The construction and validation of a health-related quality of life measure for women with endometriosis
| dc.contributor.advisor | Kagee, Ashraf | en_ZA |
| dc.contributor.author | Roomaney, Rizwana | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. | en_ZA |
| dc.date.accessioned | 2017-01-26T11:08:18Z | |
| dc.date.accessioned | 2017-03-29T11:36:57Z | |
| dc.date.available | 2017-01-26T11:08:18Z | |
| dc.date.available | 2017-03-29T11:36:57Z | |
| dc.date.issued | 2017-03 | |
| dc.description | Thesis (PhD)--Stellenbosch University, 2017. | en_ZA |
| dc.description.abstract | ENGLISH SUMMARY: The purpose of this study was to construct and validate a health-related quality of life (HRQOL) measure for patients with endometriosis. The study employed an exploratory, sequential mixed methods research design, consisting of a qualitative phase, followed by a quantitative phase. The study consisted of three aims. The first aim was to describe and understand the QOL-related experiences of women with endometriosis. This qualitative phase of the study involved in-depth, semi-structured interviews with 25 women diagnosed with endometriosis. I recorded and transcribed the interviews. I used thematic analysis to code the data and identify themes. Eleven themes emerged from the data, namely psychological functioning, sexual functioning, financial impact and considerations, healthcare and medical treatment, reproductive functioning, information and knowledge, interpersonal functioning, menstrual characteristics, occupational functioning, somatic features and physical functioning. The second aim of the study was to construct items for the instrument based on data collected during the first phase. The initial item pool consisted of 314 items. I then consulted with two experts in psychometry, who provided feedback relating to the clarity, conciseness, wording and ambiguity of items. This process resulted a reduced pool of 184 items. I asked five endometriosis experts to review the items in terms of relevance. Items that the experts regarded as highly relevant were retained in the measure and items that were not regarded as highly relevant were removed from the measure. The review resulted in the retention of 64 items. I piloted these items among seven women with endometriosis in order to assess the readability of the items. The final aim of the study was to determine the test reliability, validity and factor structure of the measure. This formed the quantitative component of the study. I administered the 64-item HRQOL measure, Endometriosis Health Profile 30, Short Form Health Survey World Health Organization Quality of Life Brief scale and the Beck Depression Inventory to 203 patients with endometriosis. I conducted an item analysis and removed 16 items that displayed corrected item total correlations below .35. I then conducted an exploratory factor analysis (EFA) on the remaining 48 in order to establish the factor structure of the measure. The factor analysis identified thirteen items that either cross-loaded on more than one factor or that did not significantly load on any factor. These items were removed. The remaining 35 items produced an eight-dimension factor structure. A second EFA produced the same factor structure. I named the measure the Stellenbosch Endometriosis Quality of life (SEQOL) measure and the named the dimensions as follows: (1) Psychological well-being; (2) Income; (3) Sexual functioning and romantic relationships; (4) Reproductive functioning; (5) Vitality; (6) Occupational functioning; (7) Menstrual characteristics and (8) Support. The SEQOL and its subscales demonstrated excellent internal consistency reliability. The SEQOL produced a Cronbach’s α of .92 and the Cronbach’s α for the subscales ranged from .72 to .88. Correlations between scores on SEQOL, its subscales and other measures indicated promising validity. The initial validation indicates that the SEQOL may be a useful assessment of HRQOL in women with endometriosis, both in research and clinical practice. | en_ZA |
