Anleitung zur Einsch?tzung und Validierung des gesundheitsbezogenen Lebensqualit?tsstatus in der chirurgischen Behandlung der Hyperhidrose

摘要

BACKGROUND: As interest in quality of life (Qol) burgeons in all medical disciplines, this review wants to analyze the development of Qol in sympathetic surgery for hyperhidrosis (HH). The most important types of Qol instruments, generic, disease-specific, discriminative, and evaluative questionnaires and guidelines for correct development and use of Qol instruments are given in detail. Validity, responsiveness, and reliability of Qol measures are discussed. METHODS: The frequency of Qol measures in studies concerning HH and surgical treatment has been evaluated by Medline research. Results were compared to other diseases, such as breast cancer and GERD, which are treated in general surgery. Out of 40 articles dealing with Qol in HH, 14 articles and 1 abstract published in the period between 1976 and 2004 have been examined on correct use of Qol instruments in sympathetic surgery. RESULTS: 4 disease-specific (26.7%), 5 generic (33.3%) and 3 ad hoc (20%) questionnaires were used in the studies. One study (6.7%) included a generic (SF-36) and a disease-specific instrument. The generic questionnaires, SF-36 and DQLI, have been validated, the rest is lacking in validity, responsiveness and/or reliability. Consequently, just 6 studies (40%) were assessed by validated instruments. Satisfaction rates, ranging from 81.3% up to 98%, have been presented in 10 papers (66.7%). CONCLUSIONS: The growing importance of Qol in clinical daily life leads to the need for validated and standardized Qol instruments. The SF-36 is a qualified gold standard generic instrument, and Keller’s questionnaire is a promising candidate in the disease-specific category but should be validated by an international group of experts in sympathetic surgery.