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Validation of the PROQOL-HIV Questionnaire in light of cross cultural differences from 5 continents

Duracinsky, M., Acquadro, C., Lalanne, C. and Herrmann, S. (2009) Validation of the PROQOL-HIV Questionnaire in light of cross cultural differences from 5 continents. In: ISPOR 12th Annual European Congress, 24 - 27 October, Paris, France.


OBJECTIVES: The PROQOL-HIV questionnaire was developed to measure the health-related quality-of-life (HRQL) of People living with HIV/AIDS (PLWHA) in different cultures in the highly-active antiretroviral therapy era. This study presents the psychometric validation and the conceptual model: the psychosocial and clinical factors impacting on HRQL.

METHODS: 830 patients were included in a cross-sectional survey in 8 countries: Australia, Brazil, Cambodia, China, France, Senegal, Thailand and USA. Item reduction was based on content, distribution of responses and factorial analysis. Reliability, construct and clinical validity with reference to biological markers and socio-demographic data were assessed.

RESULTS: The 39-item questionnaire (and 4 individual items including Care Satisfaction and Financial Impact) demonstrates consistent psychometric properties (60% variance explained, Cronbach’s alpha above 0.8, intrascale correlations above 0.5). Concurrent validity was demonstrated (MOSHIV, EQ-5D). From 9 dimensions, 4 subscores were derived: Physical Health and Symptoms, Treatment Impact, Social and Intimate Relationships, Emotional Distress. Significant differences in HRQL scores according to symptoms, comorbidities, CD4 and CDC stage support our endpoint model. PROQOL-HIV dimensionality across countries is consistent with previous qualitative research. Western countries (early diagnosis and treatment, higher income) and emerging countries like Thailand and Brazil had better HRQL than China and Cambodia. Chinese and Khmer patients had lower HRQL scores (p < 0.001), particularly on physical health and symptoms, health concerns, and stigma dimension, which was highest in Senegal. Between-country differences are also reflected by significant correlations between PROQOL scores and external factors: frequency of symptoms (higher in Cambodia, China and Thailand), omorbidities (higher frequency of psychiatric disorders in Cambodia), and CD4 count (low in Chinese and Khmer patients). These results refine the conceptual model and support the validity of the PROQOL-HIV questionnaire.

CONCLUSIONS: PROQOLHIV is a valid questionnaire to assess the quality-of-life of PLWHA and sensitive to clinical outcome measures and cultural differences.

Item Type: Conference Item
Notes: Oral presentation
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