Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV)

The Medical Outcomes Study HIV Health Survey (MOS-HIV) is a brief, comprehensive measure of health-related quality of life (HRQoL) used extensively in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The 35-item questionnaire includes ten dimensions (health perceptions, pain, physical, role, social and cognitive functioning, mental health, energy, health distress and quality of life (QoL)) and takes approximately 5 minutes to complete. Subscales are scored on a 0–100 scale (a higher score indicates better health) and physical and mental health summary scores can be generated. The MOS-HIV has been shown to be internally consistent, correlate with concurrent measures of health, discriminate between distinct groups, predict future outcomes and be responsive to changes over time. Limited experience suggests acceptable reliability and validity in women, injecting drug users and African–American and lower socioeconomic status patients. The MOS-HIV is available in 14 languages and has been included as a secondary outcome measure in numerous clinical trials for all stages of disease. In several studies it has detected significant differences between treatments; in some cases concordant with conventional end-points and, in others, discordant. The interpretation of scores is facilitated by an explanation in terms meaningful to the intended audience. Research is needed to compare the MOS-HIV to other strategies for HRQoL assessment in early HIV disease.     

Quality of life among people living with HIV/AIDS in northern Thailand: MOS-HIV Health Survey

OBJECTIVES: Translation and psychometric evaluation of a Thai version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) in Thailand. METHODS: A cross-sectional survey in Chiang Mai province, northern Thailand, with data collected in face-to-face interviews using a structured questionnaire designed to measure 10 scales of quality of life (QOL). We recruited 200 people with HIV/AIDS attending self-help groups in the municipal area. Standard guidelines were followed for questionnaire translation and psychometric evaluations. RESULTS: Item-level internal consistency and discriminant validity were reasonably established. Success rates were 93.8 and 97.4%, respectively. Scale-level internal consistency reliability of multi-item scales was satisfactory, ranging from 0.74 to 0.88, with all exceeding inter-scale correlations. Principal components analysis of item and scale scores identified two hypothesized dimensions of the MOS-HIV. The mental health component was strongly loaded by health distress, mental health, vitality and cognitive function scales, and physical health by role, physical and social functions, and pain scales. Respondents manifesting symptoms or reporting worsening health status scored significantly lower on all scales. CONCLUSIONS: These preliminary studies have shown the Thai version of the MOS-HIV to have psychometric properties comparable with those reported in previous surveys. Further testing and modification should make it useful as an HIV-specific QOL measure in Thailand.     

鄂西南某少数民族聚居区HIV感染者/AIDS病人干预前后生存质量比较

目的 了解鄂西南某少数民族聚居区HIV感染者/AIDS病人干预前后的生存质量,评价干预措施的效果,为更好地开展该地区AIDS防制工作提供科学依据.方法 采用《个人基本情况调查表》了解研究对象的一般情况及艾滋病相关知识的掌握情况,简体中文版MOS-HIV量表评价HIV感染者/AIDS病人的生存质量,SPSS16.0软件进...     

艾滋病患者生存质量简体中文版MOS-HIV量表应用评价

对艾滋病患者生存质量量表(简体中文版MOS-HIV)的应用进行评价,评价H IV感染者在我国的艾滋患者群中使用简体中文版MOS-HIV分析,发现有较好的信度和效度,可以在我国艾滋病人群中进行推广使用.     

Health-related quality of life of patients with HIV: Impact of sociodemographic, clinical and psychosocial factors

Objectives: This study aims to analyse how a wide group of clinical, social, demographic and psychological factors are related to both physical and mental quality of life in HIV+ patients. Design: A cross-sectional study was carried out of 320 HIV+ patients in antiretroviral treatment who attended infectious diseases units in four hospitals in the region of Andalusia (Spain). Methods: Health-Related Quality of Life was measured by the MOS-HIV. Included as independent variables were: sociodemographic variables, variables related to antiretroviral therapy, psychosocial variables like social support (Duke-UNC-11) and psychological morbidity (GHQ-28), variables related to main risk behaviours and clinical variables. Results: In the multiple linear regression analysis, a better PHS quality of life was found to be associated with the absence of mental illness, social support, not being an intravenous drug user and using more than one type of non-injectable drug. A better quality of life, in mental terms, was found to be associated with fewer years as a non-intravenous drug user, having social support, absence of mental illness, not being an intravenous drug user taking only one additional pill, not having any difficulty in taking the medication, and being female. Conclusions: The study of other non-biological factors that may be related to quality of life has been limited practically to social support and the emotional state. This study highlights the importance of these factors independently from the clinical state, as well as the existence of other psychological and behavioural factors that are also related.     

