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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">INTRODUCTION</span><p id="par0005" class="elsevierStylePara elsevierViewall">Assessment of health-related quality of life &#40;HRQoL&#41; has become a key component of managing chronic wounds since it reflects patient perspective of disease and treatment<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a>&#46; Thus&#44; quality of life &#40;QoL&#41; instruments have been introduced in clinical care<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;10</span></a>&#44; quality management<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#8211;14</span></a> and clinical trials<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Several questionnaires have been validated and tested for use such as the Nottingham Health Profile&#44; the Cardiff Wound Impact Schedule<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#44; the W&#252;rzburg Wound Score<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> and the Freiburg Life Quality Assessment for wounds &#40;FLQA-w&#41;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Recently&#44; a multinational study developed and approved an instrument deriving from the three validated questionnaires and presented data on several types of wounds<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46; This questionnaire named Wound-QoL resulted in a shorter&#44; better to apply and well accepted questionnaire by the patients<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; Moreover&#44; it appeared that the questionnaire provided enhanced validation characteristics&#44; too<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the meantime&#44; the Wound-QoL has been linguistically validated into several languages&#44; including English&#44; German&#44; French&#44; Italian&#44; Dutch&#44; Swedish&#44; Polish and Danish according to international guidelines for patient-reported outcomes &#40;PRO&#41; instrument development<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#46; Beyond the formal translation process&#44; a Spanish version was now tested regarding its operating characteristics and psychometric properties for clinical use&#46; In order to conduct rigorous cross-cultural research to evaluate outcomes from new treatments and generalisation of observed treatment effects beyond national borders&#44; operating characteristics between the original German and Spanish samples were inspected&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">MATERIAL AND METHODS</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design and sample</span><p id="par0020" class="elsevierStylePara elsevierViewall">First&#44; a validated desk-based translation process was conducted&#44; followed by a prospective&#44; longitudinal non-interventional validation study in a cohort of patients with chronic wounds of the lower extremities&#46; For the longitudinal study&#44; patients were examined and completed questionnaires at baseline &#40;T1&#41; and after a follow-up period of two to three months &#40;T2&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Patients with leg ulcers of various underlying causes were recruited in the dermatology departments of five Spanish University Hospitals&#46; Inclusion criteria were an active chronic wound of the lower extremity&#44; age &#8805; 18 years and the capability to understand and fill in a Spanish questionnaire&#46; Patients were only included after informed consent&#46; The study was approved by the Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital General Universitario Gregorio Mara&#241;&#243;n code &#8220;Wound-PRO&#8221;&#44; on July 27&#44; 2016&#46; The license holders of the Wound-QoL also agreed on the adaption and validation&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Instruments used in the validation study</span><p id="par0030" class="elsevierStylePara elsevierViewall">The Wound-QoL questionnaire consists of 17 questions i&#46;e&#46; items&#46; Each item is scored on a five-point Likert scale from 0 &#61; not at all to 4 &#61; very much&#46; The mean rating of all questions results in the global score&#46; Additionally&#44; the three subscales everyday-life&#44; body and psyche were determined in the original version of the Wound-QoL<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#46; Fourth and back-translations of the original German Wound-QoL questionnaire were conducted following international guidance<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#46; Briefly&#44; the original German version was submitted to two Spanish native speakers who independently translated it into Spanish&#46; These two versions were retranslated into German by two further German native speakers&#46; The resulting two German versions were then compared with the original version and a semantic discussion on any deviation was conducted itemwise&#46; This discussion included the original first author of the questionnaire&#44; two physicians and psychologists familiar both with German and Spanish language and a linguist&#46; After refining the Spanish version&#44; a feasibility test was conducted in 10 patients from Spain&#46; The objective of this test was to analyse if the patients feel comfortable with the questionnaire