Use of the WoundQoL instrument in routine practice: Feasibility, validity and development of an implementation tool
Introduction
Patients with chronic wounds show marked reductions in health-related quality of life (HRQoL) [1], [2], [3], [4]. Thus, evaluation of HRQoL is a major component of wound care in studies and in clinical routine. Development and refinement of methods for the evaluation of HRQoL has been a research topic in the past decades [5], [6], [7] and stringent criteria for the development and validation of such instruments were raised [8], [9], [10].
The most frequently used and cited disease-specific questionnaires for the evaluation of HRQoL in wounds are the Freiburg Life Quality Assessment for chronic wounds (FLQA-w, [11]), the Cardiff Wound Impact Scale (CWIS, [12], [13]) and the Würzburg Wound Scales (WWS, [14]). A recent study revealed that these questionnaires show satisfying validity, however, they also have limitations and shortcomings [15]. For this, the WoundQoL questionnaire was developed which combines components of all three questionnaires but rearranges and abbreviates the scales to a 17-items-questionnaire loading onto 3 subscales [15]. In order to identify areas of need for action, a panel of wound specialists and patients developed an implementation tool called WoundAct.
The present study intended to test the WoundQoL questionnaire under routine conditions in different wound clinics. In particular, patient feasibility was assessed. Moreover, the feasibility of the WoundAct tool was to be evaluated.
Section snippets
Patients and centers
In this non-interventional health care study, patients from one university and three community wound clinics in Hamburg were consecutively included at presentation for a first or consecutive visit. Routine treatment was applied according to local standards.
Quality of life evaluation
HRQoL was evaluated using the WoundQoL questionnaire and the EQ-5D.
The WoundQoL is a wound-specific questionnaire developed for use in clinical routine and in wound research [15]. It consists of 17 items with Likert scales from 0 to 4 (no –
Results
The patient cohort of n = 100 (mean age 69.3 years, median age 73 years, 51% women) consisted of patients with vascular (n = 65), immunological (n = 18) and post-surgical (n = 17) hard-to-heal wounds.
Mean total score of WoundQoL was 1.3 ± 0.9 (Table 1); 45% showed a score > 2. Mean values for the subscales for as follows: “Body” 1.0 ± 0.8, “Psyche” 1.7 ± 1.1, “Everyday life” 1.3 ± 1.2. Distribution analysis shows a fair distribution of the global as well as of the subscores with no ceiling and only moderate
Discussion
The aim of the present study was to further evaluate the WoundQoL questionnaire which measures HRQoL in chronic wounds. By purpose, the current validation focused on real-world care for different types and stages of chronic wounds. It was not intended to gain information on the QoL outcomes from defined treatments but to observe the psychometric properties and the handling of the questionnaire in routine wound care.
The WoundQoL was generated from three existing validated instruments [15] for
Conclusion
The WoundQoL questionnaire measuring the health-related quality of life in patients with chronic wounds has been shown to be valid and feasible for use in practice. The implementation questionnaire WoundAct was perceived a helpful tool for health care professionals to transfer patient needs into active measures.
Conflict of interest
No potential conflicts of interest relevant to this article were reported.
References (18)
- et al.
A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications
J Am Acad Dermatol
(1994) - et al.
Quality of life in chronic leg ulcer patients: an assessment according to the Nottingham Health Profile
Acta Derm Venereol
(1993) - et al.
Development and validation of a disease-specific questionnaire on the quality of life of patients with chronic venous insufficiency
VASA
(1997) - et al.
Quality of life and satisfaction of patients with leg ulcers – results of a community-based study
VASA
(2011) Quality of life measures in health care and medical ethics
Assessing health related quality of life in medicine: an overview over concepts, methods and applications in international research
Restor Neurol Neurosci
(2002)- et al.
Economic evaluation in health care
(2001) - et al.
Erfassung von Lebensqualität in der Dermatologie
J Dtsch Dermatol Ges
(2004) - et al.
Die Erfassung von Lebensqualität in der Versorgungsforschung – konzeptuelle, methodische und strukturelle Voraussetzungen
Gesundheitswesen
(2009)
Cited by (34)
Current status of patient-reported outcome measures in vascular surgery
2021, Journal of Vascular SurgeryCitation Excerpt :The Wound-QoL instrument measures wound-related QOL in patients with chronic wounds of varying etiology (Table V). The Wound-QoL incorporates components of three different preexisting PRO surveys—the Freiburg Life quality Assessment for wounds, the Cardiff Wound Impact Schedule, and the Wurzburg Wound Score—and has been validated for use in all patients with chronic wounds.78,79 Compared with these preexisting instruments, the Wound-QoL also evaluates multiple dimensions of quality of life; it is validated in English and is shorter in length, decreasing the patient burden of responding and improving the chances of obtaining high-quality data.80
Validation of the Spanish Wound-QoL Questionnaire
2021, Actas Dermo-SifiliograficasDisease-specific, health-related quality of life (HRQoL) of people with chronic wounds—A descriptive cross-sectional study using the Wound-QoL
2017, Wound MedicineCitation Excerpt :The quality of life of people with chronic wounds is frequently impaired, even under nearly optimal treatment conditions as with the participants of this study. The use of Wound-QoL in the day-to-day treatment practice, in combination with the Wound-Act [25] that was developed as a practical aid, appears to be prospectively useful. This could expand the focus to include the patient perspective and help optimize the care of people with chronic wounds on the basis of patient-relevant outcome factors.
Validation of the Wound-QoL-17 and the Wound-QoL-14 in a European sample of 305 patients with chronic wounds
2024, International Wound JournalTranslation and validation of 17-item Wound-QoL questionnaire in a Chinese population
2023, International Wound Journal