Validation of a Chinese version of the Medical Outcomes Study HIV Health Survey (MOS-HIV) among Chinese people living with HIV/AIDS in Hong Kong

Objectives: To evaluate the Chinese version of the 35-item Medical Outcomes Study HIV Health Survey (MOS-HIV) in Chinese people living with HIV/AIDS (PLWHA). Methods: A cross-sectional survey of 242 ethnic Chinese PLWHA in Hong Kong was conducted. Results: Cronbach’s αs of the eight multi-item scales of the MOS-HIV ranged from 0.78 to 0.90. Item-total and inter-scale correlation coefficients were acceptable. Factor analysis of the MOS-HIV identified two factors (Mental Health Summary scores and Physical Health Summary scores, or MHS and PHS), accounting for 63% total variance. The PHS and MHS correlated significantly with the WHOQOL-BREF(HK) and the three sub-scales of Profile of Mood States used in this study. Both PHS and MHS were significantly associated with self-perceived change in health status. PHS but not MHS was associated with Karnofsky Performance Status scores. PHS was also associated with disease stage. The MOS-HIV however, did not distinguish between groups of different CD4 cell counts. It is likely that the quality of life of these PLWHA of different disease stages was good in general. Conclusions: There is a large demand for evaluating treatments and services programs offered to PLWHA in China. The validated Chinese MOS-HIV would facilitate such research activities.     

Socio-economic,behavioural, (neuro)psychological and clinical determinants of HRQoL in people living with HIV in Belgium: a pilot study

Introduction

Due to highly active antiretroviral therapy (HAART), HIV-1 infection has evolved from a lethal to a chronic disease. As such, health-related quality of life (HRQoL) has become an important outcome variable. The purpose of this study was to identify socio-economic, behavioural, (neuro)psychological and clinical determinants of HRQoL among people living with HIV (PLHIV).

Methods

This study was conducted between 1 January and 31 December 2012 at the AIDS Reference Centre of Ghent University Hospital, a tertiary care referral centre in Belgium. Validated self-report questionnaires were administered to collect socio-demographic data, to assess HRQoL (Medical Outcomes Study-HIV), depressive symptoms (Beck Depression Inventory-II) and adherence to HAART (Short Medication Adherence Questionnaire) and to screen for neurocognitive dysfunction.

Results

A total of 237 people participated, among whom 187 (78.9%) were male. Mean age was 45.8±10.7 years and 144 (63.7%, 144/226) participants were homosexual. Median physical and mental health score (PHS, MHS) were 55.6 (IQR 48.2–60.6) and 52.0 (IQR 44.2–57.9), respectively. Multivariable regression analysis revealed that incapacity to work, depressive symptoms, neurocognitive complaints (NCCs), dissatisfaction with the patient–physician relationship and non-adherence were all negatively associated with HRQoL.

Conclusions

Socio-economic (work status), behavioural (adherence) and (neuro)psychological (depressive symptoms, NCCs) determinants independently impact HRQoL among this cohort of PLHIV. Clinical parameters (viral load, CD4 cell count) were not independently associated with HRQoL.     

Validity and reliability of the Italian translation of the MOS-HIV health survey in persons with AIDS

Objectives: To evaluate the validity and reliability of the Italian version of the 35-item Medical Outcome Study HIV Health Survey (MOS-HIV) when applied to persons with AIDS. Methods: The study population consisted of 185 adults with AIDS residing in Rome and participating in a randomised controlled trial on home-care. Diagnosis was made between 1 October 1994 and 1 April 1996, and enrollment took place within 2 months of diagnosis. The MOS-HIV, which measures 10 dimensions of health-related quality of life (QoL), was administered at baseline and every 3 months thereafter during the 1-year follow-up. Tests of convergent and concurrent construct validity were conducted for all scales. Results: Of the 185 trial participants, 146 responded to the questionnaire; 82 responded at least twice (including baseline collection) during follow-up. For the role functioning, general health, and vitality scales, the distribution of scale scores was concentrated at the lower half of the range. Internal consistency reliability was adequate (>0.80) for all scales. Baseline scores tended to increase with decreasing AIDS severity and with increasing age. There were improvements over time in the role functioning, vitality, and health distress scales. Conclusions: The MOS-HIV had good reliability among persons with AIDS. There was a moderate floor effect for some of the subscales. Tests of convergent and construct validity were generally confirmed. Additional studies are needed to evaluate the responsiveness to changes over time.     

MOS-HIV量表测量PLWHA生存质量现状

目的了解艾滋病病毒（HIV）感染者和艾滋病（AIDS）病人（简称PLWHA）的生活质量现状,探讨其影响因素,为制定艾滋病综合关怀措施提供客观依据。方法采用简体中文版MOS-HIV量表,测量广州市番禺区PLWHA生活质量现状,并调查可能影响生活质量的相关特征,采用SPSS统计软件进行统计分析。结果番禺区PLWHA生理领域总分为（53.92±6.85）分,心理领域总分为（45.88±7.57）分。HIV感染者在生理、心理领域总分,总体健康、躯体角色、社会功能、肌体疼痛、健康压力和生命质量领域等方面评分均高于AIDS病人,差异有统计学意义（P〈0.05）。HIV感染者不同年龄组中,30~39岁年龄组生理领域总分最高;不同职业组中,无/待业组评分最低,差异有统计学意义（P〈0.05）。AIDS病人不同年龄组、不同职业组各领域评分差异无统计学意义（P〉0.05）。CD＋4T淋巴细胞计数〉350个/mm3者在生理、心理领域总分,总体健康、躯体健康、躯体角色、社会功能、肌体疼痛和心理健康领域等方面评分,均高于CD＋4T淋巴细胞计数≤350个/mm3者,差异有统计学意义（P〈0.05）。结论广州市番禺区PLWHA的生存质量水平较低,并受多方面因素的影响,应倡导提供多方位的综合干预服务,提高其生存质量。