and understand the questions in the same way&#46; We also wanted to find out how long it takes to complete the questionnaire under routine conditions&#46; The questionnaire appeared to show no problems in terms of understanding and feasibility&#46; A content adaption was not necessary&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the Spanish version of the Wound-QoL that was used in this validation study&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">General patient data on socioeconomic and clinical background were obtained following a specific assessment of the wound condition based on a standard case report</p><p id="par0040" class="elsevierStylePara elsevierViewall">Besides the Spanish version of the Wound-QoL&#44; the following questionnaires were used&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0045" class="elsevierStylePara elsevierViewall">EuroQoL five dimensions questionnaire &#40;EQ-5D&#41;&#58; a generic instrument reflecting health condition and quality of life in a validated Spanish version<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Pain&#58; numerical rating scales &#40;NRS&#41; from 0&#8211;10<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0055" class="elsevierStylePara elsevierViewall">The three visual analogue scales &#40;VAS&#41; included in the FLQA-w quality of life assessment&#44; a validated&#44; widely used specific quality of life questionnaire for wounds which was translated into Spanish the same way as the WoundQoL &#40;independent translation&#47;backtranslation&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a></p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Due to the lack of recommendations on a priori sample size calculations in validation studies<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#44; the size of the study population was determined based on previous experiences and corresponds to other Wound-QoL validation studies<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Item distribution characteristics such as mean&#44; standard deviation &#40;SD&#41;&#44; percentage of items at the lower &#40;floor effects&#41; and the higher end &#40;ceiling effects&#41; were inspected&#46; For internal consistency Cronbach&#8217;s alpha was measured&#46; Scores above 0&#46;70 were interpreted as acceptable<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&#46; Explorative factor analysis was conducted to test for structural validity&#46; Difference in scores between T1 and T2 were tested using Wilcoxon signed-rank test&#46; To test for responsiveness and convergent validity&#44; the Wound-QoL scores were correlated with the EQ-5D and FLQA-w &#40;Spearman&#8217;s correlation&#41;&#46; All analyses were conducted using SPSS version 23 &#40;IBM&#44; Armonk&#44; NY&#44; USA&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">RESULTS</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Baseline characteristics</span><p id="par0070" class="elsevierStylePara elsevierViewall">In the five centres&#44; a total of 115 patients were recruited&#44; including 45 &#40;39&#46;1 &#37;&#41; with venous leg ulcers&#44; four &#40;3&#46;5 &#37;&#41; with mixed leg ulcers and four &#40;3&#46;5 &#37;&#41; with arterial leg ulcers &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Mean age was 69&#46;5 &#40;SD 14&#46;5&#41; years &#40;median 73&#44; min 28 - max 97&#41;&#44; 60&#46;0 &#37; were female&#46; Mean observation time was 9&#46;6 &#40;SD 6&#46;6&#41; weeks&#46; Mean wound size at T1 was 18&#46;9 &#40;SD 36&#46;1&#41; cm&#178;&#44; and 1&#46;9 &#40;SD 8&#46;0&#41; cm&#178; at T2 &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#46; Overall&#44; 78 &#40;67&#46;8 &#37;&#41; of the wounds showed complete healing&#44; 110 &#40;95&#46;7 &#37;&#41; an improvement of more than 10 &#37; which was considered relevant&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Quality of life</span><p id="par0075" class="elsevierStylePara elsevierViewall">Mean Wound-QoL at T1 was 1&#46;9 &#40;SD 1&#46;0&#41; and 0&#46;8 &#40;SD 0&#46;9&#41; at T2 &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#44; mean FLQA-w health state concerning the wound was 5&#46;1 &#40;SD 2&#46;7&#41; at T1 and 8&#46;1 &#40;SD 2&#46;1&#41; at T2 &#40;p&#8239;&#60;&#8239;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; VAS pain reduced from 4&#46;9 &#40;SD 3&#46;4&#41; to 0&#46;9 &#40;SD 1&#46;7&#41; &#40;p&#8239;&#60;&#8239;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Internal consistency</span><p id="par0080" class="elsevierStylePara elsevierViewall">The Wound-QoL global score in the Spanish version showed high reliability with Cronbach&#8217;s alpha &#62; 0&#46;80 in all scales&#46; There were satisfactory distribution characteristics of the global score and the subscales&#46; At T1&#44; 0&#46;9 &#37; had the lowest and the highest possible global score each&#46; At T2&#44; 18&#46;3 &#37; had the lowest possible and 0&#46;9 &#37; the highest possible global score&#46; For the subscales the percentage of patients with the lowest possible score ranged between 2&#46;6 &#37; and 12&#46;2 &#37; at T1 and between 20&#46;9 &#37; and 48&#46;7 &#37; at T2&#46; The percentage of the highest possible score in the subscales was between 7&#46;8 &#37; and 15&#46;7 &#37; at