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A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.

dc.contributor.author Dolor, RJ
dc.contributor.author Edwards, R
dc.contributor.author Hauch, O
dc.contributor.author Hedner, E
dc.contributor.author Marple, CB
dc.contributor.author Matchar, David Bruce
dc.contributor.author Samsa, Gregory P
dc.contributor.author Wiklund, I
dc.contributor.author Wygant, G
dc.coverage.spatial England
dc.date.accessioned 2016-03-01T16:34:50Z
dc.date.issued 2004-05-06
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/15132746
dc.identifier 1477-7525-2-22
dc.identifier.uri https://hdl.handle.net/10161/11676
dc.description.abstract BACKGROUND: Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of anticoagulation management. We describe the development and preliminary validation of such an instrument - the Duke Anticoagulation Satisfaction Scale (DASS). METHODS: The DASS is a 25-item scale addressing the (a) negative impacts of anticoagulation (limitations, hassles and burdens); and (b) positive impacts of anticoagulation (confidence, reassurance, satisfaction). Each item has 7 possible responses. The DASS was administered to 262 patients currently receiving oral anticoagulation. Scales measuring generic quality of life, satisfaction with medical care, and tendency to provide socially desirable responses were also administered. Statistical analysis included assessment of item variability, internal consistency (Cronbach's alpha), scale structure (factor analysis), and correlations between the DASS and demographic variables, clinical characteristics, and scores on the above scales. A follow-up study of 105 additional patients assessed test-retest reliability. RESULTS: 220 subjects answered all items. Ceiling and floor effects were modest, and 25 of the 27 proposed items grouped into 2 factors (positive impacts, negative impacts, this latter factor being potentially subdivided into limitations versus hassles and burdens). Each factor had a high degree of internal consistency (Cronbach's alpha 0.78-0.91). The limitations and hassles factors consistently correlated with the SF-36 scales measuring generic quality of life, while the positive psychological impact scale correlated with age and time on anticoagulation. The intra-class correlation coefficient for test-retest reliability was 0.80. CONCLUSIONS: The DASS has demonstrated reasonable psychometric properties to date. Further validation is ongoing. To the degree that dissatisfaction with anticoagulation leads to decreased adherence, poorer INR control, and poor clinical outcomes, the DASS has the potential to help identify reasons for dissatisfaction (and positive satisfaction), and thus help to develop interventions to break this cycle. As an instrument designed to be applicable across multiple models of anticoagulation management, the DASS could be crucial in the scientific comparison between those models of care.
dc.language eng
dc.relation.ispartof Health Qual Life Outcomes
dc.relation.isversionof 10.1186/1477-7525-2-22
dc.subject Administration, Oral
dc.subject Aged
dc.subject Anticoagulants
dc.subject Cost of Illness
dc.subject Female
dc.subject Focus Groups
dc.subject Hematologic Tests
dc.subject Humans
dc.subject Long-Term Care
dc.subject Male
dc.subject Middle Aged
dc.subject Outpatients
dc.subject Patient Compliance
dc.subject Patient Satisfaction
dc.subject Psychometrics
dc.subject Quality of Life
dc.subject Sickness Impact Profile
dc.subject Warfarin
dc.title A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/15132746
pubs.begin-page 22
pubs.organisational-group Basic Science Departments
pubs.organisational-group Biostatistics & Bioinformatics
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group Pathology
pubs.organisational-group School of Medicine
pubs.organisational-group Surgery
pubs.organisational-group Surgery, Head and Neck Surgery and Communication Sciences
pubs.publication-status Published online
pubs.volume 2
dc.identifier.eissn 1477-7525


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