Abstract
INTRODUCTION: The DL is a generic interview-based questionnaire and previously validated in measuring OQoL in nursing home residents. Our aim was to examine its reproducibility and responsiveness in the frail elderly. MATERIALS AND METHODS: The design was three repeated DL-measures 10, 30 and 365 days on consecutively recruited hip fracture patients with residence in nursing homes and sheltered housing facilities and with a Mini Mental State Examination (MMSE) score of 5 or more. The DL-questionnaire consists of 15 questions covering emotional well-being, social relationship, life-satisfaction, comfort, functional competence and autonomy. The scale ranges from 0 (=best OQoL) to score 30 (=worst OQoL). A trained occupational therapist did face-to-face interviews for measuring intra-rater reliability with 20 days interval, and 365 days after hip fracture surgery measuring responsiveness after recovery. Inter-rater reliability was evaluated by two raters in a subgroup. RESULTS: 130 residents were eligible and completed the test-retest (86%). The systematic difference was 0.49 points (95% confidence interval: -0.25; 1.23). Standard Error of Measurement (SEM) was 3.02 points, and the Minimal Detectable Change (MDC) was 8.37 points. Intra-class Correlation Coefficient (ICC) was 70%. Evaluating responsiveness, 89 patients (87%) were alive and completed the third interview. The DL improved over time (p<0.001) and was associated with improved physical recovery after hip fracture. The inter-rater reliability was high (ICC=97%). CONCLUSIONS: The DL-questionnaire is easy to use in the frail elderly. It has an acceptable reproducibility, and is able to detect a clinically relevant change over time.
