Assessing quality of life in patients with chronic leg ulceration using the Medical Outcomes Short Form-36 questionnaire

Abstract

Clinician awareness of the importance of recognizing, assessing, and ultimately addressing the negative impact of chronic wounds on patient quality of life is increasing. One hundred, eighteen (118) patients (average age 78 years) participated in a study to evaluate the use of the Medical Outcomes Short Form-36 for assessing the health-related quality of life of patients with chronic leg ulceration. Most patients (104, 88%) were treated at home by community nurses. A medical history was obtained and patients completed the Short Form-36 questionnaire at baseline and after 12 weeks of receiving standard ulcer care. Published normative data were used to ascertain the effect of leg ulcers on health-related quality of life. Short Form-36 responsiveness was determined by comparing baseline and 12-week scores. Results suggest that the questionnaire is reliable for five of eight Short Form-36 domains (alpha > 0.8), with the remainder alpha > 0.7. Compared to age-sex adjusted published normative scores, patients with leg ulcers had significantly lower mean scores in the following domains: role-emotional (d = 28.6, P <0.001), social functioning (d = 22.8, P <0.001), role-functioning (d = 20.8, P <0.001), role-physical (d = 20.7, P <0.001), and bodily pain (d = 12.3, P <0.001). Short Form-36 scores barely changed between baseline and the 12-week assessment, but bodily pain improved in the 31 patients whose ulcers healed during that time (d = 14.6, P = 0.006; SRM = 0.60). Pain did not improve in patients whose ulcers remained open (d = -2.1, P = 0.45). Compared to patients whose ulcers did not heal, patients with healed ulcers experienced greater improvements in the following domains: body pain (d = 16.8, P = 0.003), mental health (d = 9.4, P = 0.013), role-physical (d = 19.7, P = 0.06), role-emotional (d = 17.2, P = 0.12), and vitality (d = 9.0, P = 0.052). The results of this study suggest that leg ulcers reduce patient quality of life and that the Short Form-36 can be used to ascertain their impact