T1 and between 0&#46;9 &#37; and 2&#46;6 &#37; at T2&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Structural validity</span><p id="par0085" class="elsevierStylePara elsevierViewall">In the explorative factor analysis&#44; N&#8239;&#61;&#8239;115 patients who completed the Wound-QoL at T1 visit were included&#46; Three factors with an eigenvalue &#62; 1 were found&#44; explaining 71&#46;0 &#37; of the overall variance&#46; All items loaded on the intended components and the subscales body &#40;items &#35;1 to &#35;5&#41;&#44; psyche &#40;items &#35;6 to &#35;10&#41; and everyday-life &#40;items &#35;11 to &#35;16&#41; could be confirmed&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Convergent validity and responsiveness</span><p id="par0090" class="elsevierStylePara elsevierViewall">Convergent validity with other instruments &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41; and responsiveness were satisfactory &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Feasibility</span><p id="par0095" class="elsevierStylePara elsevierViewall">The Wound-QoL was considered a simple and feasible tool by the vast majority of patients&#46; Mean time needed for completely answering was 5&#46;2 &#40;SD 6&#46;4&#41; minutes at T1 and 5&#46;5 &#40;SD 3&#46;6&#41; at T2&#46; Overall&#44; 99&#46;1 &#37; of participants found it easy to understand the questions and 94&#46;7 &#37; stated that the questionnaire suits the personal situation&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">DISCUSSION</span><p id="par0100" class="elsevierStylePara elsevierViewall">Assessment of PRO is an essential component of management for chronic wounds<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Patients have a variety of quality of life impairments&#44; which results in very individual treatment needs that need to be assessed and included in the treatment plan<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; Measurement of HRQoL as a key construct in the PRO concept has been recommended by most authorities and medical societies in wound care<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;30</span></a>&#46; The condition-specific HRQoL instrument Wound-QoL was developed and validated for such measurements both in clinical trials and in routine care<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4&#44;20</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The aim of this study was to validate a Spanish version of the Wound-QoL for language validity as well as for psychometric validity in the same project&#46; The procedures for both validation steps followed international standards&#46; Patients were selected in routine care&#44; thus providing a broad sample of healthcare in wound centres in Spain&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Limitations of the current study relate to the fact that the patients were only recruited in a limited number of centres&#46; Thus&#44; a selection bias cannot be excluded&#46; However&#44; we chose patients in real-world settings of different clinics&#46; Thus&#44; there is no evidence that the selection will impact the validation properties&#46; Furthermore&#44; the instrument has not been changed in items and thus may not meet all areas of burden in the Spanish population&#46; However&#44; for the sake of comparability on an international level&#44; the items need to be kept in the same manner&#46; Furthermore&#44; we have not observed any elevated rates of missing items or objections in the pre-test&#44; which would signal reduced applicability in Spanish&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Overall&#44; the Spanish Wound-QoL showed good psychometric properties that resemble the characteristics of the original version<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46; Floor and ceiling effects were low for T1&#46; For T2&#44; higher floor effects were found&#44; which can be interpreted as a positive effect of treatment on HRQoL impairment and may thus indicate good responsiveness of the Wound-QoL to clinical improvement&#46; Moreover&#44; patients reported a great level of understanding and accepting the questionnaire&#46; The time for answering the questions was around five minutes and only few data were missing&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">CONCLUSIONS</span><p id="par0120" class="elsevierStylePara elsevierViewall">The Spanish version of Wound-QoL is a valid and feasible tool with high patient acceptance to assess HRQoL in clinical care and in clinical trials in Spain&#46; Since the current translation and validation process happened in Spain&#44; further adaptations for other regions like Latin America need to be considered&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflict of Interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">M&#46; Augustin is the licence holder of the Wound-QoL&#46; The authors otherwise do not have any conflict of interest&#46;</p></span></span>"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and aims</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds&#44; originally developed for use in German&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted&#44; followed by an expert consensus of the resulting versions&#46; After refinement&#44; the final tool was piloted