Type of Document	Master's Thesis
Author	Malo, Sharon Y.
Author's Email Address	smalo73@aol.com
URN	etd-072199-191906
Title	Measuring Change in Key HRQL Outcomes Using MOS SF-36 vs VSAQ and BDI With Patients Undergoing CABG Surgery
Degree	Master of Science
Department	Human Nutrition, Foods, and Exercise
Advisory Committee	Advisor Name Title Herbert, William G. Committee Chair Bos, Ronald R. Committee Member Griffith, Parks Committee Member
Keywords	Health-Related Quality of Life Coronary Artery Bypass Graft VSAQ MOS SF-36 BDI
Date of Defense	1999-07-02
Availability	restricted
Abstract MEASURING CHANGE IN KEY HRQL OUTCOMES USING MOS SF-36 SUBSCALES VS VSAQ AND BDI WITH PATIENTS UNDERGOING CABG SURGERY by Sharon Y. Malo Dr. William G. Herbert, Chairman Department of Human Nutrition, Foods, and Exercise (ABSTRACT) Health-related quality of life (HRQL) measures taken before and after coronary artery bypass grafting (CABG) aid in determining meaningful patient-perceived outcomes associated with alternative clinical interventions. This study compared performance of the Medical Outcomes Study Short Form-36 (MOS SF-36) subscales for Physical Functioning (PF), Role Physical (RP), Mental Health (MH), and Role Emotional (RE) against two other questionnaires, i.e. the Veteran's Specific Activity Questionnaire (VSAQ: self-efficacy for vigorous physical activity) and the Beck Depression Inventory (BDI-II: mental-emotional functioning). Seventy-one patients (59-M; 12-F; age, Mean + SD = 63 ± 8.6 years) were administered these three questionnaires just before and 3 months following CABG surgery. Score distributions were evaluated for the pre- and post-surgery measurements, as were change scores after CABG. All measures except the MOS SF-36 subscales for RP and RE showed statistically significant change after CABG (p<0.01). Only the subscales of RP and RE demonstrated substantial ceiling (21.0% and 56.3%) and floor effects (49.3% and 16.9%). Evaluation of individual change scores after CABG indicated that 59% and 62% of the patients, respectively, had clinically meaningful increases in the two measures of physical capability, i.e. PF and VSAQ. In contrast, 60% and 72% of patients, respectively, showed no clinically meaningful changes in the two measures of emotional functioning, i.e. RE and BDI-II scores. Chi-square analyses revealed that use of scales with similar definitional constructs resulted in significantly different surgical outcomes for the following: PF vs VSAQ (p<0.001), RP vs VSAQ (p<0.02); and MH vs BDI-II (p<0.0001). These findings illustrate the limitations in performance of the MOS SF-36 for assessing changes of importance in HRQL after CABG. The VSAQ and BDI-II, two simple measures of physical and emotional functioning that are fundamentally similar to those contained in the MOS SF-36, appear to be sensitive markers for detecting changes in these important outcomes after CABG surgery.
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