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Responsiveness of the MQOL-HIV to Quality of Life Changes in a Cohort of HIV+ Men

Smith, Kevin W,* Avis N,* Mayer, K.**
*New England Research Institutes, Watertown, MA, USA;
**Fenway Community Health Center and Brown University

Objective: Responsiveness, or sensitivity to change, is an important indicator of the validity of a measurement instrument. The purpose of this study was to evaluate the responsiveness of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV).

Methods: The MQOL-HIV is a 40-item questionnaire measuring 10 domains that are important to the quality of life of persons infected with HIV. The MQOL-HIV Index, derived from these domains, provides an overall quality of life score. This instrument was administered three times (baseline, 2-week follow-up, and 6-month follow-up) to a longitudinal cohort of 92 HIV+ men at a Boston community health center. At the 6-month follow-up, subjects were asked to assess changes in their quality of life over the previous 5.5 months using a 7-point scale ranging from "a great deal worse" to "a great deal better". Changes in CD4 counts (baseline mean=350 cells/mm3; 33%<200 cells/mm3), hemoglobin (baseline mean=14.4 gm/dl) and symptom severity (Whalen's HIV Symptom Scale) were also tracked during the follow-up interval.

Results: After 5.5 months, 46% of the cohort reported that their quality of life had improved, 32% reported it was about the same as before, and 23% had gotten worse. These changes were highly correlated with changes in MQOL-HIV index scores (r=.52, p<.0001). Index score changes were also associated with changes in symptom severity (r=-.44). Self-assessed quality of life changes were unrelated to changes in CD4 counts (r=.01), and only weakly related to differences in hemoglobin levels (r=.10, p=.35). Correlations between self-reported changes in individual domains and MQOL-HIV domain scores ranged from r=.44 for financial status to r=-.20 for cognitive functioning.

Conclusions: These results provide strong evidence for the ability of the MQOL-HIV Index to detect changes in both quality of life and symptom severity in HIV+ men. Changes in hematologic parameters over time do not appear to be accurate markers of quality of life differences.

(Presented at the XI International Conference on AIDS, Vancouver, Canada; July, 1996.)