A pilot study on a new model for the study of patient-perceived quality of life in the surgical treatment of PAOD: The Surgical Peripheral Artery Disease Interview questionnaire

BACKGROUND: The aim of this study was to develop a structured interview for functional evaluation of surgical treatment of peripheral arterial obstructive disease (PAOD), in terms of postoperative quality of life (QoL), including both the constructs already present in the literature and the ones derivable from direct clinical experience. METHODS: We identified the most relevant constructs, including physical symptoms (PS), discomfort with bodily integrity (DBI), satisfaction for care (SC), impact on daily life (IDL) and social functioning (SF). We developed an 11-item questionnaire with answers on 5 points to be administered in form of structured interview by physicians, namely the Surgical Peripheral Artery Disease Interview (SPADI). A pilot administration of the interview was performed in 30 patients undergone femoro-popliteal bypass for PAOD in the previous months. Data were collected in a specific answer form, containing also information about the patients, the risk factors, the kind of treatment and the follow-up outcomes. RESULTS: We found excellent correlations between items and theoretical constructs. The exploratory factor analysis confirms four constructs, with functioning composed by impact on daily life and social functioning. The internal consistency of scales was good. The indices of physical and mental functioning were similar to those of general population. Data showed a low level of aggression, depression, tension, confusion and fatigue, confirmed by the results of Self Rating Depression Scale. About SPADI items, PS was in the average range, while DBI seemed to be almost absent; SC was good and, in the postoperative setting, patients perceived themselves as efficient (IDL) and their SF appeared to be good. CONCLUSIONS: In this preliminary study, SPADI was able to investigate dimensions that were not considered before and it may become a useful tool for supporting surgeons to an even more effective management of PAOD. Prospective validation of this questionnaire is mandatory.