHS Trusts participated in focus group discussions of experiences of AAA. This information guided inclusion of items in the questionnaires, supported by the clinical experience of vascular surgeon co-authors and an existing pool of items from existing questionnaires developed by CB and colleagues for other conditions. Initial questionnaire drafts were refined through 13 one-to-one patient interviews.

RESULTS: The new Aneurysm-DQoL has 23 life domains (16 from an existing item bank, 5 modified, 2 new) that were identified as being important to the QoL of patients with AAA. The Aneurysm-SRQ is a 44-Item measure, which assesses a wide range of physical and psychological symptoms. (16 bank, 14 modified, 14 new). The Aneurysm-TSQ has 11 items (2 bank, 6 modified, 3 new): 7 are suitable pre- and post-intervention and 4 are suitable post-intervention only. The qualitative work revealed several previously unrecognised issues for patients with AAA, confirming the importance of AAA-specific measures. These included the impact on QoL of self-imposed restrictions on activity, notably patients’ avoidance of sexual activity (rather than poor sexual function). Also, follow-up scans were reassuring rather than worrying for patients.

CONCLUSIONS: The detailed development process confirmed that the new tools have good face and content validity for patients with AAA. Item banks were valuable; few new items were needed for Aneurysm-DQoL and Aneurysm-TSQ. Psychometric analyses are being reported elsewhere. The questionnaires are ready for wider clinical use and further validation.