in N&#8239;&#61;&#8239;10 patients and then used in the validation study&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A total of 115 patients were recruited&#46; Mean age was 69&#46;5 &#40;SD 14&#46;5&#41; years&#44; 60&#46;0 &#37; were female&#46; The Spanish version of Wound-QoL showed high internal consistency &#40;Cronbach&#8217;s alpha &#62; 0&#46;8 in all scales&#41;&#46; Factor analysis resulted in the same scales as the original version&#46; There were satisfactory distribution characteristics of the global score and the subscales&#46; Construct validity and convergent validity with other outcomes &#40;generic QoL&#44; healing rate&#41; were satisfactory&#46; The vast majority of patients considered the Wound-QoL a simple and feasible tool&#46; Mean time needed for completing the questionnaire was 5&#8239;minutes&#46; Overall&#44; 99&#46;1 &#37; of the participants found it easy to understand the questions and 94&#46;7 &#37; stated that the questionnaire suits the personal situation&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The Spanish version of the Wound-QoL shows good validity in clinical practice&#46; It can be recommended for use in clinical routine and trials&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background and aims"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
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      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El Wound-QoL es un cuestionario validado para medir la calidad de vida en pacientes con heridas cr&#243;nicas&#44; que fue desarrollado originalmente para su uso en alem&#225;n&#46; El objetivo de este estudio fue traducir el cuestionario Wound-QoL para su uso en la pr&#225;ctica cl&#237;nica y estudios de investigaci&#243;n en Espa&#241;a&#44; as&#237; como validar esta versi&#243;n&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se realizaron dos traducciones independientes del Wound-QoL&#44; directa e inversa&#44; a partir de la versi&#243;n original en alem&#225;n&#44; seguidas de un consenso de expertos sobre las versiones resultantes&#46; Despu&#233;s de su perfeccionamiento se realiz&#243; un estudio piloto y posteriormente el estudio de validaci&#243;n&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; un total de 115 pacientes&#46; La edad media fue de 69&#44;5 &#40;DE 14&#44;5&#41; a&#241;os&#44; de los cuales el 60&#46;0&#37; eran mujeres&#46; La versi&#243;n espa&#241;ola del Wound-QoL mostr&#243; una excelente consistencia interna &#40;&#237;ndice alfa de Cronbach &#62; 0&#46;8 en todas las escalas&#41;&#46; El an&#225;lisis factorial dio como resultado las mismas escalas que la versi&#243;n original&#46; Se objetivaron caracter&#237;sticas satisfactorias de la distribuci&#243;n de la puntuaci&#243;n global y de las subescalas&#46; La validez de constructo y la validez convergente con otros resultados &#40;calidad de vida gen&#233;rica&#44; tasa de curaci&#243;n&#41; fueron satisfactorias&#46; La gran mayor&#237;a de los pacientes consideraron que el cuestionario era una herramienta sencilla y factible&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La versi&#243;n espa&#241;ola del Wound-QoL muestra una excelente validez en la pr&#225;ctica cl&#237;nica&#46; Por lo tanto&#44; puede ser recomendada para su uso tanto en la rutina cl&#237;nica como en los ensayos&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
            "titulo" => "Antecedentes y objetivos"
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            "identificador" => "abst0030"
            "titulo" => "Materiales y m&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
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          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Conde Montero E&#44; Sommer R&#44; Augustin M&#44; Blome C&#44; Cabeza Mart&#237;nez R&#44; Horcajada Reales C&#44; et al&#46; Validaci&#243;n de la versi&#243;n espa&#241;ola del cuestionario Wound-QoL&#46; Actas Dermosifiliogr&#46; 2021&#59;112&#58;44&#8211;51&#46;</p>"
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        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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          0 => array:4 [
            "imagen" => "gr1.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Spanish version of the Wound-QoL &#40;translated from the oirignal German version&#41;&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">69&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wound duration &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wound size &#40;cm&#178;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Employment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wound etiology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pressure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Venous&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wound-QoL&#44; subscale psyche&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wound-QoL&#44; subscale everyday-life&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w&#44; generally&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w&#44; concerning the wound&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w&#44; quality of