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A Quality of Life Measure

Rodney J. Taylor, MD, MSPH; Judith C. Chepeha, MScPT; Theodoros N. Teknos, MD; Carol R. Bradford, MD; Pramod K. Sharma, MD; Jeffrey E. Terrell, MD; Norman D. Hogikyan, MD; Gregory T. Wolf, MD; Douglas B. Chepeha, MD, MSPH

Arch Otolaryngol Head Neck Surg. 2002;128:44-49.

Objectives  To validate a health-related quality-of-life (QOL) instrument for patients following neck dissection and to identify the factors that affect QOL following neck dissection.

Design  Cross-sectional validation study.

Setting  The outpatient clinic of a tertiary care cancer center.

Patients  Convenience sample of 54 patients previously treated for head and neck cancer who underwent a selective neck dissection or modified radical neck dissection (64 total neck dissections). Patients had a minimum postoperative convalescence of 11 months. Thirty-two underwent accessory nerve–sparing modified radical neck dissection, and 32 underwent selective neck dissection.

Main Outcome Measure  A 10-item, self-report instrument, the Neck Dissection Impairment Index (NDII), was developed and validated. Reliability was evaluated with test-retest correlation and internal consistency using the Cronbach coefficient. Convergent validity was assessed using the 36-Item Short-Form Health Survey (SF-36) and the Constant Shoulder Scale, a shoulder function test. Multiple variable regression was used to determine variables that most affected QOL following neck dissection

Results  The 10-item NDII test-retest correlation was 0.91 (P<.001) with an internal consistency Cronbach coefficient of .95. The NDII correlated with the Constant Shoulder Scale (r = 0.85, P<.001) and with the SF-36 physical functioning (r = 0.50, P<.001) and role–physical functioning (r = 0.60, P<.001) domains. Using multiple variable regression, the variables that contributed most to QOL score were patient's age and weight, radiation treatment, and neck dissection type.

Conclusions  The NDII is a valid, reliable instrument for assessing neck dissection impairment. Patient's age, weight, radiation treatment, and neck dissection type were important factors that affect QOL following neck dissection.

From the Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor (Drs Taylor, Teknos, Bradford, Sharma, Terrell, Hogikyan, Wolf, and D. B. Chepeha); and the Department of Physical Therapy, Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton (Ms J. C. Chepeha).

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