Validation of Italian multiple sclerosis quality of life 54 questionnaire
- Alessandra Solaria,
- Graziella Filippinia,
- Laura Mendozzib,
- Angelo Ghezzic,
- Stefania Cifanid,
- Elena Barbierib,
- Silvana Baldinic,
- Andrea Salmaggia,
- Loredana La Mantiaa,
- Mariangela Farinottia,
- Domenico Caputob,
- Paola Mosconid
- aIstituto Nazionale Neurologico “C Besta”, Milan, Italy, bFondazione Pro Juventute Don C Gnocchi, Milan, Italy, cCentro Studi Sclerosi Multipla, Gallarate, VA, Italy, dIstituto di Ricerche Farmacologiche “M Negri”, Milan, Italy
- Dr Alessandra Solari, Istituto Nazionale Neurologico C Besta, Laboratory of Epidemiology, via Celoria 11, 20133 Milan, Italy. Telephone 0039 02 2394 391; fax 0039 02 70 63 8217; email:
- Received 14 July 1998
- Revised 17 February 1999
- Accepted 19 February 1999
OBJECTIVES Health related quality of life (HRQOL) inventories are multi-dimensional measures of patient-centred health status developed for clinical research. The MS quality of life 54 (MSQOL-54) is an MS-specific HRQOL inventory originally devised for English speaking patients. It consists of a core measure, the 36-item short form health survey (SF-36) previously adapted into Italian, and 18 additional items exploring domains relevant to patients with MS (MS-18 module). The authors translated and culturally adapted into Italian the MS-18 module of the MSQOL-54 questionnaire, and clinically validated the whole questionnaire.
METHODS The MS-18 module was translated following the methodology of the International Quality of Life Assessment (IQOLA) project. The MSQOL-54 was validated in 204 consecutive patients with MS seen between April and September 1997 at three participating centres. The questionnaire was explained by the physician who also administered the expanded disability status scale (EDSS) and mini mental status scale examination, and the patient filled in the MSQOL-54 and Beck depression inventory questionnaires (BDI), with assistance if required. The contribution of impairments and disabilities to MSQOL-54 scores were assessed, and mean scores were compared with normative data for the general Italian population, and with the original sample of United States MS patients.
RESULTS The mean age of the 204 patients was 42 years; mean EDSS score was 4.5 (range 0-8.5). Patients’ participation in the assessment was satisfactory, and all scales satisfied the usual psychometric standards. The characteristics of the United States sample matched those of our patients in all but gender (72% United States patientsv 52% Italian patients were women), and education (90% United States patients and 44% Italian patients completed high school); MSQOL-54 profiles were also similar. The EDSS was significantly associated with the physical health composite but not with the mental health composite score. Multiple linear regression modelling showed that age and BDI independently predicted physical health composite (p < 0.001), and mental health composite (p < 0.001). Clinical worsening in the previous year had an independent effect on the physical health composite (p < 0.001).
CONCLUSIONS The Italian version of MSQOL-54 is easy to administer and is well accepted by patients. Neurological impairment has a limited influence on perceived quality of life, while age and depressive symptoms has a major influence.
This work was supported in part by Italian National Health Ministry (grant No 96/J/T55, to AS). We are indebted to Drs Barbara Vickrey and Iris Gutmanis for allowing us to adapt the original version of MSQOL-54, to Dr Giovanni Apolone for his critical review of the manuscript, and to Don Ward for help with the English.