life&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Pain&#44; VAS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Results of HRQoL measurement using Wound-QoL&#44; FLQA-w scales &#40;scale 0&#8211;10&#41; and pain &#40;NRS&#44; scale 0&#8211;10&#41; at baseline &#40;T1&#41; and follow-up &#40;T2&#41;</p>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">r&#44; correlation coefficient&#59; p&#44; two-tailed significance&#47;Spearman&#8217;s correlation&#59; EQ-5D&#44; EuroQoL five dimensions questionnaire&#59; EQ-5D-3&#8239;L&#44; EuroQoL five dimensions three level questionnaire&#59; FLQA-w&#44; Freiburg Life Quality Assessment for wounds&#59; QoL&#44; quality of life&#59; VAS&#44; visual analogue scale&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Convergent validity of Wound-QoL global score with</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">FLQA-w health state&#44; generally</td><td class="td" title="\n
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                  \t\t\t\t">-0&#46;255&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;099&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " rowspan="3" align="left" valign="\n
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                  \t\t\t\t">FLQA-w health state&#44; concerning the wound</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w health state&#44; quality of life</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Pain &#40;VAS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;710&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;315&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
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                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Convergent validity with other instruments at baseline &#40;T1&#41; and follow-up &#40;T2&#41;</p>"
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          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">&#42;difference T2-T1&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">r&#44; correlation coefficient&#59; p&#44; two-tailed significance&#47;Spearman&#8217;s correlation&#59; EQ-5D&#44; EuroQoL five dimensions questionnaire&#59; EQ-VAS&#44; EuroQoL visual analogue scales&#59; FLQA-w&#44; Freiburg Life Quality Assessment for wounds&#59; QoL&#44; quality of life&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Correlation with change &#40;difference T2-T1&#41; in Wound-QoL global score</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t">0&#46;576&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">EQ-VAS&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;150&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;111&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pain&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;605&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">FLQA-w health state&#44; generally&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;186&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w health state&#44; concerning the wound&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;557&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">FLQA-w health state&#44; quality of life&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Wound size reduction &#91;&#37;&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;317&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">115&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Responsiveness&#58; correlation of change in Wound-QoL global score with change in other scores</p>"
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      "titulo" => "References"
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                0 => array:1 [
                  "referenciaCompleta" => "European Wound Management Association &#40;EWMA&#41;&#46; Position Document&#58; Hard-to-heal wounds&#58; a holistic approach&#46; London&#44; MEP&#44; 2008 &#91;Accessed 1 August 2019&#93;&#46; Available from&#58; <a target="_blank" href="https://ewma.org/fileadmin/user_upload/EWMA.org/Position_documents_2002-2008/EWMA_08_Eng_final.pdf">https&#58;&#47;&#47;ewma&#46;org&#47;fileadmin&#47;user&#95;upload&#47;EWMA&#46;org&#47;Position&#95;documents&#95;2002-2008&#47;EWMA&#95;08&#95;Eng&#95;final&#46;pdf</a>&#46;"
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                      "titulo" => "Quality of life in chronic leg ulcer patients&#46; An assessment according to the Nottingham Health Profile"
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                          "etal" => false
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                            0 => "C&#46; Lindholm"
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                            2 => "O&#46;B&#46; Christensen"
                            3 => "B&#46; Zederfeldt"
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                        "volumen" => "73"
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        "texto" => "<p id="par0135" class="elsevierStylePara elsevierViewall">We thank the study centres and their clinical staff for excellent support&#46; We also gratefully acknowledge our team for support in publication management&#44; Mario Gehoff&#44; Pia Dahlhoff and Sabine Ahrendt&#46;</p>"
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