| dc.description.abstract | AFRIKAANS OPSOMMING: Die doel van hierdie studie was om ’n meetinstrument saam te stel om die gesondheidsverwante lewensgehalte (GVLG) van pasiënte met endometriose te meet. Die studie het gebruik gemaak van ’n ondersoekende, sekwensiële gemengde metode-ontwerp bestaande uit ’n kwalitatiewe fase, gevolg deur ’n kwantitatiewe fase. Die studie het drie doelstellings nagestreef. Die eerste doelstelling was om die KVL-verwante ervaringe van vroue met endometriose te beskryf en te verstaan. Hierdie kwalitatiewe fase van die studie het in-diepte, semigestruktureerde onderhoude met 25 vroue wat gediagnoseer is met endometriose behels. Ek het die onderhoude opgeneem en getranskribeer. Ek het tematiese analise gebruik om die data die te kodeer en temas te identifiseer. Ek het elf temas uit die data geïdentifiseer, naamlik sielkundige funksionering, seksuele funksionering, finansiële gevolge en oorwegings, gesondheidsorg en mediese behandeling, reproduktiewe funksionering, inligting en kennis, interpersoonlike funksionering, menstruele eienskappe, werksverwante funksionering, somatiese kenmerke en fisiese funksionering. Die tweede doelstelling van die studie was om items vir die meetinstrument te identifiseer op grond van die data wat gedurende die eerste fase ingesamel is. Ek het ’n aanvanklike kombinasie van items saamgestel bestaande uit 314 items. Ek het daarna twee kenners in psigometrie geraadpleeg en hulle het terugvoer verskaf rakende die duidelikheid, bondigheid, bewoording en dubbelsinnigheid van items. Die proses het uitgeloop op 184 items. Ek het vyf endometriose-kenners gevra om die items te hersien met betrekking tot relevansie. Die items wat die kenners beskou het as hoogs relevant is behou as deel van die meetinstrument en items wat nie beskou is as hoogs relevant nie, is verwyder. Dit het die behoud van 64 items tot gevolg gehad. Hierdie items is getoets tydens ’n toetsopname onder sewe vroue met endometriose om die leesbaarheid van die items te toets. Die finale doelstelling van die studie was om die toetsbetroubaarheid, geldigheid en faktorstruktuur van die meetinstrument te bepaal en te toets. Dit het die kwantitatiewe komponent van die studie uitgemaak. Ek het die 64-item GVLG meetinstrument, die EHP 30, die SF12v2, die WHOQOL Bref en die BDI by 203 pasiënte met endometriose afgeneem. Ek het ’n item-analise gedoen en 16 items wat gekorrigeerde itemtotaal-korrelasies onder .35 vertoon het uitgehaal. Daarna het ek ’n ondersoekende faktoranalise (OFA) gedoen van die oorblywende 48 om die faktorstruktuur van die meetinstrument vas te stel. Die faktoranalise het dertien items uitgewys wat hetsy met meer as een ander faktor oorkruis gelaai het, of wat nie beduidend gelaai het op enige faktor nie. Hierdie items is verwyder. Die oorblywende 35 items het ’n agt-dimensie faktorstruktuur gelewer. ’n Tweede OFA het dieselfde faktorstruktuur gelewer. Ek het die meetinstrument die Stellenbosch Endometriose Lewensgehalte (SELG) genoem en die dimensies soos volg benoem: Psigologiese welstand; (2) Inkomste; (3) Seksuele funksionering en romantiese verhoudings; (4) Reproduktiewe funksionering; (5) Vitaliteit; (6) Werksverwante funksionering; (7) Menstruele eienskappe; en (8) Ondersteuning. Die SELG en sy subskale het uitstekende interne internekonsekwentheid getoon. Die SELG het ’n Cronbach α van .92 gelewer en die Cronbach α vir die subskale het gewissel van .72 tot .88. Korrelasies tussen tellings op SELG, sy subskale en ander meetinstrumente het belowende geldigheid getoon. Die aanvanklike geldigheid het aangedui dat die SELG ’n bruikbare meting van GVLV in vroue met endometriose kan wees in beide navorsingkontekste en kliniese praktyk. | af_ZA |
| dc.format.extent | xix, 291 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/100839 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Quality of life | en_ZA |
| dc.subject | Endometriosis -- Psychological aspects | en_ZA |
| dc.subject | UCTD | |
| dc.title | The construction and validation of a health-related quality of life measure for women with endometriosis | en_ZA |
| dc.type | Thesis | en_ZA |